Original title: Prognostic impact of clopidogrel pretreatment in patients with acute coronary syndrome managed invasively. Reference: Almendro-Delia M et al. Am J Cardiol. 2015; Epub ahead of print. This study analyzed the ARIAM data including 9621 AMI patients diagnosed with coronary angiography receiving clopidogrel in 49 center between 2002 and 2012. Most patients had STEMI (63%), and most…
Safety and efficacy of DES in saphenous vein bypass graft PCI
Original title: Safety and effectiveness of drug-eluting versus bare-metal stents in saphenous vein bypass graft percutaneous coronary interventions: insights from the Veterans Affairs CART program. Reference: Aggarwal V et al. J Am Coll Cardiol. 2014;64:1825-1836. This study retrospectively evaluated 2471 receiving after saphenous vein graft (SVG) PCI between October and September 2011. Outcomes were compared using propensity…
Net clinical benefit of bivalirudin in STEMI patients
Original title: Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention: Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials. Reference: Stone GW et al. J Am CollCardiol. 2015 Jan 6;65(1):27-38. The HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) that included 3602 STEMI patients undergoing…
Tomography vs FFR to identify lesions that cause ischemia
Original title: Atherosclerotic Plaque Characteristics by CT Angiography Identify Coronary Lesions That Cause IschemiaA Direct Comparison to Fractional Flow Reserve. Reference: Hyung-Bok Park et al. J Am CollCardiolImg. 2015;8(1):1-10. This trial evaluated the characteristics of arteriosclerotic plaques and its association with lesion ischemia by CT angiography (CTA) vs fractional flow reserve (FFR). FFR is the gold standard to…
Never ending controversy over the duration of post DES dual antiplatelet therapy
Original title: Second Generation Drug-Eluting Stents Implantation Followed by Six Versus Twelve-Month – Dual Antiplatelet Therapy- The SECURITY Randomized Clinical Trial. Reference: Antonio Colombo et al. J Am CollCardiol. 2014 Nov 18;64(20):2086-97. The optimal duration of dual antiplatelet therapy after second-generation DES implantation is still debated and apparently will remain controversial for some time. The aim of this…
Risks and benefits of Dual Antiplatelet beyond the year of a drug-eluting stent
Original title: Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. Reference: Laura Mauri et al. N Engl J Med 2014;371:2155-66. Dual antiplatelet therapy is recommended after a drug-eluting stent to prevent thrombotic complications. The clinical benefit of this scheme it is not clear beyond one year. Patients were registered to receive a…
Hybrid Revascularization in Multiple Vessels
Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83 According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications. This study randomized 102…
Thienopyridine Pretreatment in Non ST Elevation ACS syndrome
Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:…
The SYNTAX Score II: a tool that should be used
Original title: Validation and Comparison of the Long-Term Prognostic Capability of SYNTAX Store-II Among 1528 Consecutive Patients Who Underwent Left Main Percutaneous Coronary Intervention. Reference: Bo Xu, et al. JACC Cardiovascular Intervention 2014;7:1128-37. The SYNTAX angiography score is useful when deciding revascularization in multivessel, but with the addition of clinical variables in the second version, SYNTAX score…
FFR results could change over the years
Original title: The impact of age flow reserve-guided percutaneous coronary intervention: A FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) trial substudy. Reference: Hong-Seok Lim et al. International Journal of Cardiology 2014; 177:66-70 The FAME study has shown the benefit of FFR guided PCI, but the question as to whether age affects lesion evaluation remains unclear. A…
Despite the evidence, visual estimation continues to dominate the decision on intermediate lesions
Original title: Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions. Results of the International Survey on Interventional Strategy. Reference: Gabor G. Toth et al. CircCardiovascInterv. 2014. Epubahead of print. Measurement of fractional flow reserve (FFR) is recommended by the guidelines and supported by evidence in intermediate lesions when not any proof of ischemia is available…