Fractional flow reserve (FFR) proved to be very useful and safe in the FAME study, but its trade-off was using adenosine (which has a short half-life) and adverse reactions, which fortunately were rare. Subsequently, two large studies—the iFR-SWEDEHEART and DEFINE-FLAIR—demonstrated that instantaneous wave-free ratio (iFR) offered comparable results to FFR in the short term, avoiding...
Prior research has shown that women with coronary artery disease who undergo percutaneous revascularization present more comorbidities, require less aggressive treatments, have greater long-term morbidity rates and worst functional status and/or post-procedure angina. This study used data from the CPORT-E trial (Cardiovascular Patient Outcomes Research Team Non primary Percutaneous Coronary Intervention) to assess baseline differences...
Currently, edge-to-edge therapy with MitraClip has demonstrated efficacy and safety for the treatment of patients with degenerative or functional mitral regurgitation who are at high risk for surgery. However, device-related complications are still present—though their frequency is subsiding due to greater experience, 3D doppler echocardiography development, and technological advancements: loss of leaflet insertion (LLI), single...
Positron emission tomography (PET) with F sodium fluoride (F-NaF) allows for the assessment of microcalcification activity (MA) in a wide variety of cardiovascular conditions, including atherosclerosis. In coronary artery disease, this tracer correlates with progressive disease and allows for the prediction of atherosclerosis progression. Unlike PETs, computed tomography (CT) allows for the evaluation of an...
This last year, new data in coronary disease gave way to changes in practices and new hypotheses, when not simply further justified the already existing evidence. In this new editorial section, we share the most relevant of last year’s works to keep you up to speed on the main topics in the field. The Most...
01- Management of Abdominal Aortic Aneurysms in 2021 Abdominal aortic aneurysms (AAA) are those of >3 cm aortic diameter. They run the risk of rupture and ensuing death by bleeding. In consequence, they are treated to repair the aneurysm before it ruptures. Read more HERE 02- Ten Commandments for 2021 Guidelines on Valvular Heart Disease Since...
Suspending ticagrelor a couple of days before surgery was non-inferior to waiting 5-6 days in terms of bleeding in patients with acute coronary syndrome (ACS) requiring myocardial revascularization surgery. Patients who waited longer had more ischemic events and longer hospitalizations. Current American guidelines recommend waiting at least 5 days before operating on patients with ACS who...
Angioplasty could not reach non-inferiority to surgery to treat patients with three-vessel lesions. In this head-to-head study of both revascularization strategies in patients with three-vessel coronary disease, fractional flow reserve (FFR)-guided angioplasty could not reach the performance of myocardial revascularization surgery in relation to a composite of adverse events. The FAME 3 study was presented during...
The predecessor of this research—RIPCORD, published in 2014—showed that using fractional flow reserve (FFR) changes the treatment strategy in about 25% of patients. That marked the rise of FFR. In fact, the DEFER, FAME, and FAME 2 studies offered results consistent with the original RIPCORD. In this research, authors tested the hypothesis of systematic use of...
Yet another observational study has come to question the antiaggregation power of ticagrelor when it comes to death or MI reduction, pointing at its higher risk of bleeding vs. clopidogrel. This new analysis recently published in JAHA includes a large number of patients undergoing acute coronary syndrome (ACS) in the clinical practice. Ticagrelor has been...