The coronavirus pandemic has had a negative impact on the most pressing cardio and neurological emergencies, such as strokes or aortic dissection. These emergencies are normally treated in high complexity centers, which is why it is relatively simple to analyze the number of transfers before and after the pandemic. For some time, care centers have…
Long Term Changes ACS Revascularization
Long term outcomes support complete revascularization in multivessel patients undergoing acute coronary syndrome (ACS). This large contemporary registry recently published in J Am Coll Cardiol Intv. has shown complete revascularization is gaining ground in the daily practice and is associated to clinical benefits in patients undergoing ACS. It included 9094 individuals with ACS and multivessel…
Webinar SOLACI | NSTE-ACS Revascularization: Times and Methods in the COVID-19 Era
Watch again our Webinar on “NSTE-ACS Revascularization: Times and Methods in the COVID-19 Era” on our Youtube account. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
European Association of Percutaneous Cardiovascular Interventions Position Statement During the Pandemic
This document emerges from the assembly of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the Acute Cardiovascular Care Association (ACVC). Both associations gathered their most prominent experts, including people who worked in the European areas most affected by COVID-19. Their aim was to modify diagnostic and therapeutic algorithms to adapt the evidence collected…
EuroPCR 2020 | FABOLUS FASTER: In the Quest for the Fastest, Most Potent Platelet Inhibition
This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor…
EuroPCR 2020 | Sudden Death Increase Two to Three Times While MI Rate Falls
The number of sudden deaths reported around the world is on the rise in Covid-19 times. These deaths are caused either by the virus and its capacity to produce lethal arrhythmias or by the fact that patients are staying away from hospitals and are not being examined. Cardiologists were the first to warn that the…
Myocardial Injury in One Third of COVID-19 Patients
Roughly one third of patients hospitalized for COVID-19 have some degree of myocardial injury and this comes hand in hand with increased mortality compared against patients with no troponin elevation. Even mild forms of myocardial injury, such as 0.03 to 0.09 ng/mL troponin elevation, is associated with close to 100% increase in mortality (HR: 1.75;…
Optimal Intervention Timing for NSTEMI with No Antiaggregant Pre-Treatment
Patients undergoing non-ST elevation MI (NSTEMI) who are not pre-treated with P2Y12 receptor inhibitors will benefit from a very early intervention strategy. The optimal intervention timing for NSTEMI patients is still under debate, despite multiple studies, but the ideal timing had never been tested in patients with no platelet aggregation inhibitor pretreatment. After the surge of…
Multiple vs. Culprit vessel MI in Cardiogenic Shock: Anything New?
The Shock Trial, the one that set revascularization as the standard strategy to treat all STEMI and cardiogenic shock lesions, had not been discussed for nearly 20 years. The CULPRIT-SHOCK was presented at TCT 2017 (and also in NEJM), and again this one study changed the standard completely, since we went back to treating only…
Compare-Acute Sub-Study: Natural History of Non-Culprit Lesions in MI
The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients. We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically. The treating…
Bleeding and Cardiogenic Shock: An “Unholy Alliance”?
Courtesy of Dr. Carlos Fava. Mortality in acute myocardial infarction (MI) with cardiogenic shock (CS) has been reduced over the past two decades. This has been possible thanks to early angioplasty, greater operator (and overall medical team) experience, new antiplatelet therapies, and ventricular assist devices, which have also been somewhat relevant in this setting. However, in…