While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when...
The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to...
In patients with stable chronic angina, percutaneous coronary intervention (PCI) is often conducted to relieve symptoms. However, there is still some uncertainty regarding whether PCI provides superior symptomatic relief compared with a placebo in patients not receiving anti-anginal medication. Researchers conducted a controlled and randomized study in which patients with stable angina discontinued all anti-anginal...
The impact of diabetes on the development of cardiovascular disease is widely known, with a strong association with extensive and diffuse coronary artery disease. Decision-making regarding how to revascularize patients with multi-vessel disease is a complex process. In this context, coronary artery bypass grafting (CABG) has been recommended over percutaneous coronary intervention (PCI) based on...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access is not successful. The use of ultrasound (US) to guide access has emerged as a technique that allows for precise cannulation, avoiding accesses above and below the inguinal ligament. However, evidence regarding the effectiveness of this tool has shown variable results. Two...
According to several studies, in patients with high-risk atherosclerotic disease, such as those affected by coronary artery disease, achieving target LDL levels through high-intensity statin therapy has been shown to lead to a significant reduction in long-term cardiovascular events. Therefore, the management of dyslipidemia has become a fundamental pillar of secondary prevention. However, reaching such...
Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX...
Chronic coronary syndrome (CCS) has been considered another comorbidity in previous studies, and there has been no significant reduction in cardiovascular mortality or myocardial infarction (MI) rates with revascularization through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS) compared with optimal medical treatment (OMT). One possible reason for the lack of benefit has been...
The preference for the use of potent P2Y12 inhibitors such as ticagrelor and prasugrel in patients with high risk of acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is based on randomized studies and current guideline recommendations. However, clopidogrel is still recommended for patients at high risk of bleeding. Several strategies have been looked...
Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery....