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THEMIS: eventos isquémicos y hemorrágicos en difícil equilibrio para el ticagrelor crónico

Ticagrelor to Improve Venous Graft Patency

Ticagrelor to Improve Venous Graft Patency

Saphenous vein graft patency is one of CABG’s “Achilles heals”, especially after the ARTS trial came out showing bilateral internal mammary artery grafting was not superior to simple internal mammary artery grafting.  Antiaggregation more potent than aspirin might prolong venous graft patency in cases when the available techniques will fail to improve poor outcomes.    Previous

Rincón del Fellow | Caso Clínico N°2: Misión Explosiva

The Fellow’s Corner | 2nd Clinical Case: An Explosive Mission

Here we have the second clinical case in our section “The Fellow’s Corner,” to continue discussing and learning together with the whole community of fellows in hemodynamics in Latin America. In this second issue, we will discuss a case of acute myocardial infarction with trapped balloon and coronary rupture. Read the case presentation and join

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention

Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure.  This highlights the huge variation in indication and the scarce evidence there is on this matter.  Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does

ESC 2020 | New European Guidelines on Non-ST-Segment Elevation Acute Coronary Syndromes: What’s New?

The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. This document includes news regarding a more agile infarction diagnosis, the use of non-invasive imaging, the simplification of anticoagulant therapy, infarction with normal coronary arteries,

Otro “escándalo” en la medicina basada en la evidencia ¿El monitoreo ambulatorio de presión puesto en duda?

Do We Need to See a Cardiologist before a Carotid Endarterectomy?

Cardiac complications are among the most frequent in patients undergoing carotid endarterectomy for asymptomatic lesions.  This excess of cardiac events in patients with no neurological symptoms of carotid stenosis is essential to balance the risk/benefit ratio of carotid endarterectomy.  A routine cardiology consultation prior surgery could reduce perioperative infarction rate, general complications and even mortality. 

Score de Calcio, “dónde está” parece más importante que “cuánto hay”

Outflow Tract Calcification and the Best Valve in This Context

Moderate or severe left ventricle outflow tract calcification increases the risk of annulus rupture, residual aortic regurgitation and the need for a second valve. This recent study analyzed the performance of different contemporary prosthetic valves in patients with this particular anatomy.  Since the early days of transcatheter aortic valve replacement (TAVR) outflow tract calcification has

ESC 2020 | Ticagrelor Might Increase Bleeding and Mortality in the Elderly

Ticagrelor compared against clopidogrel produces more bleeding and also more deaths in patients over 80 recently undergoing acute myocardial infarction. Contrary to what has been observed in the general population, these data from the SWEDEHEART registry of post MI patients over 80, show higher bleeding and mortality rates with ticagrelor compared against clopidogrel. These findings

ESC 2020 | Antihypertensive Therapy Reduces Events Regardless of BP Levels or Risk

Antihypertensive therapy reduces the risk of cardiovascular events even in patients with no history of heart disease or with normal baseline blood pressure (BP). This fuels a long-running debate about thresholds for hypertension diagnosis (which may or may not exist). Beyond that, the higher the baseline BP, the better the benefit. The decision to prescribe

ESC 2020 | El Rivaroxaban puede reducir los eventos cardíacos, cerebrales y periféricos

ESC 2020 | Rivaroxaban Might Reduce Cardiac Cerebral and Peripheral Events

Adding rivaroxaban to the standard treatment might reduce events incidence in lower limbs, heart, and brain, in patients with peripheral vascular disease undergoing revascularization.   These new data resulted from the analysis of the VOYAGER PAD subgroups and were presented at the virtual ESC 2020. The COMPASS study had reached similar conclusions using 2.5 mg rivaroxaban

ESC 2020 | Acute Myocardial Infarction and Anemia: Are Transfusions Necessary?

In anemic patients undergoing acute myocardial infarction, a restrictive transfusion strategy is as safe as a more liberal approach, in addition to saving costs. The cutoff value to decide for a transfusion would be < 8 g/dl hemoglobin. The REALITY outcomes were presented during the virtual ESC 2020 sessions. Anemia is relatively common in patients