Compared with fibrinolytic therapy, reperfusion through primary angioplasty is more reliable and durable, and has less complications. This results in a higher net clinical benefit, both in terms of mortality and of reinfarction and bleeding. In the midst of the COVID-19 pandemic, the discussion on the usefulness of thrombolysis has emerged once again. Some societies...
The DANish Acute Myocardial Infarction 2 (DANAMI-2) trial showed the 30-day superiority of patient transport to a primary angioplasty site vs. fibrinolysis at the hospital where the patient had been originally admitted. Those 30-day results became a landmark in the history of interventional cardiology. However, some suspected that such initial benefit could fade away over...
Remote ischemic conditioning does not offer any clinical benefit to patients with ST-segment elevation acute myocardial infarction undergoing primary angioplasty, according to this study presented on Sunday at the European Society of Cardiology Congress 2019. Prior studies were limited and small, but this analysis seems to provide definitive evidence with regard to ischemic pre-conditioning. The...
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. Cindy Grines, entitled “Primary angioplasty and cardiogenic shock”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Recent studies in patients undergoing acute myocardial infarction showed that a complete revascularization strategy in an acute or subacute setting, whether it be guided through angiography (PRAMI, CvLPRIT) or fractional flow reserve (FFR) (PRIMULTI, COMPARE-ACUTE), improves the combined endpoint of major adverse cardiac events (MACE) when compared with treatment of the culprit artery only. Based...
Both prasugrel and ticagrelor showed superiority in terms of efficacy, reducing the number of major cardiovascular events at the expense of increased bleeding. This is an affordable cost, and the net clinical benefit supports these new antiplatelet therapies. The one-year follow-up of the PRAGUE-18 study focused on a comparison of efficacy and safety between prasugrel...
Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may...
Courtesy of the SBHCI. About 50% of patients admitted with acute ST-segment elevation myocardial infarction also present lesions in another vessel. Whether to treat these or not, and the optimal moment to treat non-culprit infarction-related vessels are still controversial issues. The COMPARE-ACUTE study was recently published and showed that fractional flow reserve (FFR)-guided complete...
Courtesy of Dr Carlos Fava. The association of primary angioplasty with multivessel lesions is not infrequent and has been analyzed in various studies and meta-analyses. However, the proper course of action remains unclear. According to this study, fractional flow reserve (FFR) could better define the ischemic impact of lesions and help with the identification of...
No randomized head-to-head study comparing the efficacy and safety of ticagrelor and prasugrel has been carried out in the last 7 years since these newer P2Y12 inhibitors first showed a higher efficacy relative to clopidogrel. This study was designed to compare the efficacy and safety of prasugrel and ticagrelor in patients with acute myocardial infarction...