The impact of diabetes in patients with coronary artery disease (CAD) are well known, and after percutaneous coronary intervention (PCI), outcomes tend to be less favorable, with higher restenosis rate, repeat myocardial infarction (MI) and stent thrombosis. Despite the development of drug eluting stents, procedures and techniques, treating bifurcation lesions in diabetic patients still show...
For many years, percutaneous transluminal coronary angioplasty (PCTA) has expanded significantly worldwide. However, despite the demonstrated advantages of intravascular ultrasound (IVUS) in terms of minimal luminal area, reduced cardiovascular events, and restenosis, its use is not very common due to various reasons. On the other hand, optical coherence tomography (OCT) offers even higher resolution than...
Researchers conducted a randomized study involving 827 patients who experienced out-of-hospital cardiac arrest without ST-segment elevation myocardial infarction, and then underwent percutaneous coronary intervention. In this group, 414 patients were transferred to a specialized cardiac arrest center (CAC), while 413 were taken to the geographically closest hospital (closest emergency department, CED). The primary endpoint (PEP)...
The empirical prescription of anticoagulants after percutaneous coronary intervention (PCI), also know as post-procedural anticoagulation (PPA), is nowadays a common practice that uses various types of medications. Despite studies like HORIZONS-AMI and EUROMAX, in which 41% of patients received PPA, and the CCC-ACS registry, where 75% of subjects received PPA after primary PCI, European and...
An increasing number of patients currently present both an elevated ischemic risk and hemorrhagic risk. This means that the selection of the optimal antiplatelet treatment is a clinical challenge. Several studies have shown that P2Y12 monotherapy after minimum dual antiplatelet therapy (DAPT) is a novel strategy to reduce bleeding risk without increasing ischemic risk. Furthermore,...
The OCTOBER Study randomized 1201 patients with bifurcation lesions in a 1:1 ratio to undergo percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) or by angiography. The primary endpoint (PEP) was major adverse cardiovascular events (MACE) over a 2-year period. Group characteristics were similar. The average patient age was 66 years, most...
The use of intravascular ultrasound (IVUS) to guide percutaneous coronary interventions (PCI) has been shown to reduce the risk of major adverse cardiovascular events (MACE) across controlled randomized studies, registries and meta-analysis. Current guidelines recommend the use of IVUS in left main disease and complex lesions. As the prevalence of complex PCI increases over time,...
The proportion of patients undergoing high risk PCI (HRPCI) is on the rise. It includes patients with different clinical, anatomical and procedural characteristics, such as low ejection fraction, severe vascular disease, three vessel or left main disease, severe lesion calcification and the use of atherectomy. Mechanical circulatory support devices (MCS) during HRPCI, such as the...
Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical...
Reduced dosage of tenecteplase in elderly patients undergoing a pharmaco-invasive strategy. Delays in achieving timely reperfusion in patients with acute coronary syndrome with ST elevation (STEACS), whether through fibrinolysis or primary percutaneous coronary intervention (PCI), are associated with increased mortality. European guidelines establish a target reperfusion time of 120 minutes after the first medical contact...