The enthusiasm for direct oral anticoagulants after transcatheter aortic valve replacements (TAVR) is waning. At least, when it combines with atrial fibrillation. The ENVISAGE-TAVI AF has shown excessive bleeding with endoxaban vs. the classical vitamin K antagonists. Endoxaban resulted non-inferior to vitamin K antagonists in terms of net clinical adverse events, but major bleeding events…
ESC 2021 | STEP: Blood Pressure Values in the Elderly, A Never-Ending Debate
The results of the STEP study were presented at the European Society of Cardiology (ESC) 2021 Congress! The main finding from this research was that an ideal target of 110 mmHg or at least <130 mmHg blood pressure (compared with a target of 130 mmHg or at least 150 mmHg) yielded an absolute risk reduction of composite events of…
ESC 2021 | GREENNESS: Surprising New Protective Factor against Cardiovascular Disease
What Is “Greenness”? This factor—which generally refers to the proximity to vegetation, as measured by satellite pictures—could serve as a new protection against cardiovascular disease. During five years (the total research time), this study compared individuals who lived in the lowest tercile of “greenness” with those who lived in the highest tercile (i.e., those who…
ESC 2021 | Empagliflozin in Heart Failure with Reduced and Preserved Ejection Fraction
The full results of the EMPEROR-Preserved study confirm as findings that empagliflozin decreases the risk of death or hospitalization for heart failure (HF) in both patients with reduced and with preserved function. The primary endpoint (a composite of death and hospitalization for HF) was reduced by 21% on a relative basis with sodium/glucose cotransporter 2…
ESC 2021 | ISAR-REACT 5: Prasugrel Superior to Ticagrelor in ACS across Kidney Function Spectrum
When we have to choose between two potent P2Y12 receptor inhibitors for a patient undergoing ACS with a planned invasive strategy, kidney function should not interfere in this decision. The main findings of this study were that prasugrel has lower risk of all cause death, MI or stroke, and also had a similar risk of…
ESC 2021 | MASTER DAPT: Dual Antiplatelet Therapy After Coronary Angioplasty in Patients at High Bleeding Risk
Courtesy of Dr. José Álvarez. In patients at high bleeding risk with drug-eluting stents, the duration of dual antiplatelet therapy has been subjected to ongoing review. Guidelines from the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) suggest shortening this treatment to a maximum of three to six months (Class IIb).…