1- What’s New in the European Guidelines on Peripheral Arterial Disease Since the last version of the European guidelines on the diagnosis and treatment of peripheral arterial disease in 2011, there have been many trials and registries that warrant guideline adjustments in many aspects. The first novelty is the teamwork that gave way to these...
The Most Important Articles of 2018 in Structural Heart Diseases
1- ESC 2018 | MITRA FR: Testing MitraClip for Secondary Mitral Regurgitation In secondary mitral regurgitation, mitral-valve leaflets and chordae are structurally normal and mitral regurgitation results from alterations in left ventricular geometry and function. Read more 2- TCT 2018 | COAPT: MitraClip in Patients with Secondary Mitral Regurgitation The prognosis of patients with...
In Diabetics with Multivessel Disease SYNTAX Score Calculations Are Redundant
In diabetic patients with multivessel disease, anatomical complexity assessed by SYNTAX score is an independent predictor of combined events only por PCI patients, and has absolutely no consequence for surgery. The score should not be used to decide on a revascularization strategy. If the patient is diabetic and has multivessel disease, they simply ought to...
Acute Coronary Syndromes After TAVR: Frequent and Not All Undergo Coronary Angiography
Approximately 10% of patients who undergo transcatheter aortic valve replacement (TAVR) are readmitted for an acute coronary syndrome after a mean follow-up of 25 months. Male sex, prior coronary artery disease, and (surprisingly and hard to explain) nontransfemoral approach were independent predictors of acute coronary syndrome after TAVR, an event associated with high midterm mortality. While...
Radial Access Is Always Preferred, Even for Treatment of the Left Main Coronary Artery
The potential need for a 7-Fr guidewire, the use of several coronary guidewires and/or a kissing balloon, and the requirement of indispensable monitoring by intravascular ultrasound (IVUS) have been used by some interventional cardiologists as excuses to resist radial access. In that sense, left main coronary artery angioplasty was the last stand of femoral access....
Predicting Coronary Angioplasty Benefits
Coronary angioplasty or percutaneous coronary intervention (PCI) reduces angina and improves quality of life in patients with stable ischemic cardiomyopathy, though the ORBITA study has shed new light on this. Meanwhile, we will assume this is indeed the case, until new studies either confirm or refute the above mentioned, controversial study. Either way, it is...
AHA 2018 | New Dyslipidemia Guidelines Support Non-Statin Therapy and Coronary Artery Calcium Screening
While the guidelines do not recommend a specific treatment target, they suggest additional therapy in high-risk patients with LDL 70 mg/dL or higher. These new guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) start recommending ezetimibe or PCSK9 inhibition in select high-risk patients and proposing noninvasive coronary artery calcium screening...
Complete Revascularization Improves Long-Term Prognosis in Acute Coronary Syndromes
Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty. This study, published online before...
What Should We Use for the Functional Assessment of Coronary Lesions in Severe Aortic Stenosis?
This systematic analysis measured intracoronary pressure in different phases of the cardiac cycle and flow velocity in patients with severe aortic stenosis and coronary artery disease, who were scheduled for transcatheter aortic valve replacement (TAVR). The aim was to determine the impact of aortic stenosis on: 1) flow, at different phases; 2) hyperemic coronary flow;...
TCT 2018 | CorMicA Trial: Coronary Function in Patients with Angina and Normal Coronary Arteries
Angina pectoris without stenosis in the epicardial coronary arteries is a common problem with several possible underlying causes. The main purpose of this work was to test the hypothesis that stratified medical therapy guided by an interventional diagnostic procedure might improve outcomes. Patients without coronary lesions and with angina were immediately randomized 1:1 to an...