Negative one-year outcomes of Mitra-FR led to several discussions and hypothesis, especially after the COAPT was published only a few weeks later. According to the COAPT study, the MitraClip was able to reduce hospitalization rate for cardiac failure and also all-cause mortality, compared against optimal medical treatment alone. When comparing the COAPT to the Mitra-FR,…
ESC 2019 | DAPA-HF: Dapagliflozin Shows Benefit for All Subgroups
Dapagliflozin (a sodium glucose co-transporter 2 [SGLT2] inhibitor), when indicated concomitantly with standard therapy, reduces significantly the risk of worsening heart failure events and cardiovascular events, and improves symptoms in patients with heart failure and reduced ejection fraction according to this new work presented during last Sunday’s scientific sessions at the European Society of Cardiology…
ESC 2019 | New European Guidelines on “Chronic Coronary Syndromes”
In Paris, during the European Society of Cardiology (ESC) Congress 2019 Scientific Sessions, new guidelines for the diagnosis and treatment of chronic coronary syndromes were presented. This document, simultaneously published in Euro Heart J, updates the 2013 guidelines on stable ischemic heart disease and takes out the word “stable” so as to emphasize that the…
ESC 2019 | COMPLETE: Definitive Evidence for Infarction with Multivessel Disease
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the…
ESC 2019 | CONDI-2ERIC-PPCI: Final Blow Against Ischemic Pre-Conditioning in Primary Angioplasty
Remote ischemic conditioning does not offer any clinical benefit to patients with ST-segment elevation acute myocardial infarction undergoing primary angioplasty, according to this study presented on Sunday at the European Society of Cardiology Congress 2019. Prior studies were limited and small, but this analysis seems to provide definitive evidence with regard to ischemic pre-conditioning. The…
ESC 2019 | ISAR-REACT 5 | Which Is Better in ACS, Prasugrel or Ticagrelor?
Courtesy of Dr. Carlos Fava. The benefit of dual antiplatelet therapy in acute coronary syndromes (ACS) has been proven long ago, and both prasugrel and ticagrelor have offered best results than clopidogrel. However, nowadays, it is unclear which of them is superior in the long term, taking into account the fact that one starts to…
Experts Reach Consensus on Post TAVR Pacemaker Indication
This new consensus published this week in J Am Coll Cardiol has provided us with an algorithm to manage conduction disturbances after transcatheter aortic valve replacement. This consensus is intended to reduce potential deaths caused by conduction disturbances and, at the same time, reduce unnecessary definite pacemaker implantation. This document is a big step ahead…
ESC 2019 | PARAGON-HF: Sacubitril/Valsartan Somewhat Disappointing, though a Few Would Benefit.
The combination Sacubitril/valsartan did not reduce the risk of rehospitalization for heart failure or cardiovascular death in patients with cardiac failure symptoms and preserved ejection fraction, according to the new study presented on Sunday at ESC 2019 scientific session in Paris and simultaneously published in NEJM. Despite the negative results, we remain hopeful that this…
ESC 2019 | THEMIS-PCI: Unlike in the Main Study, Here Ticagrelor Is Indeed Effective
This is a sub-study of the THEMIS presented during the ESC 2019 scientific sessions in Paris, and simultaneously published in Lancet. They were all diabetics with stable coronary artery disease, but in this sub-study patients also had prior PCI. It included over 11000 patients with prior PCI for whom the combination of ticagrelor and aspirin…
ESC 2019 | THEMIS: Ticagrelor in Diabetics with Stable Coronary Artery Disease
The use of ticagrelor in patients with stable coronary artery disease significantly reduces the rate of major cardiovascular events when compared against aspirin, according to this study presented on Sunday at ESC 2019 simultaneously published in NEJM, though the cost in terms of major bleeding seems unacceptable. Primary end point rate (composite of cardiovascular death,…