When we decide that 30-day mortality to repair an abdominal aortic aneurysm (AAA) is at least twice as high with conventional surgery compared against endovascular treatment, many of us think choosing a strategy is far from hard, and recent stats show exactly that. However, are we sure our patient agrees with us, or at least...
Patients who undergo complex angioplasty are at higher ischemic risk, but only benefit from extended dual antiplatelet therapy if there are no factors for high bleeding risk. These data suggest that the bleeding risk must weigh more than the ischemic risk on the determination of dual antiplatelet therapy duration. Complex angioplasty is associated with higher...
Patients who suffered their first coronary event before turning 40 years old have similar long-term mortality to those who experienced it even 10 years later, according to the YOUNG-MI Registry presented at the American College of Cardiology [ACC] 2019 Scientific Sessions. Secondary prevention must be used aggressively in both young and elder patients. Over more than...
This study was not able to show benefits in terms of mortality or bleeding when using radial vs. femoral approach in patients undergoing ST elevation myocardial Infarction. This small trial does not change things for “radialists” way past their learning curve who already feel confident with this technique. For them, there is no way back....
Patients admitted with transient ST elevation MI and later normalize completely (symptimos disappear before being treated) are those we normally say are “undergoing a non-ST elevation MI”. This is complex, because revascularization time remains nuclear, as is whether to treat them as STEMI or non-STEMI patients. The aim of this study was to determine the...
The Fourth Universal Definition of Myocardial Infarction is a document developed jointly by the European Society of Cardiology (ESC), the American College of Cardiology (ACC), the American Heart Association (AHA), and the World Heart Federation (WHF). The Fourth Definition was necessary for multiple reasons, including increasingly higher troponin sensitivity. While troponin obviously does not...
Troponin elevation is a common finding in acute patients admitted by an emergency service, even in the absence of an acute coronary event. There are patients in whom we simply cannot identify the origin of such troponin elevation. Initially, we relied on this marker as an exclusive marker of acute coronary syndrome. In consequence, many...
Recent studies show the potential damaging effect of supplemental oxygen in the context of acute stroke and myocardial infarction. Experts now say that it should not be used in patients with >92% oxygen saturation. These guidelines have looked into the most recent studies, including the DET02X-AMI, which suggest supplemental oxygen therapy could increase mortality in...
At 10-year follow-up, unrecognized or silent MIs have similar mortality to clinically recognized MI and, even though this does not justify routine screening, these findings call for more aggressive prevention. Unrecognized MI, detected by MRI, is associated to long term mortality risk similar to that of recognized MI; therefore, these patients have higher risk...
New information has been published fast, and what we thought we knew about hypertension has also changed fast. One of the biggest differences between American and European hypertension guidelines is whether patients with systolic blood pressure (BP) 130/139 mmHg and diastolic BP 80/89 mmHg are considered hypertensive or not. The only place where enough patients with these...