Courtesy of Dr. Brian Nazareth Donato. The relative safety of drug-eluting stents (DES) and conventional bare-metal stents (BMS) in primary angioplasty (percutaneous coronary intervention, PCI) in patients with ST elevation myocardial infarction (STEMI) is still subject of debate. A search was carried out using Medline, CENTRAL, EMBASE, TCTMD and Cardiosource. There were 9673 patients included,…
No Extra Benefit for Combined Use of Bivalirudin and Transradial Approach
The aim of this meta-analyzis was to study the relation between bivalirudin and access site in patients undergoing acute coronary syndrome (ACS). Both bivalirudin and the transradial access site are strategies aiming at reducing bleeding complication in patients with ACS undergoing invasive approaches. The interaction of both strategies and the potential benefits of their combined use…
All-Spectrum Transradial Approach: Safer than Femoral
Original Title: Radial vs femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. Reference: Ferrante G et al. J Am Coll Cardiol Intv. 2016; Epub ahead of print. Regardless the type of coronary syndrome, the transradial approach results in lower mortality and complications…
Metoprolol before primary PCI doesn’t reduce infarction size
Original Title: Early Intravenous Beta-Blockers in Patients with ST-Segment Elevation Myocardial Infarction before Primary Percutaneous Coronary Intervention. Reference: Roolvink V et al. J Am Coll Cardiol. 2016 Jun 14;67(23):2705-15. The impact of endovenous beta-blockers before primary PCI has not been established yet. This is the first double blind multicenter trial, controlled with placebo, to…
A new round against aspiration thrombectomy
Original Title: Aspiration thrombectomy prior to percutaneous coronary intervention in ST elevation myocardial infarction: a systematic review and meta-analysis. Reference: Regina El Dib et al. BMC Cardiovascular Disorders (2016) 16:121. Courtesy of Dr. Brian Nazareth Donato. Based on contradicting results obtained from different studies on the role of mechanical aspiration thrombectomy before PCI vs. PCI alone,…
Coronary angiogram for all post cardiac arrest patients?
Courtesy of Dr. Agustín Vecchia. There is no doubt cases of post out of hospital cardiac arrest (OHCA) secondary to an ST elevation acute coronary syndrome (STEMI) should be submitted to a coronary angiogram and eventually an angioplasty (PCI). However, in patients with non ST elevation MI, the use of a similar invasive strategy is…
Aspiration thrombectomy in primary PCI could increase risk of stroke
Original Title: Meta-analysis of the long-term effect of routine aspiration thrombectomy in patients undergoing primary percutaneous coronary intervention. Reference: Mancini JG et al. Am J Cardiol. 2016; Epub ahead of print. A large meta-analyzis confirms routine aspiration thrombectomy in the context of primary PCI has no clinical benefit and could increase the risk of…
Translunar Access, an Alternative Worth Considering
Título original: Transulnar versus transradial access for coronary angiography or percutaneous coronary intervention: A meta-analysis of randomized controlled trials. Khagendra Dahal. Et al. Catheterization and cardiovascular Intervention 2016:87;857-865 Courtesy of Dr. Carlos Fava. Transradial access site (TRA) has been shown beneficial over the femoral (TFA), but there is little information on translunar access (TUA) that could…
Conservative Management of MI risk in ACS
Original Title: Spontaneous MI after Non–ST-Segment Elevation Acute Coronary Syndrome Managed without Revascularization. The TRILOGY ACS Trial. Reference: Renato D. Lopes et al. J Am Coll Cardiol. 2016;67(11):1289-1297. Patients admitted with acute coronary syndromes (ACS) and especially those managed conservatively without revascularization, are at high risk of a new spontaneous infarction. However, MI risk rate…
Ventricular Assist Device in Acute Myocardial Infarction
Original Title: Ventricular Assist Device in Acute Myocardial Infarction. Reference: Deepak Acharya et al. J Am Coll Cardiol. 2016;67(16):1871-1880. Patients undergoing acute myocardial infarction (AMI) with acute cardiac failure or cardiogenic shock have a high mortality rate with the conventional treatment. This study assessed the outcomes of patients with AMI receiving a durable ventricular assist…
Optimal Duration of Dual Antiplatelet Therapy: New ACC-AHA Guidelines
Original Title: 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease. Reference: Levine GN et al. Circulation. 2016 Mar 29. [Epub ahead of print]. Courtesy of Dr. Alejandro Lakowsky. The new ACC-AHAGuidelines on the optimal duration of dual antiplatelet therapy(DAPT) in patients with coronary artery disease have just been…