Chronic Ischemic cardiopathy articles

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

IVUS vs OCT to Guide PCI: Which Should We Choose?

IVUS vs OCT to Guide PCI: Which Should We Choose?

Controlling stent expansion with optical coherence tomography (OCT) based on an external elastic membrane–based protocol for stent sizing resulted non-inferior to the control group which used intravascular ultrasound (IVUS) and superior the angiography only group. Based on these study outcomes and the prior outcomes, we should use IVUS imaging if available.  There are no specific algorithms

reserva fraccional de flujo

The Future of Prevention? Stenting Vulnerable Fractional FFR Negative Lesions

For many patients, the first symptom of heart disease is acute MI, or even sudden death.  Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it.  Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed

Impacto del FFR post stent ¿dato útil o solo una curiosidad?

Impact of FFR After Stenting: Useful or Mere Fun Fact?

Suboptimal fractional flow reserve (FFR) results after stenting only have a moderate impact on clinical hard points but might predict a much higher risk of reintervention. FFR has shown a huge impact on the decision-making process when it comes to revascularizing (or not) a lesion. Its impact after angioplasty has not been fully studied, particularly

Esquema corto y monoterapia, una práctica llena de evidencia

Short Therapy and Monotherapy, Plenty of Evidence

A short dual antiplatelet therapy (DAPT) of 1 to 3 months followed by P2Y12 inhibitor monotherapy after second generation drug eluting stent (DES) implantation is safer and as effective as the traditional scheme. The idea is clear, but why hasn’t aspirin monotherapy been tested as follow up? Is aspirin old fashioned? Are there physiopathological reasons

Tratamiento médico óptimo

Medical Therapy Optimization Achieved Prior Clinical Trial

12 weeks prior the ORBITA randomization, medical therapy optimization of all antianginal medication was achieved.   Most importantly, optimization was well tolerated by all patients, with scarce adverse effects leading to therapy termination.  In clinical practice, there is skepticism towards achieving maximal dosage with a cost-effective therapy, good tolerance, adherence, and no drug-drug interaction.  The ORBITA


Net Clinical Benefit of Long-Term Ticagrelor

Ticagrelor reduces ischemic risk in patients with a history of acute myocardial infarction, but it increases the risk of bleeding. Keeping a delicate balance is paramount when prescribing long-term ticagrelor to patients with a history of infarction. The PEGASUS-TIMI 54 study randomized 21,162 patients with a history of infarction on a 1:1:1 ratio: some received ticagrelor

El éxito en las CTO reduce la isquemia residual local y a distancia

Revascularization Is Needed Before TAVR

Disease prevalence in patients with severe aortic stenosis is highly variable: from 80% in inoperable patients to only 15% according to the most recent research including low-risk patients. Given the high mortality observed in patients with heart disease, guidelines suggest considering coronary bypass revascularization in those in need of a valve replacement. This experience with

DES con polímero bioabsorbible vs Bare Metal Stents en angioplastia primaria

Last Bastion of Bare Metal Stents Finally Falls

Multiple studies have shown the safety and efficacy of drug eluting stents (DES) in patients with high risk of bleeding. Only one last bastion of bare metal stents (BMS) was left standing: vein grafts.  With controversial evidence and different physiopathology, many still argued against DES in saphenous vein grafts.  This multicenter study randomized patients with

Saltearse el desayuno y riesgo cardiovascular

Regression of High-Risk Plaque with Lifestyle Changes

Diet and lifestyle intervention in addition to optimal medical therapy can slow down plaque building and even reduce plaque volume compared against optimal medical treatment (OTM) alone. Diet and lifestyle intervention are amongst the most important strategies to manage coronary artery disease. However, its direct impact on atherosclerosis remains unclear.  Atherosclerosis plaque building is associated

Colchicina post infarto: buenos resultados y costo-efectivo

Reducing Chronic Inflammation in Atherosclerosis with an Old Drug

Inflammation plays a crucial role in atherosclerosis progression. Recently, the COLCOT study has shown the benefits of colchicine in cardiovascular events.  This good old drug has an inflammatory effect which attenuates the NLRP3 cascade. This explains its effect on uric acid crystals in gout, which might be the same on atherosclerosis cholesterol crystals.  This study

La meseta por la que transcurre la cirugía desde hace varios años

FREEDOM with FFR: Different Outcomes?

The FREEDOM has clearly established the benefit of myocardial revascularization surgery (CABG) over percutaneous coronary intervention (PCI) in diabetic patients with multivessel disease. Coronary physiology as guideline for revascularization works best precisely in this kind of patients and its impact has never been studied in diabetics.  This study, published in Circ Cardiovasc Interv, assessed the