Pharmacology articles

Escándalo con los resultados del EXCEL que hicieron “caer” las últimas guías

Clnical Practice Dissociated from Study Outcomes: Bad News for Our Patients?

Clnical Practice Dissociated from Study Outcomes: Bad News for Our Patients?

Differences in patient characteristics, changes in treatment algorithms, and advances in device technology, together or separately, might limit the applicability of older randomized trials to contemporary clinical practice. In this case, we look at patients and devices used in the contemporary clinical practice vs. those in the EXTEND DAPT. These differences were associated with attenuated


Left Atrial Appendage Closure vs Direct Anticoagulants at Long Term

The PRAGUE-17 has shown that left atrial appendage closure is not inferior to direct anticoagulants at long term to prevent major cardiovascular, neurological, or bleeding events. Moreover, procedures not related to prosthesis implantation saw significant reduction. The PRAGUE-17 was a randomized non-inferiority study comparing left atrial appendage closure (Watchman or Amulet) with direct anticoagulants (95%

Fentanilo en la angioplatia: ¿Cuál es el precio de un mayor confort en el procedimiento?

TICO: Age Impacts the Effect of Antiplatelet Monotherapy

The higher the age, the greater the benefit of ticagrelor monotherapy vs. dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome. This post hoc sub-analysis of the TICO study goes along the same lines as the TWILIGHT study (which we recently discussed), given that age is the most common reason for considering that a

Esquema corto y monoterapia, una práctica llena de evidencia

Post-PCI Ticagrelor Monotherapy in High-Risk Bleeding

In patients at high risk of bleeding undergoing coronary PCI and after completing 3-month DAPT with no events, you may discontinue aspirin and follow up with ticagrelor monotherapy. This will significantly reduce bleeding without increasing ischemic events.  With this strategy, the greater the risk of bleeding, the greater the absolute reduction of bleeding. Patients at


PRAGUE-17: Appendage Closure vs. Direct Anticoagulant Agents

After four years of follow-up, the PRAGUE-17 study showed that appendage closure is non-inferior to direct anticoagulant agents (non-warfarin oral anticoagulants, NOAC) to prevent major neurological events, cardiovascular events, and bleeding events in patients at high risk of atrial fibrillation. Appendage studies were compared with warfarin studies—it was necessary to update anticoagulant agents and reach

ticagrelor vs. aspirina

Empagliflozin: Better Quality of Life for Patients with Cardiac Failure and Preserved Ejection Fraction

Empagliflozin has shown early and sustained improved quality of life (at least for a year) in patients with cardiac failure and preserved function. Patients with cardiac failure and preserved ejection fraction present a deteriorated quality of life. The EMPEROR-Preserved assessed the efficacy of Empagliflozin in several baseline health status assessments. HRQoL was measured using the

Dieta proinflamatoria y su potencial para desencadenar eventos cardiovasculares

Dietary Guidelines to Improve Cardiovascular Health in 2021

A poor diet is associated with high risk of heart disease, morbidity and mortality.  This scientific document emphasizes the importance of a dietary pattern beyond food or nutrients: it highlights the critical role of early nutrition, presents us with elements to build healthy eating habits and underscores the need to introduce structural changes to achieve

Estenosis aórtica moderada y disfunción ventricular ¿debería apurarse la indicación del recambio?

Swan Ganz Associated with Better Outcomes in Cardiogenic Shock: Is It Back?

The Swan Ganz catheter has been used in the clinical practice for years. However, its usefulness remains under discussion and its use keeps dropping.   A new analysis published in JAHA might bring it back at least in the context of cardiogenic shock, where it showed improved prognosis and more effective complexity management.  Recently, the lack

Sangrado y mortalidad en el reemplazo valvular aórtico por catéter

AFIRE Study | Hidden Risks After Bleeding in Coronary Disease and Atrial Fibrillation

Patients with atrial fibrillation (AF) and stable coronary disease who suffer from major bleeding present an extremely high risk of subsequent cardiovascular events. Preventing bleeding is necessary, and so is preventing the risk of subsequent cardiovascular events and death. The association between coronary angioplasty, early bleeding, and an increase in death and infarction rates after