Approximately 10% of patients who undergo transcatheter aortic valve replacement (TAVR) are readmitted for an acute coronary syndrome after a mean follow-up of 25 months. Male sex, prior coronary artery disease, and (surprisingly and hard to explain) nontransfemoral approach were independent predictors of acute coronary syndrome after TAVR, an event associated with high midterm mortality. While...
1- Everolimus-Eluting Stents Finally Have a Rival and Not Just a “Non-Inferior” Stent In this large randomized trial, there were significant differences as regards both target-lesion failure and target-vessel-related infarction, which persisted through a 2-year follow-up and favored treatment with an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (Orsiro) compared with the gold standard, a durable-polymer everolimus-eluting stent...
Long-term follow-up of patients under 50 with multivessel coronary artery disease suggests surgery outcomes are significantly better than angioplasty outcomes. This study, presented at the Society of Thoracic Surgeons’ (STS) Annual Meeting, concludes that surgery should continue as plan A when it comes to young patients with three-vessel disease. Surgeons complain that many patients never actually...
St elevation acute coronary syndromes are typically caused by thrombotic obstruction of a coronary artery due to ruptured atherosclerosis plaque. However, there is a significant number of patients with similar clinical presentations but no evidence of obstructive coronary artery disease (CAD). Read also: CTO in patients with acute myocardial infarction increases long term mortality. In general, patients without...
Previous studies in which revascularization was guided by angiography alone found that coronary angioplasty does not improve outcomes compared with optimal medical treatment in patients with chronic stable angina. The FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared angioplasty guided by fractional flow reserve (FFR) with optimal medical treatment, arriving to...
Courtesy of Dr. Carlos Fava. The treatment of vein graft lesions has always been difficult in relation to angioplasty, due to their characteristics. While drug-eluting stents (DES) have proven to be superior to bare-metal stents (BMS) for coronary arteries, such superiority is unclear as regards vein grafts. Several studies with first-generation DES (DES1) have even reported...
Original Title: Utilizing Post-Intervention Fractional Flow Reserve to Optimize Acute Results and the Relationship to Long-Term Outcomes Reference: Shiv K. Agarwal, et al. JACC Cardiovascular Intervention 2016;9:1022-31 Courtesy of Dr. Carlos Fava. Fractional flow reserve has shown benefits and it is considered the gold standard to assess intermediate lesions (Class IA), but its...
Original Title: Coronary Flow Reserve and Microcirculatory Resistance in Patients with Intermediate Coronary Stenosis. Reference: Joo Myung Lee, el al. J Am Coll Cardiol 2016; 67:1158-69 Courtesy of Dr. Carlos Fava. Measuring fractional flow reserve (FFR) helps establish whether intermediate stenosis will generate ischemia, but it won’t help assess microcirculatory function. It has been shown that...
This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the study was mortality from any cause. Side end points were infarction, stroke, and revascularization. Propensity score was used to compare populations. Between 34819 patients were eligible 9223 patients in each group...
Coronary angioplasty in patients with kidney failure is associated with an increased occurrence of events. This study compared the efficacy of preventing clinical restenosis using an everolimus-eluting stent versus a conventional stent, both implanted in the same patient with lesions in more than one vessel and suffering from kidney failure. The primary endpoint was target...