Chronic Ischemic cardiopathy articles

ESC 2021 | RIPCORD-2: Routine FFR Evaluation of All Epicardial Vessels During Angiography

ESC 2021 | RIPCORD-2: Routine FFR Evaluation of All Epicardial Vessels During Angiography

The predecessor of this research—RIPCORD, published in 2014—showed that using fractional flow reserve (FFR) changes the treatment strategy in about 25% of patients. That marked the rise of FFR. In fact, the DEFER, FAME, and FAME 2 studies offered results consistent with the original RIPCORD. In this research, authors tested the hypothesis of systematic use of

ESC 2021 | MASTER DAPT: Doble antiagregación plaquetaria después de la angioplastia coronaria en pacientes con alto riesgo isquémico

ESC 2021 | MASTER DAPT: Dual Antiplatelet Therapy After Coronary Angioplasty in Patients at High Bleeding Risk

Courtesy of Dr. José Álvarez. In patients at high bleeding risk with drug-eluting stents, the duration of dual antiplatelet therapy has been subjected to ongoing review. Guidelines from the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) suggest shortening this treatment to a maximum of three to six months (Class IIb).

El alta en el mismo día luego de una angioplastia coronaria es cada vez más popular pero todavía no es regla

Post PCI Same Day Discharge: from Convenience to Need

Same day discharge following programed PCI with no complications has been a way for health centers to reduce costs that has resulted both safe and convenient for patients.  With the arrival of the pandemic, reduced bed capacity, uninfected patient exposure and their potential contagion, and the always pressing need to reduce hospital costs have turned

El acceso radial se asocia a menor mortalidad y menor sangrado en los pacientes cursando un infarto con supradesnivel del segmento ST que reciben angioplastia primaria.

Large Differences between Focal and Diffuse Patterns of Stable CAD

PCI is far more successful at reducing ischemia when treating focal stable coronary artery disease (CAD). However, there were no differences in symptoms between both types of CAD.  Physiological assessment with pressure wire pullback can be used to distinguish focal vs diffuse CAD, even though the relevance of this distinction has not been looked at

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

How Bad is Malapposition? OCT Findings and Events

Most post-angioplasty findings with optical coherence tomography (OCT) were not associated with clinical adverse events. Exceptions were small intra-stent area, and significant malapposition. Suboptimal findings after angioplasty are very common (almost expected), although their clinical implications are uncertain. This registry—recently published in JACC—was developed in an attempt to answer these questions. The analysis included a

revascularizacion incompleta en cirugia no cardiaca

Best Revascularization Strategy in Patients with Left Ventricular Deterioration

Multivessel disease associated to ventricular function deterioration is challenging in terms of risk, when choosing a revascularization strategy.  According to this recent analysis of the SCAAR registry published in the European Heart Journal, long term followup seems to justify taking a higher risk initially, higher risk being myocardial revascularization surgery (CABG). The study looked at

DKCRUSH-V: El tronco de la coronaria izquierda no es una bifurcación más

Bifurcations: A Long Return Journey

When it looked like the simplest techniques reach the best outcomes, along came the DK Crush studies. Indeed, after the COVIS III results in bifurcations, it appeared we had started to retrace our steps back to the foundation.  The purpose of this study was to compare long term outcomes of the remarkably simple 1-stent strategy

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

IVUS vs iFR for Left Main Decision Making

No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions.   This reality should be looked into, since operating or intervening moderate left main lesions on

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

A Headache for Cardiologists: Ischemia with Non-Obstructive Disease

Treating patients with functional stress test induced ischemia and non-obstructive coronary artery disease (INOCA) is complex and often frustrating.  The multifactorial nature of this disease in addition to the complex physiopathological relationship between angina and ischemia turn these patients into a real headache for cardiologists. The CIAO-ISCHEMIA was recently published in Circulation and was designed

doble antiagregación plaquetaria

DAPT vs. Monotherapy: The Dilemma Remains After Surgery

Patients who undergo myocardial revascularization surgery and are discharged on dual antiplatelet therapy (DAPT)—aspirin plus clopidogrel—have a lower risk of major cardiovascular and cerebral events than patients on aspirin monotherapy. Furthermore, the risk of bleeding is not increased for those receiving DAPT. This information comes from a registry of over 18,000 patients recently published in the

stent-provisional-2-stent

EuroPCR 2021 | EBC MAIN: Provisional Stenting vs. Systematic Dual Stenting in Left Main Coronary Artery

Treating the left main coronary artery with provisional stenting was non-inferior to systematic dual stenting in the EBC MAIN trial, presented at EuroPCR 2021 and simultaneously published in the European Heart Journal. The composite primary endpoint of death, infarction, and target-lesion revascularization was 14.7% for provisional stenting vs. 17.7% for systematic dual stenting (hazard ratio:

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