cardiac surgery

Ticagrelor Monotherapy after 3 Months: Is the Current Strategy Worth Changing?

Dual antiplatelet therapy (DAPT) after PCI with DES has shown noticeable reduction of thrombotic events, especially in acute coronary syndromes (ACS). However, this therapy encompasses increased bleeding, especially in elderly patients increasingly undergoing percutaneous intervention. Even though most bleeding events might not be fatal (many of them are mostly digestive) they do involve higher hospitalization...

La FDA aprueba el ticagrelor en pacientes de alto riesgo como prevención primaria

Abbreviated DAPT in ACS: The End of Clopidogrel Monotherapy?

Compared with patients with chronic coronary syndromes, patients with acute coronary syndromes (ACS) are more likely to suffer from long term major adverse cardiac events (MACE). To prevent this, both the American and the European guidelines recommend prolonging dual antiplatelet therapy (DAPT) in this population for at least 12 months. However, in patients with certain clinical...

AHA 2021 | AVATAR: Early Intervention in Asymptomatic Aortic Stenosis

Early surgical aortic valve replacement (SAVR) in patients with severe asymptomatic aortic stenosis can be beneficial in selected patients vs. waiting for symptoms.  Severe AS in patients with no symptoms and conserved ventricular function raises few questions, clinically speaking. However, there is little evidence in favor of early intervention vs. close observation.  The best data...

revascularizacion incompleta en cirugia no cardiaca

Best Revascularization Strategy in Patients with Left Ventricular Deterioration

Multivessel disease associated to ventricular function deterioration is challenging in terms of risk, when choosing a revascularization strategy.  According to this recent analysis of the SCAAR registry published in the European Heart Journal, long term followup seems to justify taking a higher risk initially, higher risk being myocardial revascularization surgery (CABG). The study looked at...

EuroPCR 2021 | Un nuevo meta-análisis desafía al ISCHEMIA

EuroPCR 2021 | A New Meta-Analysis Challenges the ISCHEMIA Trial

This paper suggests that patients with stable coronary artery disease who undergo elective coronary revascularization find a long-term benefit in terms of cardiac death compared with patients who receive medical treatment alone. These findings, presented at EuroPCR 2021 and simultaneously published in the European Heart Journal, challenge the results from the ISCHEMIA trial. Researchers state...

ACC 2021 | Cirugía de emergencia en el infarto: beneficios a pesar del alto riesgo

ACC 2021 | Emergent CABG for acute MI: Benefits Despite Risk

The latest figures show a lower number of emergency CABG for acute MI, and in turn increased primary PCI.  The combination of surgeons not willing to take risks and interventional cardiologists empowered to treat practically any lesion has resulted in fewer patients receiving emergency CABG. Only a few years ago, interventional cardiologists at least had...

Ischemia

ISCHEMIA: New Analysis Might Change Study Outcome Interpretation

A new ISCHEMIA analysis has shown its outcomes are highly dependent on MI definition. The original conclusion had shown a significant difference between invasive and conservative strategies using the most sensible definition of MI: troponin elevation.  When looking at events using MI definition as troponin elevation, we will see the conservative treatment reduces primary end...

Nuevas guías de valvulopatías con actualizaciones clave en TAVI e insuficiencia mitral

New Valvular Heart Disease Guidelines with Key TAVI and Mitral Regurgitation Updates

Valvular heart disease management guidelines were updated last week by the AHA and the ACC.  The last complete version had been published in 2014; therefore many of its recommendations have become obsolete before the latest evidence.  The studies that made the FDA approve TAVI for low-risk patients are probably the most important incorporations. They also...

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