Several clinical guidelines differ in their recommendation regarding the prescription of proton pump inhibitors to patients being treated with dual antiplatelet therapy after infarction. In 2015, the European Society of Cardiology (ESC) recommended their use in patients with high bleeding risk; however, in the 2017 update that recommendation became general after the assumption that, for…
5-Year Experience of Appendage Closure: More Evidence that Does Not Translate into Clinical Practice
The use of percutaneous left appendage closure increased 3.6-fold from 2011 to 2015, but this volume increase did not entail a significant uptrend of in-hospital events in this “real-world” population in Germany. However, can Germany be considered a real-world setting for Latin America? This question is warranted by the fact that there is no apparent…
Improved Outcomes after Lower Limb Revascularization
Operator ability combined with improved and diverse devices for lower limb revascularization has clearly increased in the last decade. However, is this technical feasibility we did not use to have translating into better clinical outcomes for patients, or is it simply inflating our interventionist egos? This study aims at answering the question above by identifying…
Peri-Procedural Infarction in Angioplasty vs. Surgery in the Left Main Coronary Artery
According to the EXCEL trial, peri-procedural infarction was more common after left main coronary artery surgery compared with angioplasty, and it was strongly associated with increased 3-year mortality after controlling all possible confounding variables. This increased mortality was only present in extensive infarctions with an increase in CK-MB ≥10×. The EXCEL trial seems to want…
Next-Day Discharge after TAVR: Equally Safe for All Prosthesis?
Yet scarce, there is evidence supporting next-day discharge (NDD) after TAVR is safe when patients receiving balloon expandable valves meet certain conditions. This had not yet been shown for self-expandable valves. This study looks into NDD after TAVR by femoral access with self-expandable valves. The authors retrospectively compared all consecutive patients undergoing elective minimalist TAVR…
The Most Read Articles in Interventional Cardiology in SOLACI
1- What to Do with Blood Pressure Levels Between 130/80 and 139/89 mmHg The decision to be made with a treatment-free patient with systolic blood pressure over 160 mmHg or diastolic blood pressure over 100 mmHg is an easy one. All guidelines agree: treatment should be started immediately alongside lifestyle changes. Read also HERE 2- Low-Risk…
Functional Assessment of Lesions: Advances with MRI
Computer tomography (CT) had taken over in the race to develop software capable of measuring FFR non-invasively. Magnetic resonance imaging (MRI) wouldn’t fall behind and has also tried non-inferiority vs an FFR based strategy, according to this study recently published in the prestigious NEJM, called MR-INFORM. In patients with chronic angina and CAD risk factors,…
Antithrombotic Strategies in Atrial Fibrillation and Angioplasty
What is the most appropriate antithrombotic strategy for a patient with atrial fibrillation and coronary artery disease, particularly when admitted with acute coronary syndrome or undergoing coronary angioplasty? This is a question whose answer is still in the works and that literature is addressing dynamically. Whatever we read yesterday may already be out of date…
500 Years after What Might Have Been the Start of Modern Cardiology
500 years have passed since Leonardo da Vinci passed away (1452–1519), which is why we believe this is the perfect time to remember his passionate effort to study the human heart. Not only was Leonardo a gifted artist, but also an innovative engineer and inventor, a pioneer far ahead of his time. His scientific exploration…
What Happens When We Are Blinded by Left Main Disease and Ignore All Other Lesions?
According to this recent Excel analysis, mortality seems to rise when the SYNTAX II score is not taken into account when defining the revascularization strategy. The difference does not reach statistical significance and further studies are required, but the message is clear: the left main coronary artery is not the only thing that matters; other…