Chronic Ischemic cardiopathy articles

Los 10 mandamientos de las nuevas guías de infarto con ST de la ESC

Mechanisms of Post PCI Persistent Angina

Mechanisms of Post PCI Persistent Angina

Angina persistence or recurrence after PCI can affect between 20 to 40% of patients in the short and mid-term. This might be true despite PCI optimization using FFR, intravascular ultrasound and the latest generation stents. This problem is associated with high healthcare cost, which can double in patients with recurrent or persistent angina compared against

Balancear el riesgo de sangrado vs trombótico para definir el tiempo de doble antiagregación

Can Antiplatelet Therapy Affect the Life of Coronary Grafts?

The antiplatelet treatment strategy providing optimal balance between thrombotic and bleeding risks in patients undergoing myocardial revascularization surgery is unclear. What does seem somewhat certain is that some antiplatelet therapy is necessary to prevent early thrombosis, mainly in vein grafts, but (as opposed to what happens with angioplasty) there are other relevant factors such as

FFR para guiar la revascularización en SCA

FFR to Predict CABG Result: All Benefits in a Population Much Too Pure?

Coronary artery bypass graft (CABG) anastomosed to one vessel with normal or nearly normal fractional flow reserve (FFR) have poorer graft patency at one year compared against anastomosed grafts to vessels with functionally significant lesions shown by FFR. However, the recent study FARGO (Fractional Flow Reserve Versus Angiography Randomization for Graft Optimization) did not show

La anticoagulación jugando un papel controvertido en el TAVI

PCI and Anticoagulation: What is the best strategy?

Most patients with atrial fibrillation require anticoagulation to reduce the risk of stroke or systemic embolization. Today, this is achieved with the new direct oral anticoagulants, which present lower intracranial bleeding risk compared against the old vitamin K antagonists. On the other hand, approximately between 5% to 10% of patients receiving PCI also present atrial

Por primera vez se publican guías de prevención primaria ¿Serán útiles en todos los pacientes?

Primary Prevention Guidelines Published for the First Time: Are They Useful for All Patients?

The American College of Cardiology/American Heart Association (ACC/AHA) have recently published primary prevention cardiovascular disease guidelines. They were originally considered very useful for general practitioners who had no choice but to review separately expert consensus or clinical practice guidelines for hypertension, cholesterol, diabetes, etc. Now, everything is concentrated in a single reference document. But is

Monto de isquemia basal en pacientes con múltiples vasos y evolución a largo plazo

Amount of Baseline Ischemia in Patients with Multivessel Disease and Long-Term Progress

According to this recent analysis of the MASS II trial, which will soon be published in JAMA, baseline ischemia is not associated with events at 10 years in patients with chronic stable angina. The ischemic burden induced through exercise does not predict events or long-term ventricular function. Such data add some suspense to the results

Estenosis aórtica severa asintomática en añosos: ¿cuándo intervenir?

How to Prevent Pharmacological Overtreating in the Elderly

Cardiovascular risk increases dramatically with over the years, which almost inevitable leads to treating the elderly with statins, based on risk. To prevent over treatment, we need to identify fragile patients (bed-ridden or with dementia), whose condition might make this treatment futile on the one hand, and on the other hand, patients who regardless their

Functional Assessment of Lesions: Advances with MRI

Computer tomography (CT) had taken over in the race to develop software capable of measuring FFR non-invasively. Magnetic resonance imaging (MRI) wouldn’t fall behind and has also tried non-inferiority vs an FFR based strategy, according to this study recently published in the prestigious NEJM, called MR-INFORM. In patients with chronic angina and CAD risk factors,

¿Qué pasa cuando nos encandilamos con el tronco y no vemos el resto de las lesiones?

What Happens When We Are Blinded by Left Main Disease and Ignore All Other Lesions?

According to this recent Excel analysis, mortality seems to rise when the SYNTAX II score is not taken into account when defining the revascularization strategy. The difference does not reach statistical significance and further studies are required, but the message is clear: the left main coronary artery is not the only thing that matters; other

ticagrelor vs. aspirina

Aspirin in Primary Prevention: Another “Trendy” Topic in Publications

Aspirin is the standard treatment when it comes to optimal medical treatment in the context of secondary prevention of coronary artery disease, in patients with diagnosed, established atherosclerosis. Even though bleeding risk is rather small in the short period an acute event takes place, it increases substantially over time. However, the evidence clearly supports the

EuroPCR 2019 | BASKET-SMALL 2: balones farmacológicos vs DES en vasos pequeños

EuroPCR 2019 | BASKET-SMALL 2: Drug-Coated Balloons vs. DES in Small Vessels

This angiographic substudy supports the safety of drug-coated balloons in small vessels. Despite better angiographic outcomes, there were eight cases of stent thrombosis among drug-eluting stent (DES) patients, while there was none with drug-coated balloons. In patients with small vessels, using a drug-coated balloon appears safe and comparable to DES, with favorable angiographic outcomes at

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