Courtesy of Dr. Carlos Fava. As we all know, TAVR is gaining ground fast in the lower risk patient population, but in addition to analyzing the most important events, researchers are increasingly looking at health status, not only at hospital level, but also after one year. This study looked into PARTNER 3 patient health status…
Major Bleeding in Patients with Aspirin Plus Rivaroxaban
The combination of coronary artery disease or peripheral vascular disease and a reason for anticoagulation, such as atrial fibrillation, results in many patients who receive antiplatelet therapy with aspirin plus anticoagulation with rivaroxaban, for example. It is a well-known fact that this combination (aspirin 100 mg per day plus rivaroxaban 2.5 mg twice per day) reduces cardiovascular…
Major Bleeding in Patients with Aspirin Plus Rivaroxaban
The combination of coronary artery disease or peripheral vascular disease and a reason for anticoagulation, such as atrial fibrillation, results in many patients who receive antiplatelet therapy with aspirin plus anticoagulation with rivaroxaban, for example. It is a well-known fact that this combination (aspirin 100 mg per day plus rivaroxaban 2.5 mg twice per day) reduces cardiovascular…
THEMIS: Ischemic and Hemorrhagic Events in Delicate Balance for Chronic Ticagrelor
The THEMIS study published this week in NEJM, tested chronic ticagrelor + aspirin in diabetic patients with stable coronary artery disease (CAD), but with no prior history of Myocardial infarction (MI) or stroke. The tempting hypothesis behind this study is that reducing ischemic events might increase bleeding events, and this calls for careful cost/benefit assessment. …
Pulmonary Illness and E-Cigarettes: New Devices with New Diseases
We are seeing patients with similar clinical characteristics that shared the used of e-cigarettes. Even though we have been unable to identify one single responsible component or a set of them, clearly the use of e-cigarettes has brought new pathologies. E-cigarettes are electronic battery powered devices that heat a liquid forming an inhalable aerosol. Several…
TCT 2019 | PCI in Stable CAD. Prior TAVR, with TAVR or Never?
Courtesy of SBHCI. This interesting study presented at TCT 2019 and simultaneously published in Am J Cardiol tells us PCI in stable coronary artery disease cannot lower risk in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). Unless patients are symptomatic, most coronary artery lesions do not need revascularization according to researchers.…
TCT 2019 | IVUS-XPL: 5-Year Follow-up for Angiography-vs. IVUS-Guided Angioplasty
Courtesy of SBHCI. The aim of this work, which was presented during the TCT 2019 Scientific Session and simultaneously published in JACC Intv, was to prove the benefit of intravascular ultrasound (IVUS) in angioplasty. The IVUS-XPL trial randomized 1400 patients with long coronary lesions (≥28 mm) to IVUS-guided angioplasty (n = 700) vs. angiography-guided angioplasty (n = 700). All procedures were…
TCT 2019 | FORZA: OCT vs FFR to Define Intermediate Lesions: Anatomy or Function?
Courtesy of SBHCI. Both fractional flow reserve (FFR) and optimal coherence tomography (OCT) can be useful to help define intermediate coronary lesions and optimize PCI outcomes. The FORZA study presented at San Francisco TCT 2019 scientific sessions simultaneously published in JACC randomized patients with intermediate lesions 1:1 to FFR vs OCT. For the FFR arm,…
TCT 2019 | PARTNER 3: Obvious Short-Term Quality of Life Improvement, but What Happens Afterwards?
Courtesy of SBHCI. Patients with severe aortic stenosis and low surgical risk showed decreased mortality, stroke, and heart failure hospitalization at one year with transcatheter aortic valve replacement compared with surgery. Improved quality of life may seem an obvious consequence, but until now that was mere speculation. This work, presented at the TCT 2019 Scientific Sessions…
TCT 2019 | COAPT Cost Effectiveness: Better Quality of Life and Survival Rate, but Worth It?
Courtesy of SBHCI. The COAPT showed transcatheter repair of the mitral valve using the MitraClip resulted in reduced mortality and hospitalization for cardiac failure and improved quality of life, compared against optimal medical treatment in patients with cardiac failure and moderate to severe functional mitral regurgitation. The cost-effectiveness of this procedure has not been analyzed…