Infarct size is an independent predictor of survival and ventricular function. Several alternatives have been tried to reduce the size of the infarcted area and its consequences. Small pilot studies suggest that inhaled nitric oxide may improve reperfusion in acute myocardial infarction with ST-segment elevation. Patients were randomized to conventional treatment versus inhalation of 80…
MITOCARE: TRO40303 intravenous infusion in the context of primary angioplasty
Prospective, multicenter, randomized, double-blind study evaluated intravenous infusion of TRO40303 versus placebo administered immediately before balloon dilation of the culprit artery during primary angioplasty. Infarct size was evaluated using the CK Mb levels and troponin together with magnetic resonance imaging. 163 patients were included; no significant differences were observed in the area under the curve…
ATLANTIC: administration of ticagrelor in the ambulance versus in the cath lab
The platelet P2Y12 receptor antagonist ticagrelor is shown to reduce the incidence of cardiovascular events when administered in hospital admission to patients suffering an ST-segment elevation acute myocardial infarction. Pre-hospital management that could improve coronary reperfusion and events like death or stent thrombosis was not studied. 1862 patients were included suffering ST-segment elevation acute myocardial…
BIOSCIENCE study: Absorbable polymer versus permanent in sirolimus-eluting stents
This multicenter study randomized 1063 patients to receive the sirolimus-eluting stent with absorbable polymer and 1056 patients to permanent polymer stent. No differences in stent thrombosis (3.4% in the group with permanent polymer versus 2.8% in the group with absorbable polymer), target vessel revascularization (6.7% for both) or mortality (2.1% versus 2.9%; p = 0.7).…
ANTHEM-HF: autonomic regulation to improve ventricular function
In the context of heart failure, there is an autonomic imbalance characterized by increased sympathetic activity and decreased parasympathetic activity. This autonomic imbalance may contribute to the progression of heart failure symptoms. Preclinical studies showed benefits with vagal stimulation. The aim of this work was to demonstrate the safety and efficacy of the therapy system…
BIOPACE STUDY: biventricular pacing to prevent cardiac desynchronization
Single chamber pacemaker implantation leads to a desynchronization of ventricular depolarization. This study aims to evaluate the implant of biventricular versus univentricular pacemaker. 902 patients were included in the group with biventricular pacemaker and 908 in the univentricular pacing group. The primary objective was to evaluate the long-term mortality and needs hospitalization for heart failure.…
CRT-D: Comparison between septum stimulation or right ventricle in patients receiving resynchronization.
Resynchronization therapy is a strategic therapeutic recommended in patients with ventricular dysfunction and prolonged QRS, but only two-thirds of patients have echocardiographic improvement. The aim of this study was to compare whether ventricular lead implantation in the septum versus apical localization might have some effect on left ventricular remodeling in patients with an indication of…
STAR AF 2: Comparison between ablation techniques of the atrial fibrillation
This paper compares the circumferential ablation technique to isolate pulmonary veins, the ablation technique with a hybrid (linear) technique and the isolation technique of the pulmonary veins in fractionally approach. After 18 month follow-up, atrial fibrillation autonomy was similar among the three groups. Atul Verma2014-09-01 Original title: Optimal method and outcomes of catheter ablation of persistent…
EUROECO: Safety and cost effectiveness of new home monitoring device
Home monitoring is essential in modern medicine, but the cost-benefit analysis is essential for patients, insurance companies, and administrators. Domiciliary monitoring service by BIOTRONIK allows physicians to follow their patients remotely with cardioverter, reducing the need for clinic visits. Their use could result in a more efficient tracking reducing costs. The study included 303 patients…
CULPRIT: Complete revascularization versus culprit artery of infarct only
Current guidelines suggest treating only the culprit artery of myocardial infarction with ST-segment elevation. This prospective and randomized work included 296 patients in 7 centers suffering ST-segment elevation acute myocardial infarction referred for primary angioplasty randomized to treat only the culprit artery (n = 146) versus complete revascularization (n = 150). In the culprit artery…
FAMOUS NSTEMI: FFR versus Angiography in non-ST segment elevation myocardial infarction
The benefit of myocardial revascularization (angioplasty or surgery) guided by fractional flow reserve (FFR) in the context of acute coronary syndromes is poorly studied in the literature. The aim of this study was to compare myocardial revascularization guided by FFR versus Angiography in patients admitted suffering a non-ST segment elevation myocardial infarction. 350 patients were…