Aspirin increases bleeding with no ischemic benefit, but a trend toward more stent thrombosis with placebo warrants further studies. Patients with atrial fibrillation who receive an anticoagulant agent and coronary angioplasty with a stent, and then continue with aspirin, experience an increased risk of bleeding without any ischemic benefit whatsoever. The use of a...
These guidelines basically remind us that we should focus on life style changes to best prevent heart disease, heart failure and atrial fibrillation. These changes, of course, should be permanent. It is estimated that life style changes translate into 80% risk reduction of heart disease. These recommendations are based on 9 topics: risk estimation,...
The new European guidelines on myocardial revascularization were developed by a joint effort of the European Society of Cardiology (ESC) and the European Association of Cardiovascular Surgery (EACTS). These guidelines are intended to support clinical practice with pragmatic recommendations based on currently available evidence and on personal experience, whenever evidence is missing. Both coronary angioplasty...
1- New High Blood Pressure Guidelines The wait is finally over: the high blood pressure guidelines that have been in the works for the past 3 years saw the light of day at the American Heart Association (AHA) 2017 Scientific Sessions. Read more 2- The 10 Commandments of ESC’s New STEMI Guidelines The authors...
Courtesy of Dr. Carlos Fava. PCI to saphenous vein grafts is one the greatest challenges these days because, as opposed to native arteries, they present important thrombolytic material, diffuse and long lesions, and abundant macrophage and inflammatory cells, which makes the procedure more complex. At present, we have not yet agreed on the best antiplatelet...
We often inform our patients we should first approach the superficial femoral with an endovascular intervention, and that should it fail or develop restenosis, we could always resort to a bypass. We were not lying when we’d assume a bypass following endovascular intervention would have the same outcome as a primary bypass. Simply put, no...
After rechanneling occluded superficial femoro-popliteal arteries, interventional physicians are left with the question of how to proceed with infrapopliteal disease. This work (soon to be published in Eur J Vasc Endovasc Surg) shows us the importance of achieving patency in tibial arteries so as to obtain better mid-term outcomes. The gist is that, after an...
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...
Hopes were raised high by the ARTS study, when set to show the benefit of bilateral internal mammary arteries (BIMA) during coronary artery bypass graft surgery compared over the use of a single internal mammary artery (SIMA) at 10 year follow up, but only one sub-study was able to show an advantage over radial grafts....
According to this new work (soon to be published in Ann Thorac Surg), discharging a patient during the weekend or a holiday after cardiac surgery is not associated with higher rates of readmission compared with patients discharged during weekdays. A total of 4877 patients were discharged after cardiac surgery in high-volume sites in the United States. Among them,...