CLI-randomized study CLI-OPCI (n = 670, 1:1) evaluated the impact of stent implantation guided by angiography and optical coherence tomography (OCT), versus angioplasty guided alone by angiography. All patients who had been subjected to stent placement were then evaluated by angiography. Arm OCT, after an optimal angiographic result, an intracoronary OCT evaluation was performed. In...
POST trial: Post-conditioning effect in myocardial reperfusion with primary angioplasty.
Ischemic postconditioning obtained through reversible ischemia and reproduced during reperfusion after a prolonged ischemic injury has shown comparable effects to ischemic preconditioning in preclinical phase. A study in humans showed a reduction in serum markers of AMI thanks to Ischemic postconditioning in the context of primary angioplasty. Different MRI studies showed conflicting results regarding the...
AIDA STEMI MRI: Intracoronary versus intravenous abciximab in primary angioplasty. MRI analysis in AIDA study
Basics: Recent meta-analysis showed benefits of intracoronary abciximab administration compared with intravenous (A-EV). Although the AIDA study showed no such benefit when analyzing the combined endpoints of death, reinfarction and congestive heart failure, it did show a decrease of CHF in isolation over the group receiving intracoronary abciximab. This time, the study authors of AIDA...
SWISS AMI: Stem cells infusion after primary angioplasty
The trial enrolled 200 patients post AMI treated with successful PCI, with LVEF ≤45% randomized to placebo, to receive early (before 7 days) or late (after 7 days) stem cells infusion. Primary end point was LVEF at 4 months. At follow up, stem cells infusion, both early and late, did not improve LVEF, compared to...
FAME 2: Cost-effectiveness of FFR-guided angioplasty in patients with stable angina
Introduction: FAME study 2, presented at the European Congress of Cardiology 2012, is a multicenter study that randomized patients with stable angina FFR-guided angioplasty and optimal medical therapy versus optimal medical therapy alone. The study was stopped early due to a significantly higher rate of primary endpoints, (death, MI, or urgent revascularization), in the conservative...
FREEDOM trial: CABG versus angioplasty treatment for diabetic patients with multivessel disease
The trial included 1,900 patients followed for at least 2 years, (mean 3.8 years), randomized 1:1 to pharmacological angioplasty stents, (sirolimus or paclitaxel at surgeon discretion), or CABG. We excluded acute coronary syndromes and left coronary trunk injury. The primary endpoint was death, myocardial infarction or stroke and the secondary main was the sum of...
CHAMPION PHOENIX: Cangrelor compared with clopidogrel improves efficiency without increasing bleeding in patients undergoing angioplasty
Background: Oral antiplatelet agents have a limitation in their duration of action and bioavailability. Cangrelor is an intravenous adenosine diphosphate (ADP) inhibitor that has a powerful effect, is rapid and reversible within one hour and with the advantage of intravenous administration that reduces variability in the bioavailability of the drug. The study was designed to...
SELECT ACS: The Inclacumab seems to reduce myocardial injury post angioplasty
P-selectin is an adhesion molecule involved in the interactions between endothelial cells, platelets and leukocytes. Inclacumab is a recombinant monoclonal antibody against P-selectin, a potential anti-inflammatory, anti-thrombotic and anti-atherogenic. The objective of the SELECT-ACS was to evaluate whether Inclacumab could reduce myocardial damage during percutaneous coronary intervention (PCI) in patients with non-ST elevation myocardial infarction...
MASS COMM: Elective angioplasty can be performed in hospital with or without emergency surgical support.
Increasingly, the frequent performances of elective angioplasties are in hospitals that do not have a cardiac surgery team. The occurrence for the need of emergency surgery varies from 0.1 to 0.4% in the contemporary age. There is an ongoing debate on health policy about whether to perform elective coronary angioplasty at hospitals without cardiac surgery...
STREAM trial: It is time to check out facilitated angioplasty?
It is not clear so far whether pre-hospital fibrinolysis with early angiography could provide a clinical outcome similar to primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). This study included 1,892 patients who presented within three hours of symptom onset and who could not undergo primary angioplasty within the first hour. Patients were...