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…
DES versus Bare in primary angioplasty at five years. Initial advantage is reducing
Original: title Long-Term Outcome After Drug-Eluting VersusBare-Metal Stent Implantation in Patients WithST-Segment Elevation Myocardial Infarction. 5 Years Follow-Up From the Randomized DEDICATION (Drug Elution and DistalProtection in Acute Myocardial Infarction) Trial. Reference: Lene Holmvang et al. J Am CollCardiolIntv 2013, article in press. Primary angioplasty reduced mortality and reinfarction compared with thrombolytics in patients experiencing an ST…
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…
Monoclonal antibodies to decrease peri-procedural myocardial damage
Original title: Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non–ST-Segment Elevation Myocardial Infarction Results of the SELECT-ACS Trial. Reference: Jean-Claude Tardif et al. J Am Coll Cardiol 2013;61:2048–55. The pathophysiology of myocardial injury after angioplasty is multifactorial but it is clear that inflammation and platelet activation play a major role. P-selectin…
Transradial Angioplasty: do we need more proof to adopt it for good?
Original title: Influence of Arterial Access Site Selection on Outcomes in Primary Percutaneous Coronary Intervention. Are the Results of Randomized Trials Achievable in Clinical Practice? Reference: Mamas A. Mamas et al. J Am Coll Cardiol Intv 2013. Article in press. Antithrombotic therapy has improved the prognosis of patients with acute ST-segment elevation myocardial infarction by reducing ischemic events.…
Adenosine, the best vasodilator to improve blood flow in primary angioplasty
Original title: Open Label, Randomized, Placebo-Controlled Evaluation of Intracoronary Adenosine or Nitroprusside Alter Thrombus Aspiration During Primary Percutaneous Coronary Intervention for the Prevention of Microvascular Obstruction in Acute Myocardial Infartion . The Reopen-AMI Study Reference: Giampaolo Niccoli, et al. J Am Coll Cardiol Intv 2013. Article in Press One of the challenges of PCI is to achieve the…