We are still asking the same question: ticagrelor or prasugrel? With narrow margins between these drugs in terms of efficacy and bleeding, it is difficult to decide which to prescribe. While it has certain methodological limitations, this research published in JAMA seems to clarify the picture at least for patients with acute coronary syndromes who…
Novel DES Technology Promises to Become the Next DES Generation
The novel technology of drug-eluting stent Supreme was designed to synchronize antiproliferative drug release and leave a base behind to promote healing. Accelerated endothelial healing after antiproliferative drug release may limit the long-term inflammatory response. This multicenter, single-blind study included 1600 patients who were randomized 2:1 to receive drug-eluting stent Supreme vs. a classic permanent-polymer everolimus-eluting…
The Fellow’s Corner | 3rd Clinical Case: True Bifurcation Lesion: Which Strategy Should We Use?
Here is the third Fellow’s Corner clinical case to keep discussing and learning alongside the entire community of hemodynamics fellows in Latin America. In this instance, we will present a case of True Bifurcation Lesion: Which Strategy Should We Use? Content 1- Case Presentation 2- Case Resolution 3- Expert Commentary Authors: Dr. Carlos Fava (ARG)…
Bifurcations: A Long Return Journey
When it looked like the simplest techniques reach the best outcomes, along came the DK Crush studies. Indeed, after the COVIS III results in bifurcations, it appeared we had started to retrace our steps back to the foundation. The purpose of this study was to compare long term outcomes of the remarkably simple 1-stent strategy…
IVUS vs iFR for Left Main Decision Making
No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions. This reality should be looked into, since operating or intervening moderate left main lesions on…
Post TAVR Acute Coronary Syndrome: Frequency and Potential Damage
After Transcatheter Aortic Valve Replacement (TAVR) acute coronary syndromes (ACS) are rare and mostly present as non-ST elevation events. In this context, the few ST elevation events have bad prognosis, with close to 30% mortality at 30 days. This study included patients undergoing TAVR between 2012 and 2017 admitted for acute coronary syndrome during followup. …
A Headache for Cardiologists: Ischemia with Non-Obstructive Disease
Treating patients with functional stress test induced ischemia and non-obstructive coronary artery disease (INOCA) is complex and often frustrating. The multifactorial nature of this disease in addition to the complex physiopathological relationship between angina and ischemia turn these patients into a real headache for cardiologists. The CIAO-ISCHEMIA was recently published in Circulation and was designed…
SOL SOLACI Program Took Part in the Venezuela Sessions 2021 with a New Charitable Case
SOLACI’s SOLidario Program took part in the XLII Regional SOLACI Sessions in Venezuela, where a charitable intervention was performed in collaboration with the Venezuelan Society of Interventional Cardiology (SOVECI) and Caracas University Hospital. In this opportunity, physicians treated a 60-year-old patient with significant heart disease under study for acute myocardial infarction after thrombolysis. Coronary angiography identified…
DAPT vs. Monotherapy: The Dilemma Remains After Surgery
Patients who undergo myocardial revascularization surgery and are discharged on dual antiplatelet therapy (DAPT)—aspirin plus clopidogrel—have a lower risk of major cardiovascular and cerebral events than patients on aspirin monotherapy. Furthermore, the risk of bleeding is not increased for those receiving DAPT. This information comes from a registry of over 18,000 patients recently published in the…
FLOWER-MI: FFR vs. Angiography for Complete Revascularization in Infarction
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)…