Hypothermia improves myocardial ischemia in animals but studies in humans failed to demonstrate benefit to that extent.We admitted 120 patients experiencing anterior-posterior STEMI with up to 6 hours after onset, randomized to conventional invasive therapy versus conventional invasive therapy associated with hypothermia. The primary endpoint was infarct size by MRI at 4 days.There was no…
HeartFlowNXT: Using noninvasive FFR shows promising results
The use of fractional flow reserve (FFR) is useful to determine the significance of coronary lesions. The ability to perform this physiologicalevaluation in a noninvasive base is an interesting alternative.The primary objective of the study was to compare the noninvasive FFRusing multislice CT versus invasive FFR. 357 patients were included in this multicenter study succeeded…
Exclusive Interview with Dr. Henrique Ribeiro on his article: coronary obstruction after TAVI
Recentemente uma revisão e metanálise sobre obstrução coronária após o implante de TAVI foi publicada na revista JAAC. Este artigo foi motivo de uma aula no TCT 2013 ministrada pelo Dr. Henrique Ribeiro (autor principal deste estudo). Segue abaixo o resumo do estudo e a entrevista com o dr. Henrique: Obstrução coronária pós TAVI Fundamentos…
LEVANT 2: Initial results from the new drug eluting balloon for femoropopliteal lesions
This prospective multicenter study randomized 476 patients 2:1 to paclitaxel eluting balloon versus conventional balloon for femoropopliteal region lesions with the primary objective of assessing death, free amputationsurvival and reintervention at 6 months. At 6 months follow-up a higher rate of restenosis with conventional balloon was observed.These are preliminary results and we must wait for…
RIBS V: Pharmacological balloon vs second-generation drug-eluting stent in the treatment of BMS restenosis
The ideal therapy for treating in-stent restenosis continues to be debated . The pharmacological balloons showed good results in this context, but no direct comparisons available of pharmacological balloonsversus second-generation DES.This prospective, multicenter randomized 189 patients with in-stent restenosis of conventional stents receiving pharmacological balloon or everolimusDES.The primary endpoint was angiographicat 9 months spotting a…
SMART-CASE: Angiographic Guidanceangioplastyto >50% versus >70% lesions.
This prospective randomized study compared aggressive revascularization angiography injuries 50% versus a most conservative revascularization lesions>70%.The primary end point was death, myocardial infarction and recurring revascularization. We included a total of 889 patients (449 in the aggressive revascularization group and 450 in the conservative revascularization group).No differences in major cardiac events between the two groups…
ADVISE II: iFFR comparable toFFRbut with out adenosine
Several studies tested the utility of fractional flow reserve (FFR) to assess coronary lesions functionally. The FFR required for its measurement amaximum hyperemia that usually, is achieved with adenosine infusion. The “InstantaneousWave-freeRatio™” or iFR, has the advantage of not requiring maximum hyperemia.This prospective, multicenter, observational study that included 690 patients detectedthat iFR adequately classified 91.6%…
EUROMAX: Early and prolonged infusion of bivalirudin reduces mortality in AMI
Bivalirudin reduced mortality and bleeding compared to heparin and glycoprotein IIbIIIa in HORIZONS- AMI study. However there was a higher rate of acute stent thrombosis in patients receiving bivalirudin. This randomized study (> 90 % randomized in the ambulance) enrolled 2218 patients with ASTEMIto prolonged infusion of bivalirudin compared with heparin -associated glycoprotein inhibitors. The…
NORDIC-BALTIC IV: 2 stents versus provisional stent in bifurcations
This study aimed to compare the strategy of 2 stents versus provisional stenting in true bifurcations.It was a multicenter, randomized trial included 221 patients in the provisional group and 229 patients in the 2 stent group. No significant differences were observed in the clinical or angiographic characteristics of the two groups (16% diabetic).There were no…
TRYTON: Stent dedicated to bifurcations fails to demonstrate non-inferiority when compared with provisional
The aim of this study was to compare the results of stent TRYTON (non-drug eluting) in the side branch associated with the implantation of a drug-eluting stent in the main branch compared to the drug-eluting stent implantation in the main branch with provisional stent technique.704 patients were included with the intention of demonstrating non-inferiority versus…