Acute coronary syndromes articles

FRAME-AMI: FFR vs. Angiography of Non-Culprit Vessel in ACS

FRAME-AMI: FFR vs. Angiography of Non-Culprit Vessel in ACS

This study compared fractional flow reserve (FFR) vs. angiography to guide the angioplasty of non-culprit vessels in patients with acute coronary syndrome (ACS) and multivessel disease. Landmark studies such as COMPLETE, COMPARE-ACUTE and DANAMI-3-PRIMULTI have demonstrated the prognostic value of revascularization (after treatment of the artery responsible for the ACS) of non-culprit arteries with respect

La coronariografía precoz reduce la mortalidad en SCA sin supradesnivel del ST de alto riesgo

Long-Term Evolution of Hybrid Coronary Revascularization

Currently, myocardial revascularization surgery (MRS) and percutaneous coronary intervention (PCI) are the available strategies for multivessel coronary artery disease. However, an alternative strategy has long been developed, called hybrid coronary revascularization (HCR), where the anterior descending artery is bypassed with a graft from the mammary artery and the rest of the lesions are treated by

Nueva y discrepante información sobre los vasos no culpables en el infarto

Non-ST Elevation MI: How Long Do We Have for A Coronary Angiography?

This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography

Can We Use DAPT for 3 Months in Acute Coronary Syndrome?

Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk.  The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis.  Prolonged DAPT has been associated with

Leak periprotésico en cierre de orejuela, algo más que un valor para tener en cuenta

Invasive Myocardial Viability Indexes

From a cellular standpoint, the term ‘myocardial viability’ refers to a myocyte that has no irreparable damage. From a clinical standpoint, it refers to areas with myocardial contractile dysfunction at rest that are expected to improve with correct revascularization. There are specific vessel ischemia and viability indexes that may help identify hibernation areas that could

Una nueva molécula para evitar la nefropatía por contraste

Is There Any Difference in Clinical Outcomes Between Transient and Persistent Acute Kidney Injury in ACS Patients after Invasive Treatment?

Acute kidney injury (AKI) following acute coronary syndrome (ACS) is associated with prolonged hospital stay and worse prognosis at followup. However, serum creatinine level increase can either be transient or permanent. At present, retrospective studies show transient AKI patients present similar survival rate to patients with no AKI. The prognostic implications of transient and persistent

Pronóstico al año en lesiones ateroscleróticas vs las no ateroscleróticas en pacientes con MINOCA

One Year Prognosis of Atherosclerotic vs. Non-Atherosclerotic Lesions in MINOCA Patients

The use of intravascular imaging helps improve diagnosis in situations where a conventional coronary angiography might not be conclusive. That is the case of patients with myocardial infarction with non-obstructive coronary artery lesions (MINOCA). The largest MINOCA cohort reported so far has shown 5%-7% prevalence.  This pathology, initially considered benign, presents a remote mortality rate

How Do We Manage Antiaggregation in BARC I Bleeding after AMI?

Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management.  A subanalysis of

¿Hay diferencias entre mujeres y hombres luego de una intervención percutánea?

Sex Differences According to Thrombus Burden in STEMI Patients

Many studies have shown there is higher mortality and complications among women after acute myocardial infarction (AMI) vs. men, especially after 30 days. Even though the mechanism driving higher mortality remains uncertain, recent studies have seen differences in thrombus formation with increased platelet count among women. In STEMI patients, intracoronary thrombus burden is a predictor

Disección coronaria espontánea: ¿Hay diferencias entre hombres y mujeres?

Coronary Artery Dissection and Cardiogenic Shock: How Do They Evolve?

Spontaneous coronary artery dissections (SCD) are more frequent in women and account for about 25% of all acute myocardial infarctions (AMI) before the age of 50. While the presence of cardiogenic shock due to AMI is infrequent, its evolution is still somewhat unclear and it has not been fully analyzed. Researchers conducted an analysis in

Carotídeas asintomáticas ¿Tenemos todas las respuestas?

Post AMI Ventricular Septal Defect: Contemporary Results of Endovascular vs Surgical Repair

In the era of endovascular intervention, with shorter revascularization times, we see lower rates of mechanical complications due to acute myocardial infarction (AMI). Increased rates were recorded during the COVID-19 pandemic, but driven by delays in consultation.  Though occasional (with an estimated incidence of 0.2%), post AMI ventricular septal defect (VSD), or interventricular communication, involves