The high platelet reactivity is associated with adverse events after stent implantation. Current guidelines consider the measurement of aggregability as a class IIB and there is no information about the routine performance of these measurements. This was a multicenter, prospective, randomized study that included 3800 patients with myocardial infarction. The primary study end point was…
MOZART: IVUS reduces contrast volume needed for angioplasty
Contrast nephropathy is associated with increased morbidity and so this study evaluates the possibility of reducing the required necessary volume of contrast using coronary intravascular ultrasound (IVUS). Patients were randomized to IVUS guided angioplasty (n = 41) and angiography guided angioplasty (n = 42). IVUS-guided angioplasty requires a smaller volume of contrast (22.9 ± 12.5…
OPTIMIZE: 3 versus 12 months dual antiplatelet therapy after angioplasty with DES
Currently the recommendation is 12 months of dual antiplatelet after a drug-eluting stent angioplasty. This study compared the 3 – months versus 12 months of dual antiplatelet after angioplasty with zotarolimus-eluting stent in real-world patients. This was a prospective, multicenter study randomized 1563 patients to receive aspirin and clopidogrel for 3 months and 1556 to…
DUTCH PEERS: Everolimus DES versus zotarolimus DES
This study randomized 1:1, 906 patients to receive zotarolimus-eluting stent and 905 patients to receive everolimus-eluting stent. The clinical and angiographic characteristics of both groups were similar with approximately 45% of the population experiencing an acute coronary syndrome. There were no significant differences in major cardiac events between the two stents with 6.1% to for…
FREEDOM: Insulin dependent versus non-insulin dependent with multivessel disease
From the total of 1900 patients in the FREEDOM study, 1248 did not require insulin (631 received angioplasty and 617 received CABG) and 602 if required (325 received angioplasty and 277 received CABG). Insulin dependent patients were more obese, with higher glycosylated hemoglobin, increased incidence of heart failure and increased incidence of acute coronary syndromes.…
HYBRID: Hybrid revascularization in patients with multi-vessel
We included 200 patients (100 with hybrid revascularization and 100 with conventional surgery). The complete revascularization rate was similar between both groups (70%). Also, the event-free survival was similar with 92% for conventional surgery group and 89% for the hybrid. The revascularization of the anterior descending artery with breast bridge and angioplasty to the rest…
GIANT: Evaluation of the genetic profile of CYP2C19 in patients undergoing primary angioplasty
The aim of this study was to evaluate the clinical impact resistance thienopyridines through genetic analysis of CYP2C19 receptor. The primary endpoint was a combination of mortality, myocardial infarction, stent thrombosis in the resistance group (few responders) versus non-resistant (responders) to the thienopyridines. 1445 patients were included of which 22% were considered few responders. There…
TATORT-NSTEMI: Routinely thromboaspiration in patients with non ST-elevation AMI
Thromboaspiration in patients with ST-elevation is being questioned while in patients without elevation this strategy has not been studied. The study included 440 patients with non ST-elevation AMI and presence of thrombus randomized to receive or not thromboaspiration. The primary study end point was the extent of microvascular obstruction assessed by magnetic resonance imaging. No…
REPRISE II: LOTUS valve for percutaneous aortic valve replacement
The aim of this study was to evaluate the safety and efficacy of the new device in patients with severe aortic stenosis at high surgical risk. We included 120 patients with a mean age of 84 years and the aortic valve area of 0.7 cm2. The device was successfully implanted in all patients with a…
ARCTIC-INTERRUPTION: 1 years versus 2 years of double anti-platelet
This study randomized 1259 patients to receive one year versus 2 years of double anti anti-platelet after implantation of a drug-eluting stent. The primary end point was a composite of death, myocardial infarction, stroke, stent thrombosis, and urgent revascularization that were equivalent between the two schemes. There was a trend to a higher rate of…