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…
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. …
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)…
EuroPCR 2021 | CELEBRATE-02: Novel Glycoprotein IIb/IIIa Inhibitor for ST-Segment Elevation Infarction
Promising fast subcutaneous administration and a quick and potent antiplatelet effect, here comes a novel glycoprotein IIb/IIa inhibitor called RUC-4. This novel drug was tested in the CELEBRATE-02 study, presented at EuroPCR 2021 and simultaneously published in EuroIntervention. The mean platelet inhibition begins 15 minutes after injection and increases with each of the three tested doses…
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…
New Unexpected Data on Non-Culprit Vessels in MI
Patients with acute myocardial infarction presenting lesions in multiple vessels is not associated with reduced infarct size in non-culprit lesions, even when functionally significant. Animal models suggest brief periods of ischemia in non-infarct territories (non-culprit) might protect culprit territory thanks to remote ischemic preconditioning. This pre-conditioning, according to this perspective, would reduce reperfusion injury and…
18/05 | Update on the treatment of acute coronary syndromes without ST segment elevation
Another virtual event open to the whole community! At SOLACI we want to continue promoting continuous medical education and, in that sense, to expand the development of interventional cardiology in Latin America. For this reason, we bring you a new educational proposal, this time an Update on the treatment of acute coronary syndromes without ST…