What to Do and What Not to Do in Case of PE According to the New European Guidelines

As a “friendly,” easy-to-read document, the new European guidelines on pulmonary embolism (PE) include an excellent summary chart with new and modified items (compared with the 2014 guidelines), and also some sort of final conclusion composed of crucial tips and contraindications that come in handy in case of emergency. Diagnosis stage In suspected high-risk PE,<a href="https://solaci.org/en/2020/03/04/what-to-do-and-what-not-to-do-in-case-of-pe-according-to-the-new-european-guidelines/" title="Read more" >...</a>

La complejidad de la angioplastia puede definir el tiempo de doble antiagregación

Ticagrelor Monotherapy One Month After DES Implantation

The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required<a href="https://solaci.org/en/2020/01/13/ticagrelor-monotherapy-one-month-after-des-implantation/" title="Read more" >...</a>

We Should Indicate More than 6 Months of DAPT in Lower Limb Disease

Courtesy of Dr. Carlos Fava. Advanced peripheral vascular disease is frequently associated with cardiovascular events and amputation. It has been proven that mono-antiplatelet therapy (MAPT) offers some benefit (with either aspirin or clopidogrel), but there are scarce data on the role of dual antiplatelet therapy (DAPT) in these patients. Researchers analyzed 404 patients who received MAPT for<a href="https://solaci.org/en/2020/01/07/we-should-indicate-more-than-6-months-of-dapt-in-lower-limb-disease/" title="Read more" >...</a>

Pretratamiento con estatinas para prevenir eventos peri angioplastia carotidea

Secondary Prevention: A Responsibility We Should Not Delegate

After coronary angioplasty, the use of drugs whose efficacy for the reduction of major events has been proven declines over time, which is associated with worse patient prognosis. Sometimes, without meaning to, we convey to patients the idea that, once the stent has been implanted, the artery is “cured” or that the only potential future<a href="https://solaci.org/en/2019/12/26/secondary-prevention-a-responsibility-we-should-not-delegate/" title="Read more" >...</a>

AHA 2019 | COMPLETE: la revascularización completa es superior por tratar otras placas vulnerables

AHA 2019 | COMPLETE: Complete Revascularization Is Superior since It Treats Other Vulnerable Plaque

This COMPLETE sub-study using optical coherence tomography (OCT) showed the prevalence of vulnerable lesions other than the culprit which should provide a physiopathological explanation of the benefit of complete revascularization observed in the original study.  STEMI patients with multivessel disease will benefit from complete revascularization in terms of reduced cardiovascular death and repeat MI according<a href="https://solaci.org/en/2019/11/27/aha-2019-complete-complete-revascularization-is-superior-since-it-treats-other-vulnerable-plaque/" title="Read more" >...</a>

AHA 2019 | Sapien vs Evolut: A Head-to-Head Study Seems Mandatory

Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality.  The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both<a href="https://solaci.org/en/2019/11/27/aha-2019-sapien-vs-evolut-a-head-to-head-study-seems-mandatory/" title="Read more" >...</a>

Treat Stroke to Target: terapia agresiva con estatinas post stroke

AHA 2019 | Treat Stroke to Target: Post-Stroke Aggressive Therapy with Statins

Indicating statins to reach more aggressive LDL goals in patients that have suffered transient ischemic attack or ischemic stroke driven by atherosclerosis significantly reduces major cardiovascular events according to this study presented in the AHA 2019 scientific sessions simultaneously published in NEJM. The study was prematurely ended because of lack of funding, but its outcomes<a href="https://solaci.org/en/2019/11/26/aha-2019-treat-stroke-to-target-post-stroke-aggressive-therapy-with-statins/" title="Read more" >...</a>

AHA 2019 | GALILEO-4D: rivaroxabán y prevención de engrosamiento y trombosis de las valvas post TAVI

AHA 2019 | GALILEO: Rivaroxaban After TAVI, Another Nice Theory that Clashes with Reality

In patients without formal indication for oral anticoagulation after successful transcatheter aortic valve implantation (TAVI), a treatment strategy including rivaroxaban 10 mg daily was associated with a higher risk of death or thromboembolic complications and, on top of that, a higher risk of bleeding than a conventional antiplatelet strategy. So far, we did not know whether<a href="https://solaci.org/en/2019/11/21/aha-2019-galileo-rivaroxaban-after-tavi-another-nice-theory-that-clashes-with-reality/" title="Read more" >...</a>

AHA 2019 | DAPA-HF: la dapagliflozina efectiva en todos los subgrupos con insuficiencia cardíaca

AHA 2019 | DAPA-HF: Dapagliflozin Effective for all Heart Failure Subgroups

SGLT2 inhibitor dapagliflozin had a consistent impact regardless of glycemic level, age, or general health status. Dapagliflozin was originally developed for the treatment of type 2 diabetes. However, it has had a positive impact on various types of patients with chronic heart failure and reduced ejection fraction, including those without diabetes. This information is derived from<a href="https://solaci.org/en/2019/11/21/aha-2019-dapa-hf-dapagliflozin-effective-for-all-heart-failure-subgroups/" title="Read more" >...</a>

AHA 2019 | GALILEO-4D: Rivaroxaban in the Prevention of Post TAVR Valve Thickening and Thrombosis

This sub study of the GALILEO specifically looked at valve thickening and reduced leaflet motion after TAVR documented with 4D CT. Whether anticoagulation with rivaroxaban might reduce or prevent this phenomenon remained unanswered. Patients receiving the same anticoagulation scheme than the general study’s (rivaroxaban + aspirin vs. aspirin + clopidogrel) were assessed by 4D CT<a href="https://solaci.org/en/2019/11/20/aha-2019-galileo-4d-rivaroxaban-in-the-prevention-of-post-tavr-valve-thickening-and-thrombosis/" title="Read more" >...</a>