Pharmacology articles

pacientes anticoagulados por fibrilación auricular que reciben angioplastia tratamiento

The Best Anticoagulant Agent for AF After TAVR

The Best Anticoagulant Agent for AF After TAVR

Direct anticoagulant agents were associated with lower long-term mortality in patients with atrial fibrillation (AF) discharged after transcatheter aortic valve replacement (TAVR), compared with classic vitamin K antagonists. The purpose of this paper published in JACC Interv was to compare long-term results between classic vitamin K antagonists and novel direct anticoagulant agents in patients with

Beta Bloqueantes

Post MI Betablockers for Good?

Patients receiving optimal medical treatment after MI do not seem to benefit from betablockers in the long term, provided they do not present cardiac failure or systolic function deterioration.  This study looked into the cardio protection effect of betablockers (BB) after long term follow up in stable patients with no cardiac failure and a history

Esquema corto y monoterapia, una práctica llena de evidencia

Short Therapy and Monotherapy, Plenty of Evidence

A short dual antiplatelet therapy (DAPT) of 1 to 3 months followed by P2Y12 inhibitor monotherapy after second generation drug eluting stent (DES) implantation is safer and as effective as the traditional scheme. The idea is clear, but why hasn’t aspirin monotherapy been tested as follow up? Is aspirin old fashioned? Are there physiopathological reasons

Las nuevas guías Europeas de Hipertensión contrastan con las Americanas

Diastolic Pressure Could Play a Dirty Trick on Patients Treated for Hypertension

Having too low diastolic pressure could be linked to an increase in cardiovascular events (J-shape phenomenon). However, current guidelines suggest a target blood pressure under 130/80 mmHg with no lower limit for diastolic pressure. This paper, recently published in JAMA, sought to evaluate the J-shape phenomenon of diastolic pressure in treated patients who reached a target

Historia natural de la infección asintomática por COVID-19

Major Cause of Myocardial Injury by COVID-19

The most common cause of myocardial necrosis in patient undergoing COVID-19 infection is microthrombi. These microthrombi resulted quite different in composition vs. thrombi obtained from COVID-19 negative patients and thrombi obtained from infected patients with ACS.  Myocardial injury is common in patients hospitalized for COVID-19 and has worse prognosis. Regardless its frequency, the mechanism and

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

AAS vs Warfarin in Low Risk TAVR

We are still discussing the adequate antithrombotic scheme after transcatheter aortic valve replacement (TAVR). Additionally, we are treating a much wider array of patients ranging from low risk to inoperable.  And there is yet one more important point: hypo-attenuated leaflet thickening diagnosed by CT. We are still unaware of the impact they have on device

Tratamiento médico óptimo

Medical Therapy Optimization Achieved Prior Clinical Trial

12 weeks prior the ORBITA randomization, medical therapy optimization of all antianginal medication was achieved.   Most importantly, optimization was well tolerated by all patients, with scarce adverse effects leading to therapy termination.  In clinical practice, there is skepticism towards achieving maximal dosage with a cost-effective therapy, good tolerance, adherence, and no drug-drug interaction.  The ORBITA


Net Clinical Benefit of Long-Term Ticagrelor

Ticagrelor reduces ischemic risk in patients with a history of acute myocardial infarction, but it increases the risk of bleeding. Keeping a delicate balance is paramount when prescribing long-term ticagrelor to patients with a history of infarction. The PEGASUS-TIMI 54 study randomized 21,162 patients with a history of infarction on a 1:1:1 ratio: some received ticagrelor

Saltearse el desayuno y riesgo cardiovascular

Regression of High-Risk Plaque with Lifestyle Changes

Diet and lifestyle intervention in addition to optimal medical therapy can slow down plaque building and even reduce plaque volume compared against optimal medical treatment (OTM) alone. Diet and lifestyle intervention are amongst the most important strategies to manage coronary artery disease. However, its direct impact on atherosclerosis remains unclear.  Atherosclerosis plaque building is associated

¿El alcohol es bueno, malo o neutro para la salud cardiovascular?

Might Alcohol Consumption Reduce Stroke?

A J shaped curve illustrating the link between alcohol consumption and ischemic stroke has been reported, suggesting that a certain amount of alcohol would be beneficial compared against absolute abstinence and excessive consumption.  In order to shed some light on this matter, this study looked at alcohol consumption patterns and their effect on stroke in

Colchicina post infarto: buenos resultados y costo-efectivo

Reducing Chronic Inflammation in Atherosclerosis with an Old Drug

Inflammation plays a crucial role in atherosclerosis progression. Recently, the COLCOT study has shown the benefits of colchicine in cardiovascular events.  This good old drug has an inflammatory effect which attenuates the NLRP3 cascade. This explains its effect on uric acid crystals in gout, which might be the same on atherosclerosis cholesterol crystals.  This study