Early rhythm control therapy in patients recently diagnosed with atrial fibrillation reduces the risk of cardiovascular events compared against the usual treatment of frequency control. These data come from the EAST-AFNET 4 trial recently presented at ESC 2020, simultaneously published in NEJM. These data suggest that we should offer patients early rhythm control therapy to…
Can Aspirin Use Be Interrupted After Angioplasty?
Aspirin discontinuation 1 to 3 months after angioplasty with continued P2Y12 inhibitor therapy reduces the bleeding risk without an increase in thrombotic events. This is also the case for patients admitted with acute coronary syndrome. Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor has been shown to reduce the risk of major events compared with…
Impact on Mortality with Rivaroxaban after Discharge
Extending thromboembolic prophylaxis with rivaroxaban in patients hospitalized for heart conditions reduce fatal and thromboembolic events by 28% without major bleeding payback. Patients hospitalized for heart conditions are at risk of thromboembolic events, and this is why inhospital prophylaxis (in general with low molecular weight heparin) is within the standard treatment. It was not…
When and How Could Dexamethasone Be Useful in a COVID-19 Infection?
More details have emerged on the group of COVID-19 patients who received dexamethasone in the RECOVERY trial. These data, published as a preliminary report in the New England Journal of Medicine (NEJM), suggest that dexamethasone could reduce mortality in cases when infection effects are mainly derived from immunopathological elements in patients requiring mechanical ventilation or…
Rapid Drop of Antibodies in Mild COVID-19 patients
A fast drop in COVID-19 antibodies in mild patients triggers the alarm for protection against the new virus. This decrease, observed within the first 90 days after contagion, might slow down over time. However, it calls for caution when it comes to the feeling of “protection” in recovered patients, vaccine immunization at long-term, and ultimately…
Peripheral Artery Disease: Underestimated and Undertreated
Compared against coronary artery disease (CAD) or cerebrovascular disease patients, peripheral artery disease (PAD) patients have lower chances of receiving medication proved to be clinically effective such as statins (despite running the same risk, perhaps even higher risk). The message is we should be more active both in finding risk factors in PAD patients, and…
Vasculitis, Thrombosis and Angiogenesis: Covid-19´s Unique Patters
In this small, yet interesting series, we observe angiogenesis could differentiate pulmonary physiopathology by Covid-19 vs. from viral infections of similar severity (such as influenza). Being quite small, we can hardly consider it universal, or whether it could have clinical impact. Meanwhile, we keep learning about the new virus. Progressive respiratory failure is the main…
EuroPCR 2020 | FABOLUS FASTER: In the Quest for the Fastest, Most Potent Platelet Inhibition
This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor…
Olive Oil and Cardiovascular Risk: The Higher the Consumption, the Lower the Risk?
High olive oil intake was associated with lower risk of coronary heart disease and cardiovascular disease in two large prospective cohorts of men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil can have a significant impact on cardiovascular health. The benefits of olive oil intake have been well studied…
The FDA Approves Ticagrelor for Primary Prevention in High Risk Patients
The FDA has approved the indication of ticagrelor as primary prevention in high risk CAD patients with no history of MI or stroke. The lab producing ticagrelor has informed the FDA has based this decision on the THEMIS study, which included nearly 20,000 patients with stable CAD and type 2 diabetes. This decision has come…
Optimal Intervention Timing for NSTEMI with No Antiaggregant Pre-Treatment
Patients undergoing non-ST elevation MI (NSTEMI) who are not pre-treated with P2Y12 receptor inhibitors will benefit from a very early intervention strategy. The optimal intervention timing for NSTEMI patients is still under debate, despite multiple studies, but the ideal timing had never been tested in patients with no platelet aggregation inhibitor pretreatment. After the surge of…