In patients with atrial fibrillation and stable coronary artery disease who have not had revascularization procedures in the last 12 months, monotherapy with rivaroxaban seems the best treatment strategy compared to rivaroxaban plus antiplatelet antiaggregation. This is what resulted from the AFIRE study, presented during the ESC 2019 in Paris and published in NEJM. Monotherapy...
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the...
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though...
After the recent announcement by the US Food and Drug Administration (FDA) green-lighting transcatheter aortic valve replacement (TAVR) in patients across the whole spectrum, and given the advancements regarding devices already in the market (such as MitraClip) and a variety of pulmonary valves, there is only one territory left to conquer: the long forgotten tricuspid...
Transcatheter therapy offers a promise for a largely forgotten valve given the lack of therapeutic options. Percutaneous edge-to-edge repair with clip seems to offer some hope to patients with tricuspid regurgitation according to the TRILUMINATE. At 30 days, transcatheter repair with clip significantly reduced tricuspid regurgitation at least in one grade in most patients, which...
This new analysis shows the mechanism behind the benefit of using MitraClip and the necessary degree of residual mitral regurgitation (MR) to have an impact. Regardless the intervention type, patients with cardiac failure and secondary mitral regurgitation present lower hospitalization for cardiac failure, all-cause mortality and improved quality of life the lower the MR. MitraClip...
In the 2018 Guidelines on Hypertension, commandment no. 6 states that we should make lifestyle interventions such as sodium restriction, healthy eating, regular exercise, weight control, and smoking cessation, and also alcohol moderation. It is clear that heavy alcohol consumption induces hypertension and may probably be one of the main causes of secondary hypertension, but...
Courtesy of Dr. Carlos Fava. The aetiology of mitral regurgitation (MR) may be divided into primary, organic or degenerative MR, and secondary or functional MR. These two present different physiopathology. The treatment strategy is different for each, and edge-to-edge treatment with Mitraclip is currently emerging as a valid alternative for high-risk patients. This study analyzed 943 patients...
1- Long-Term Foramen Ovale Closure after Cryptogenic Stroke Patent foramen ovale closure is the standard treatment for cryptogenic stroke patients. However, there are is little information on its long-term evolution. Read more 2- Descending Thoracic Aortic Aneurysms: Is There a New Plan A? The last available evidence suggests that open surgery should be the...
Courtesy of Dr. Carlos Fava. Tricuspid regurgitation (TR) is more common than we thought. Around 1.6 million people in the US and over 3 million in Europe experience significant TR. It usually has a functional cause and its negative impact on patient prognosis is strong. Its surgical treatment is challenging, and it is important that its resolution...