Original title: Moderate Procedural Sedation and Opioid Analgesia During Transradial Coronary Interventions to Prevent Spasm. A Prospective Randomized Study. Reference: Spyridon Deftereos et al. J Am Coll Cardiol Intv 2013;6:267–73. The trans-radial approach has become the preferred diagnostic and therapeutic study for evidence of minor vascular complications, shorter hospital stays, less blood loss and better outcomes in acute…
Prasugrel is not as effective as Ticagrelor in acute myocardial infarction.
Original title: Comparison of Prasugrel and Ticagrelor loading doses in STEMI patients: The Rapid Activity of Platelet Inhibitor Drugs (RAPID) primary PCI Study. Reference: Guido Parodi et al. J Am Coll Cardiol 2013. Article in press. Current guidelines recommend the use of prasugrel or ticagrelor in patients with ST elevation acute coronary syndromes who are due to receive…
Cangrelor: more effective than clopidogrel without increasing bleeding
Original title: Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events. CHAMPION PHOENIX. Reference: Deepak L. Bhatt et al. N Engl J Med 2013. DOI: 10.1056/NEJMoa1300815. Despite advances in adjuvant therapy thrombotic complications remain a problem during coronary angioplasty. So far, up to the present, there was only P2Y
Revascularization could improve areas traditionally considered necrotic
Original title: Prevalence of Regional Myocardial Thinning and Relationship With Myocardial Scarring in Patients With Coronary Artery Disease. Reference: Dipan J. Shah et al. JAMA. 2013;309(9):909-918 Regional left ventricular (LV) wall thinning is believed to represent chronic myocardial infarction. In fact, the most recent guidelines, both European and American, have concluded that “Images that show regional myocardial thinning…
Complete revascularization in one procedure is more cost effective and as safe as in stages.
Original title: Staged Versus One-time Complete Revascularization With Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease Patients Without ST-Elevation Myocardial Infarction. Reference: Edward L. Hannan et al. Circ Cardiovasc Interv 2013;6;12-20. There is evidence that in patients with multi-vessel disease affected by an acute coronary syndrome (ACS) with ST segment elevation, only the cause lesion should be treated…
Coronary angioplasty reduces the risk of spontaneous myocardial infarction in chronic stable patients.
Original title: Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Prevention of Spontaneous Myocardial Infarction in Subjects With Stable Ischemic Heart Disease. Reference: Sripal Bangalore et al. Circulation. 2013;127:769-781 In the context of coronary angioplasty complications may arise, such as a periprocedural infarction. However, this event does not have the same clinical consequences compared to a spontaneous infarction. …
A worse prognosis for incomplete revascularization in both angioplasty and surgery.
Original title: The Negative Impact of Incomplete Angiographic Revascularization on Clinical Outcomes and Its Association With Total Occlusions. The SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Trial. Reference: Vasim Farooq et al. J Am Coll Cardiol 2013;61:282–94 In patients with complex coronary artery disease who underwent coronary artery bypass surgery, (CABG), or percutaneous transluminal…
Chronic Total Occlusion: increasingly better results and fewer complications.
Original title: Angiographic Success and Procedural Complications in Patients Undergoing Percutaneous Coronary Chronic Total Occlusion Interventions. A Weighted Meta-Analysis of 18,061 Patients From 65 Studies. Reference: Vishal G. Patel et al. J Am Coll Cardiol Intv 2013. Article in press. Chronic Total Occlusions (CTOs) are found in between 15% and 30% of patients undergoing coronary angioplasty. Successful CTOs…
Ambulatory Coronary Angiography: Is any further evidence required?
Original title: Same-Day Discharge Compared With Overnight Hospitalization After Uncomplicated Percutaneous Coronary Intervention. A Systematic Review and Meta-Analysis Reference: Eltigani Abdelaal et al. J Am Coll Cardiol Intv 2013. Article in press. Coronary angioplasty and subsequent same day discharge in selected patients can reduce costs and increase patient comfort. Several observational studies and a few randomized studies have…
Multislice tomography to stratify low-risk chest pain. Lower cost and larger revascularization.
Original title: Outcomes After Coronary Computed Tomography Angiography in the Emergency Department. A Systematic Review and Meta-Analysis of Randomized, Controlled Trials. Reference: Edward Hulten et al. J Am Coll Cardiol 2013. Article in press Chest pain is the second most common cause for visiting an emergency department. In all consultations, only few are finally acute coronary syndromes, for…
Ischemic preconditioning reduces infarct size in patients treated with primary angioplasty
Original title: Preinfarction Angina Reduces Infarct Size in ST-Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention Reference: Ronald Reiter et al. Circ Cardiovasc Interv. 2013;6:00-00. Ischemic preconditioning (IPC) is a phenomenon whereby transitory ischemia episodes protect the myocardium against a more prolonged episode. Until now, IPC has been the most effective approach to protect the myocardium. Pre infarction…