Transcatheter aortic valve replacement (TAVR) has revolutionized the management of high-risk patients with severe aortic stenosis. However, survival after the procedure and severe complications have been assessed in relatively small populations with limited follow-up. This article reports long-term clinical results in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. The FRANCE-2 registry…
ACS and Multivessel Disease: How to proceed
Gentileza del Dr. Javier Castro In the daily practice, a high percentage of ST elevation myocardial infarction patients (STEMI) present multivessel disease (40-65%). This group of patients presents worse clinical evolution and higher mortality than patients with one culprit lesion. When PCI is indicated to a patient with significant lesions in more than…
When to Indicate Statin Therapy
The use of non-invasive imaging can identify or rule out subclinical atheromatosis and help reduce the number of elderly patients unnecessarily treated with statins without increasing the risk of cardiovascular events. Using calcium score and carotid ECG to find elderly patients without atheromatosis helps to safely avoid the use of statins with no clinical…
AAA Screening in Men Over 65 Reduces Mortality
Systematic screening for abdominal aortic aneurysm (AAA) targeting all men over 65 years old (not just those presenting risk factors) was associated with a drop in the mortality rate specific for this disease, according to the Swedish Nationwide Screening Program. While 667 men were examined for AAA, the number of patients who required treatment to prevent…
Patients with Resistant Hypertension: Nearly 50% doesn’t take medication
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the efficacy of renal denervation in addition to antihypertensive standard care in patients with resistant hypertension. This study reports the influence of adherence to treatment to control blood pressure. It included 106 patients with resistant hypertension after four week treatment with indapamide 1.5 mg/day, ramipril 10…
Carotid PCI at Long Term: Effective in Stroke Prevention?
There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients. This registry included prospective data with a strict follow up protocol on 901…
Are Pharmacoinvasive Strategy and Primary PCI Comparable?
The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute Myocardial Infarction 2015 suggest that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PCI). This study compared the impact of pharmacoinvasive strategy with the impact of primary angioplasty in real-world patients admitted with acute coronary syndrome with ST-segment elevation. The…
Prasugrel vs. Ticagrelor in Diabetics with Heart Disease
Diabetic patients are increased risk of thrombotic events, which is why an effective antiplatelet therapy is crucial for these patients. Both prasugrel and ticagrelor have shown to reduce thrombotic complications further than clopidogrel. Subgroup analyzes of the most important studies testing prasugrel and ticagrelor vs. clopidogrel have shown that diabetic patients receiving the new…
Procedural Complexity Affects Decision-Making Regarding DAPT Duration
Much of the speculation around the way of individualizing dual antiplatelet therapy (DAPT) duration after coronary angioplasty has focused on clinical parameters (e. g., diabetes), but a new study published by the Journal of the American College of Cardiology (JACC) and presented at the last European Society of Cardiology (ESC) Congress warns about anatomical factors as…
Deferring Lesions by FFR in ACS: Yes or No?
Deferring treatment through angioplasty in non-ischemic lesions by fractional flow reserve (FFR) is associated with excellent long-term prognosis in patients with chronic ischemic heart disease. FFR is beginning to be used for clinical decision-making in patients with acute coronary syndromes, and its long-term effect on stable chronic patients has not been established. This…