What triggered this study was a long unanswered question: should patients successfully resuscitated from an out-of-hospital cardiac arrest presenting a non-STEMI ECG be immediately taken to the cath lab? In response to this question the TOMAHAWK randomized 554 out-of-hospital resuscitated patients without electrocardiographic evidence of ST-segment elevation patients to immediate angiography (n=281) vs intensive care...
The ACST-2 was designed to compare long-term outcomes of carotid artery stenting (CAS) vs carotid endarterectomy (CEA) in patients with asymptomatic stenosis. Prior to this study we had the German registry including 18,000 patients undergoing CAS and 86,000 receiving CEA between 2014 and 2019. At 30 days, disabling stroke rate was 0.7% for both strategies....
De-escalating dual antiaggregation could be the most effective strategy after acute coronary syndrome seeing as it prevents bleeding and cut down costs with no increase of ischemic events. Balancing the effects of dual antiaggregation therapy (DAPT) in the era of potent P2Y12 inhibitors has become the cornerstone of acute coronary syndrome (ACS) management. This meta-analysis...
A week brimming with educational proposals for the Latin American interventionist community is only 4 days away! At SOLACI-CACI 21 we will have 2 rooms with simultaneous scientific activities, an interactive panel with On Demand videos, a panel with more than 200 E-posters, and a commercial exhibit with the most important companies in the medical...
Polypharmacy is certainly a problem in the elderly population. Forgetfulness, and drug and dose confusion can lead to multiple problems; in addition, over time, cognitive deterioration will make complicated drug management schemes even more difficult for patients to handle. Aware of this problem, physicians often try to simplify schemes by discontinuing drugs, but what should...
All the controlled randomized evidence recently published called for an updated document on antithrombotic management in transcatheter aortic valve replacement (TAVR). While thrombotic and hemorrhagic complications have diminished over time—as both the technique and the devices have been perfected—, they still remain as common adverse events in TAVR. Recommendations in the 2017 European Guidelines were...
Aspirin monotherapy (ASA) reduced the combined risk of thrombotic and bleeding events compared against dual antiplatelet therapy (DAPT) in patients receiving transcatheter aortic valve replacement (TAVR). This meta-analysis has only reproduced smaller randomize study outcomes and does not include the OCEAN-TAVI registry, the only one that has shown something different so far. Even though ASA...
Patients who undergo myocardial revascularization surgery and are discharged on dual antiplatelet therapy (DAPT)—aspirin plus clopidogrel—have a lower risk of major cardiovascular and cerebral events than patients on aspirin monotherapy. Furthermore, the risk of bleeding is not increased for those receiving DAPT. This information comes from a registry of over 18,000 patients recently published in the...
One month ago we shared a meta-analysis stating aspirin (ASA) as the best antiplatelet following TAVR vs. 3 to 6 dual antiplatelet therapy suggested by guidelines. At that time, guideline recommendations appeared obsolete. Several studies had started to support ASA monotherapy as the best antiaggregation scheme after TAVR. However, in the light of this new...
Promising fast subcutaneous administration and a quick and potent antiplatelet effect, here comes a novel glycoprotein IIb/IIa inhibitor called RUC-4. This novel drug was tested in the CELEBRATE-02 study, presented at EuroPCR 2021 and simultaneously published in EuroIntervention. The mean platelet inhibition begins 15 minutes after injection and increases with each of the three tested doses...