Original title: Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: A collaborative meta-analysis of contemporary randomized clinical trials. Reference: Stergiopoulos K el al. JAMA Intern Med 2013; DOI:10.1001/jamainternmed.2013 The amount in ischemic patients with stable coronary heart disease is associated with poor prognosis. However, it is unclear whether revascularization to reduce…
Drug eluting balloon followed BMS versus DES in de novo lesions
Original title: Elutax paclitaxel-eluting balloon followed by bare-metal stent compared with Xience V drug-eluting stent in the treatment of de novo coronary stenosis: A randomized trial. Reference: Francesco Liistro et al. Am Heart J 2013;166:920-6. Recently, drug eluting balloons (DEB) have emerged as a potential alternative to drug-eluting stents (DES). Paclitaxel is an appropriate drug for DEBs given…
Percutaneous closure devices in coronary angioplasty, the benefit is for obese patients
Original title: Comparative safety of vascular closure devices and manual closure among patients having percutaneous coronary intervention. Reference: Gurm HS et al. Ann Intern Med. 2013; Epub ahead of print. The use of percutaneous closure devices in patients who undergo coronary angioplasty by femoral access is controversial and its use has gradually changed over time. This record analyzed…
Noncardiac surgery is safe after 6 months after implantation of a DES
Original title: Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents. Reference: Hawn MT et al. JAMA 2013;DOI:10.1001 In the patients who underwent non cardiac surgery and had coronary angioplasty with stent history within 2 years there was not increased in major cardiac events (MACE ) with the exception of those who were…
Post PCI bleeding can cause kidney injury
Original title: Impact of Periprocedural Bleeding on Incidente of Constrast-Induced Acute Kidney Injury in patients treated with Percutaneous Coronary Intervention. Reference: Yohei Ohno, et al. J Am Coll Cardiol 2013;62:1260-6 Contrast induced acute kidney injury (CI-AKI) is a serious complication associated to higher morbimortality rates and higher costs, but its correlation to bleeding remains controversial. This study included…
Usefulness of FFR in coronary bypass intermediate lesions
Original title: Long-term clinical outcome after fractional flow reserve– versus angio-guided percutaneous coronary intervention in patients with intermediate stenosis of coronary artery bypass grafts. Reference: Luigi Di Serafino et al. Am Heart J 2013;166:110-8. Bypass coronary angioplasty is often preferred strategy versus re-operation , however it is associated with a greater number of events, both short and long…
Difference in mortality with surgery versus angioplasty in diabetic multivessel patients
Original title: Comparison of coronary artery bypass surgery and percutaneous coronary intervention in patients with diabetes: A meta-analysis of randomized controlled trials. Reference: Verma S. et al. Lancet Diabetes Endocrinol. 2013;Epub ahead of print. The FREEDOM study was the last of the randomized studies that compared the results of surgery versus coronary angioplasty in diabetic multivessel patients showing a…
Intravascular imaging for event prediction: looking beyond the lumen.
Original title: Thinking Out of the Lumen: FFR Vs. Intravascular Imaging for MACE Prediction. Reference: Pedro R. Moreno et al. J Am Coll Cardiol, article in press. Intravascular imaging studies have shown that the lesions most likely to produce coronary events usually have modest luminal stenosis, large cap burden and thin fibrous cap. These plaques will evolve into a…
COURAGE patients who crossed branch.
This editorial comment was written by SOLACI.ORG and is based on an original article by Medscape which can be accessed free of charge at the bottom of this page. COURAGE patients (Patients in the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) who crossed from the optimal medical treatment branch to the revascularization branch within…
Full conversion from transfemoral to transradial: similar success rate and far less complications.
Original title: Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. Reference: Vincent Dangoisse et al. EuroIntervention 2013;9:345-352. Although the transfemoral approach has clear disadvantages when it comes to bleeding complications, it continues to be the preferred approach…
Transradial access plus bivalirudin, the best combination to reduce bleeding
Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are…