Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)…
ACC 2021 | HOST-EXAM: Clopidogrel vs ASA monotherapy post DAPT in PCI patients
Clopidogrel monotherapy after dual antiplatelet therapy (DAPT) was associated with reduced mortality, MI, stroke, and other events in patients receiving PCI compared against aspirin monotherapy (ASA). This information was provided by the Korean HOST-EXAM study, presented at ACC 2021 scientific sessions, and simultaneously published in the Lancet. Researchers followed patients for 2 years and observed…
ACC 2021 | RAPID-TnT: Usefulness of High-Sensitivity Ultra-Fast Troponin T
Patients under evaluation for acute coronary syndrome (ACS) without clear ischemia signs in an electrocardiogram find no benefit in a 0/1-hour high-sensitivity troponin T (ultra-fast) protocol compared with the conventional 0/3-hour protocol. These data come from the RAPID-TnT trial presented during the scientific sessions at the American College of Cardiology (ACC) 2021 Congress, simultaneously published in…
ACC 2021 | ADAPTABLE: Low Doses of Aspirin Are Equally Effective and Present Lower Bleeding Risk
Patients diagnosed with cardiovascular disease taking aspirin as secondary prevention can take lower doses and achieve the same efficacy level as those taking 325 mg. According to the ADAPTABLE study, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in the New England Journal of Medicine (NEJM), both schemes were associated with…
ACC 2021 | TALOS-AMI: De-escalating from Ticagrelor to Clopidogrel after One Month
After one-month dual antiplatelet therapy (DAPT) with aspirin and ticagrelor, a net clinical benefit was observed when de-escalating to clopidogrel in acute myocardial infarction (AMI) patients treated with PCI. We have discussed the pros and cons of de-escalating from a potent antiplatelets Such as ticagrelor to clopidogrel since the TOPIC presented at EuroPCR in 2017. What…
ACC 2021 | Sacubitril/Valsartan not Superior to Ramipril after AMI
The combination sacubitril/valsartan following high-risk AMI did not reduce the risk of cardiac failure or cardiovascular risk in patients compared against ramipril. These data were provided by the PARADISE-MI presented today during the scientific sessions at ACC 2021. The combination sacubitril/valsartan had gathered prior evidence (basically from the PARADIGM-HF) for its superiority in terms of total…
ACC 2021 | Emergent CABG for acute MI: Benefits Despite Risk
The latest figures show a lower number of emergency CABG for acute MI, and in turn increased primary PCI. The combination of surgeons not willing to take risks and interventional cardiologists empowered to treat practically any lesion has resulted in fewer patients receiving emergency CABG. Only a few years ago, interventional cardiologists at least had…
ACC 2021 | Stress Increases Events in Young Patients with Prior MI
Young or middle-aged patients who have already suffered a heart attack have almost twice as many adverse events when they continue to be under emotional stress after the initial suffering. The association between psychological factors and events is attenuated after making adjustments that include markers of inflammation such as interleukin-6. It follows that inflammation plays…