Original title: Reduction in Cardiac Mortality with Bivalirudin in Patients With and Without Major Bleeding: The HORIZONS-AMI Trial. Reference: Gregg W. Stone et al. J Am Coll Cardiol. Epub ahead of print The HORIZONS -AMI study included 3602 patients experiencing ST segment elevation myocardial infarction received primary angioplasty, resulting in lower mortality at 30 days and three years…
Infarct size reduction to 30 days could result in clinical benefit at one year
Original title: Intralesional abciximab and thrombus aspiration in patients with large anterior myocardial infarction: One-year results from the INFUSE-AMI trial. Reference: Stone GW et al. Circ Cardiovasc Interv. 2013;Epub ahead of print. The intra-coronary infusion of Abciximab added to thromboaspiration seems to improve outcomes at one year in patients undergoing primary angioplasty for ST-segment elevation with anterior…
The radial approach for PCI reduces mortality
Original title: Radial Versus Femoral Access for Primary Percutaneous Interventions in ST-Segment Elevation Myocardial Infarction Patients. A Meta-Analysis of Randomized Controlled Trials. Reference: Wassef Karrowni et al. J Am Coll Cardiol Intv 2013;6:814–23. Bleeding is the most frequent in-hospital complication of PCI, and it is clearly associated with adverse events that include death. STEMI patients require emergency…
Ticagrelor effective in venous bridges
Original title: Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass grafo surgery: Inssights from th PLATelet inhibition and patients outcomes (PLATO) trial. Reference: Emmanouil S. Brilakis, et al. Am Heart J 2013;166:474-80 The bridge venous occlusion is a common finding in patients with previous CABG presenting with acute coronary syndrome without ST…
Primary angioplasty , a race against time
Original title: Door-to-Balloon Time and Mortality among Patients Undergoing Primary PCI. Reference: Daniel S. Menees et al. N Engl J Med 2013;369:901-9. For more than a decade has been ranked , like a race, to the delay times that occur in hospitals until angioplasty is performed in the context of an infarct with ST segment elevation . Several…
Ticagrelor reduces in-stent thrombosis in patients with acute coronary syndromes
Original title: Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: An analysis from the prospective randomized PLATO trial. Reference: Steg PG et al. Circulation. 2013; Epub ahead of print The PLATO study randomized 18624 patients with acute coronary syndrome to receive ticagrelor (180 mg loading dose followed by 90 mg twice daily )…
Thromboaspiration in AMI, without benefit to 30 days.
Original title: Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction. TASTE trial. Reference: Ole Fröbert et al. N Engl J Med 2013. DOI: 10.1056/NEJMoa1308789 One of the biggest challenges of primary angioplasty is to restore normal coronary flow. Thromboaspiration is a relatively simple, quick and cheap it can improve the flow and resolution of ST , however , the…
Complete revascularization in acute myocardial infarction. 1 culprit lesion , then all the others
Original title: Randomized Trial of Preventive Angioplasty in Myocardial Infarction (PRAMI trial). Referencia: David S. Wald et al. N Engl J Med 2013.DOI: 10.1056/NEJMoa1305520. Patients developing ST segment elevation myocardial infarction are effectively treated with primary angioplasty to responsible artery . It is unclear whether revascularized other significant lesions in other non culprit vessels will prevent future events…
Primary angioplasty in octogenarians and nonagenarians is increasing in frequency.
Original title: Outcomes After Primary Percutaneous Coronary Intervention in Octogenarians and Nonagenarians With ST-Segment Elevation Myocardial Infarction: From the Western Denmark Heart Registry. Reference: Lisbeth Antonsen et al. Catheterization and Cardiovascular Interventions 81:912–919 (2013) With increasing life expectancy worldwide, older patients will become increasingly referred to us for angioplasty in the context of a heart attack with ST…
Ticagrelor similar to clopidogrel in terms of coronary flow and myocardial perfusion
Título original: Angiographic Outcomes in the PLATO Trial (Platelet Inhibition and Patient Outcomes). Referencia: Vijay Kunadian et al. J Am Coll Cardiol Intv 2013;6:671–83. In the PLATO (Platelet Inhibition and Patient Outcomes) trial, treatment with ticagrelor compared with clopidogrel resulted in a significant reduction in the combined endpoint of cardiac death, heart attack or stroke in patients undergoing…
The Importance of TIMI 3 flow in primary angioplasty
Original title: Predicitors of suboptimal TIMI flow alter primary angioplasty for acute myocardial infarction: results from the HORIZON-AMI trial. Reference: Adriano Caixeta et al. Eurointervention 2013;9:220-227 Primary angioplasty showed greater efficacy than thrombolytics but one out of every four patients cannot achieve TIMI 3 flow. The Horizons-AMI trial randomized 3,602 patients to receive bivalirudin or heparin plus inhibitors…