Original title: Elevated Plasma Fibrinogen Rather Than Residual Platelet Reactivity After Clopidogrel Pre-Treatment Is Associated With an Increased Ischemic Risk During Elective Percutaneous Coronary Intervention. Reference: Lawrence Ang et al. J Am Coll Cardiol 2013;61:23–34. Platelet function tests have identified differences in the response of each patient to clopidogrel and minor platelet inhibition has been associated with thrombotic…
Ticagrelor, even better than we thought
Original title: Reduction in First and Recurrent Cardiovascular Events with Ticagrelor Compared with Clopidogrel in the PLATO Study. Reference: Payal Kohli et al. CIRCULATION AHA.112.124248. In analyzing randomized and monitored study outcomes, we usually observe that after the occurrence of any primary outcome event patients are typically blocked for further analysis. This practice limits the information on subsequent…
Self-expanding stents improve positioning in primary angioplasty
Original title: Self-Expanding Versus Balloon-Expandable Stents in Acute Myocardial Infarction: Results From the APPOSITION II Study Reference: Robert-Jan van Geuns et al. J Am Coll Cardiol Intv 2012;5:1209–19 Acute myocardial infarction is associated with vasoconstriction and thrombus occlusion. Resolution of these two points during the first hours after primary angioplasty can lead to poor extension and poor positioning…
More evidence supports ventricular assist devices in complex angioplasty procedures
Original title: Percutaneous Left Ventricular Assist Device with Tandem Heart for High-Risk Percutaneous Coronary Intervention: The Mayo Clinic Experience. Reference: Oluseun O Alli, et al. Catheterization and Cardiovascular Intervention 80:728:734 There is a small group of poor surgical patients admitted for surgery that due to complex comorbidity, coronary anatomy and compromised left ventricular function that can be treated…
Radial Approach, 1st choice in Acute Coronary Syndromes
Original title: Radial Versus Femoral Randomized Investigation in ST-Segment Elevation Acute Coronary síndrome. The RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) Study. Reference: Enrico Romagnoli et al. J Am Coll Cardiol 2012;60:2481–9. Bleeding in patients with acute coronary syndromes (ACS) is an independent predictor of morbidity and mortality. Until today, evidence supporting the radial…
Periprocedural Infarction vs. Spontaneous Infarction: Prognostic Significance
Original title: Comparison of the Prognosis of Spontaneous and Percutaneous Coronary Intervention–Related Myocardial Infarction. Reference: Sergio Leonardi, MD et al. Journal of the American College of Cardiology Vol. 60, No. 22, 2012 Clinical significance of myocardial infarction (MI) associated to coronary angioplasty is a controversial issue worldwide. Most of research on coronary disease includes it as a primary…
Risk score of thrombosis in patients with acute coronary syndrome
Original title: Development and Validation of a Stent Thrombosis Risk Score in Patients With Acute Coronary Syndromes. Reference: George D. Dangas et al. J Am Coll Cardiol Intv 2012;5:1097–105. The implantation of a stent in a pro thrombotic condition such as acute coronary syndrome (ACS) is associated with a higher incidence of stent thrombosis. There is no data…
Risk scores in patients with acute coronary syndromes
Original title: Walking Beyond the GRACE (Global Registry of Acute Coronary Events) Model in the Death Risk Stratification During Hospitalization in Patients With Acute Coronary Syndrome. Reference: Rapouseiras-Roubín S, et al. J Am Coll Cardiol Intv 2012;5:1117–25. Discriminatory power of risk score predictors become fundamental in the management of patients with acute coronary syndromes. This tool lets you…
Stent MGuard, primary angioplasty with a higher TIMI III
Original title: The MASTER Trial – Prospective, Randomized, Multicenter Evaluation of a Polyethylene Terephthalate Micronet Mesh–Covered Stent (MGuard) in ST-Segment Elevation Myocardial Infarction. Reference: Gregg W. Stone et. al. J Am Coll Cardiol 2012; 60: 1975-1984 Primary angioplasty has proven effective in restoring epicardial flow but myocardial perfusion is often suboptimal. One of the main mechanisms is distal…
Bleeding risk in ACS. Do the scores we have work?
Original title: Comparing the predictive validity of three contemporary bleeding risk scores in acute coronary syndrome Reference: European Heart Journal: Acute Cardiovascular Care 2012 1: 222 DOI: 10.1177/2048872612453924 The aim of this study was to compare the validity of the three most widely used scores to predict the risk of bleeding in patients who are hospitalized for acute…
Predictors of invasive versus conservative treatment in elderly patients with acute coronary syndromes.
Original title: Predictors of Treatment in Acute Coronary Syndromes in the Elderly: Impact on Decision Making and Clinical Outcome After Interventional Versus Conservative Treatment. Reference: Harald Rittger et al. Catheterization and Cardiovascular Interventions 80:735–743 (2012). This study, recently published in Cath Cardiovasc Interven, was performed to determine the factors that helped physicians decide to be conservative or invasive.…