Myocardial ischemia induced by sudden mental stress is associated with bad prognosis, especially in patients with a history of acute myocardial infarction according to this new study. This study, called MIMS-2, was meant to be presented at ACC 2020 together with the World Congress of Cardiology in Chicago, which was shut down because of the…
Is There a Relationship between ARBs, ACE 2 Inhibitors and COVID-19?
In the past few days, many doctors appear to have caught wind of somewhat unfounded data. According to this information, the novel COVID-19 would use angiotensin converting enzyme 2 (ACE2) receptors to enter cells and, in this context, patients with an upregulated expression of these receptors (such as patients receiving angiotensin converting enzyme (ACE) inhibitors…
5 Years of FAST-MI: If Unable to Meet the Timeline, Thrombolization Is the Way to Go
A large proportion of patients undergo primary angioplasty beyond the timelines recommended by clinical practice guidelines. These patients have poorer 5-year outcomes compared with those subjected to a pharmaco-invasive strategy. ST-segment elevation myocardial infarction guidelines recommend primary angioplasty as the strategy of choice within 120 min after a diagnostic electrocardiography. If that is not possible, thrombolytic…
Cath Lab Management Protocol for the COVID-19 Outbreak
The Interventional Cardiology Association and the Cardiac Beat Association from the Spanish Society of Cardiology have released a document stating all the available information on the COVID-19 outbreak for interventionists to tackle this health crisis to the best of their ability. ” Abstract “During March 2020, the SARS-CoV-2 virus has spread throughout Europe, with special…
Impella and Adverse Events
Long after AHA 2019 had presented observational studies showing adverse events associated to Impella, JAMA is finally publishing the official results including all charts and small print. The controversial analysis of the American registry had suggested worse outcomes with the intravascular microaxial left ventricular assist device Impella vs. the intra-aortic balloon pump in acute myocardial…
ACC Recommendations against the New Coronavirus
The American College of Cardiology (ACC) has launched a document summarizing the potential implications of the new coronavirus identified in Wuhan, China. This new virus has been called COVID-19 by the WHO. According to the WHO reports, there are around 93000 confirmed cases across the world, and around 12600 are outside China. In Latin America,…
TAVR: Should Transradial Approach be the Second Access Site?
Courtesy of Dr. Carlos Fava. One of the major challenges we interventional cardiologists still face is access management. Reduced device diameter and improved transcatheter closure, together with increased operator experience, have significantly reduced vascular complications. However, we shouldn’t lose sight of the secondary access, usually transfemoral, generally used in case of primary access site related…
Chronic Coronary Syndromes Nowadays
Multiple drugs and treatment strategies have emerged in recent years to change significantly the prognosis of patients who suffer from stable chronic angina or, in terms of the latest guidelines, “chronic coronary syndromes.” This semantic change may seem of little importance, but it is intended to remind us that these are not stable patients, but…
Onyx ONE: More Options for Patients at High Risk for Bleeding
Since November 2015, when the LEADERS FREE was published in NEJM, polymer-free drug coated stents had undoubtedly been the best treatment for patients at high risk of bleeding. The benefit was owed to the safety and efficacy of the polymer-free biolimus coated stent (also called umirolimus) vs. bare metal stents in the context of just…
Repeat Revascularization Is Not Benign, at Least in Left Main Disease
After the “EXCEL scandal” at the end of last year, study investigators have been publishing explanations and sub-studies that were planned from the beginning, but which can still be interpreted as explanations. This sub-study states that revascularization was more common in the angioplasty arm, but only revascularizations performed on the target lesion, regardless of the…
Routine Continuous Monitoring After Angioplasty Might Not Be Necessary
According to a recent study published in Circ. Cardiovasc Interv, after a scheduled angioplasty, the rate of arrhythmia requiring some kind of treatment is very low, low enough to deem unnecessary the routine monitoring of all patients. The standard policy at many institutions is continuous cardiac monitoring for several hours after undergoing coronary angioplasty, with…