Low colchicine doses reduce the risk of post-AMI ischemic events according to the COLCOT trial, originally presented at AHA 2019 scientific sessions, and simultaneously published in NEJM. The new information delivered at the virtual ACC 2020 addresses its cost-effectiveness. Colchicine is an anti-inflammatory drug indicated in the treatment of gout and pericarditis, but its price…
Cardiovascular Sequelae Associated with COVID-19
Myocardial injury, as defined by an increased troponin level, can occur due to both ischemic and nonischemic processes. Myocarditis would be an example of a nonischemic event. A severe, acute respiratory infection causing hypoxia, especially due to COVID-19, can cause this myocardial injury. Elevated troponin levels have been described in patients infected with COVID-19, with…
Always in Favor of Primary Angioplasty, Even in the Pandemic Era
Compared with fibrinolytic therapy, reperfusion through primary angioplasty is more reliable and durable, and has less complications. This results in a higher net clinical benefit, both in terms of mortality and of reinfarction and bleeding. In the midst of the COVID-19 pandemic, the discussion on the usefulness of thrombolysis has emerged once again. Some societies…
In Favor of the Use of Thrombolytics in Pandemic Times
The Covid-19 pandemic has dramatically altered reperfusion therapy access in patients undergoing ST elevation MI. In these adverse times, it seems prudent to reassess the reperfusion algorithm. Even though primary PCI is the standard reperfusion strategy, to fully benefit from it is essential to keep first medical-contact-to-PCI time between 90 to 120 minutes (depending on…
Management of Infarction During the COVID-19 Pandemic
Patients with cardiovascular disease infected with COVID-19 are at a particular risk for morbidity and mortality. In any case, it should be noted that most patients requiring cardiovascular care due to ischemic heart disease, peripheral vascular disease, or structural heart disease are not infected. Being prepared to face this pandemic is as important as guaranteeing…
Thrombosis and Thromboembolism Associated with COVID-19
Coronavirus disease 2019 (COVID-19) is a viral respiratory illness that can cause a severe acute respiratory syndrome (SARS-CoV-2), predisposing patients to thrombosis (both in veins and arteries) due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis. In addition, many patients receiving antithrombotic therapy for different indications may now become infected with COVID-19, which can…
How is the Pandemic Affecting MI? The Chinese Experience
ST elevation acute myocardial infarction has high mortality and morbidity rates. It is normally treated with primary PCI. The whole system has established very effective protocols to minimize ischemic time from symptom onset to definite treatment in the cath lab. This study reports the experience in Hong Kong since January 2020, when all emergency protocols…
BIOFLOW V: Ultrathin Struts Confirm their Benefits
For several years we have been testing new devices that have introduce changes with respect to their predecessors in the hope they will bring clinical benefits. And so, the different generations of drug eluting stents came about (DES) even though we found ourselves stuck in the second generation, with the classical everolimus eluting stents. All…
Prolonged Exposure to Pollution Increases the Risk for Cardiovascular Disease
In the midst of the COVID-19 pandemic, it is hard to think of anything else that might be affecting worldwide health, particularly in China. As a topic, pollution (especially by fine particulate matter, PM2.5) has been relegated these days. At the same time, however, the preventive closing of many factories in China due to the…
ECS Guidelines for COVID-19 Management
One of the first statements in this document points out these are not “regular guidelines” developed after thorough analysis of all the available evidence published since the last update. Instead, they are meant to provide temporary basic management pointers on how to handle different scenarios of cardiac patients in the context of the COVID-19 pandemic.…
Are Non-Culprit Lesions Really Innocent?
In recent times, a lot has been said about reducing the duration or intensity of antiplatelet therapy following percutaneous coronary intervention (PCI) regardless initial indications. All evidence in support of these arguments might be failing to show the risk of non-culprit lesion events in patients with acute coronary syndromes (ACS). Potent and prolonged antithrombotic therapies…