Chronic Ischemic cardiopathy articles

High Risk Anatomy Challenges ISCHEMIA Outcomes

According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization at long term vs. the conservative treatment.  This goes against the study presented by Reynolds H et al at AHA 2020. Dr. Reynold’s was a sub-study of the ISCHEMIA trial which had observed that even

Nuevo dispositivo para tener mayor protección en la angioplastia carotídea

Axillary Access for Microaxial Ventricular Support Device Placement

There is little evidence in support of the axillary access for counterpulsation balloon insertion, but this evidence is null when it comes to microaxial ventricular support device placement (the Impella device family).  Clinical indication of short-term mechanical circulatory support devices has been on the rise. Many patients present suboptimal iliofemoral access or early mobilization is

El uso del ultrasonido intravascular en la angioplastia de tronco no protegido se asocia con mejores resultados en comparación con la angioplastia guiada solo por angiografía.

Intravascular Imaging: A Universal Approach for Angioplasty Optimization

Despite robust information supporting the use of intravascular imaging during coronary angioplasty, its use in clinical practice remains low. This paper proposes using an algorithm for decision-making throughout the procedure to promote increased intravascular imaging use. Regardless of the many technologies that have been incorporated into strut design struts and polymer type, the rate of

Efecto a largo plazo de los balones liberadores con bajas dosis de paclitaxel

Global FFR as Prognosis in CAD Patients without Ischemia

Global fractional flow reserve (FFR) results from adding up FFR values of the three major coronary arteries. This figure represents the physiological atherosclerosis burden and can predict events at long term in patients without stenosis leading to ischemia. This recent study published in JAHA looked at major cardiovascular events (death, infarction and revascularization) at 5

Protrusión de placa en angioplastia carotidea ¿Qué riesgo implica y cómo prevenirlo?

Plaque Volume Over Stenosis Degree

Paradigms are bound to eventually change. After years blinded by stenosis degree, plaque volume has proven to be a better predictor of cardiovascular events and death. Thus, patients with similar degrees of atherosclerosis burden have a similar prognosis, regardless of their lesions being obstructive or not. The aim of this work was to assess whether

Dietas bajas en carbohidratos y progresión de la calcificación coronaria

Low-Carb Diet and Coronary Artery Calcium Progression

People on low carb diets since a young age present increased risk of coronary artery calcium progression, particularly when carbs are replaced by animal protein and fat.  This study included CARDIA participants (Coronary Artery Risk Development in Young Adults) receiving a CT scan between the years 2000 and 2001 for calcium scoring, who also completed

AHA 2020 | AFFIRM-AHF: Suplemento de hierro y menos hospitalizaciones por insuficiencia cardíaca

AHA 2020 | Effect of Evolocumab in Complex Coronary Revascularization

Evolocumab, a PCSK9 inhibitor, has shown significant reduction of complex coronary disease requiring revascularization (be it PCI or CABG). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors induce plaque regression and could eventually reduce the risk of coronary revascularization, especially complex revascularization.  The FOURIER study randomized 27564 patients with stable CAD already on statins to evolocumab

AHA 2020 | El clopidogrel resiste como la mejor opción en pacientes electivos

AHA 2020 | Clopidogrel Resists as the Best Option in Elective Patients

High risk patients undergoing elective PCI treated with a more potent antiplatelet scheme (ticagrelor) vs. the classic clopidogrel do not see a benefit in protection against periprocedural events and instead see increased costs and minor bleeding rate.  These are the outcomes of the ALPHEUS study presented at AHA 2020 simultaneously published in the Lancet. Ticagrelor

AHA 2020 | El riesgo aumenta cuando los operadores no “escuchan” al FFR

AHA 2020 | The More Operators “Listen” to FFR, the Lower the Risk

When operators decide to proceed with PCI despite a negative FFR (fairly frequent in the daily practice) outcomes at 5 years are far worse. This information comes from a large Canadian register presented at AHA 2020 Scientific Sessions, simultaneously published in JAMA. PCI to a non-ischemic lesion results in increased events risk at long term,

Stress mental, activación de la corteza frontal y angina de pecho

Mental Stress, Frontal Lobe Activation and Chest Pain

Historically, we have believed that mental stress might induce chest pain as a response to increased levels of catecholamines and consequently increased product (by 100%), just as it happens with physical stress.  This innovative study published in Circ Cardiovasc Imaging shows the activation of specific areas in the brain is independently associated with chest pain

Angioplasty in Aspirin-Free Stable Patients with Prasugrel: Innovation Continues

Potent P2Y12 receptor inhibitors, such as prasugrel and ticagrelor, have been tested mainly in a setting of acute coronary syndromes. There is little evidence on stable patients, particularly for prasugrel. Designing a study with that purpose seemed challenging enough, but adding aspirin discontinuation in patients without a particularly high bleeding risk took this research to

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