Defining dual antiplatelet therapy (DAPT) seems a never-ending story. We go from trials showing the safety of shorter schemes thanks to new generation stents to others suggesting up to two years of DAPT. Rather than finding a general scheme, it seems to be about adjusting DAPT on a case by case basis, according to ischemia<a href="https://solaci.org/en/2018/09/06/antiaggregation-time-after-treating-bifurcations/" title="Read more" >...</a>
As regards the use of antithrombotic agents, the risk of bleeding will always be an issue, and in the case of aspirin this risk is twice as big: it does have the desired antiaggregation effect, but on top of the increased bleeding risk, it has a damaging effect on stomach lining that increases the risk<a href="https://solaci.org/en/2018/07/25/can-we-prevent-cardiovascular-events-without-aspirin/" title="Read more" >...</a>
Is it possible for a soccer match to trigger an infarction? Is it possible for the stress derived from watching our national team play to trigger a cardiovascular event? Many might think that these are exaggerations. However, not only is it possible, but it has been proved beyond the shadow of a doubt for some<a href="https://solaci.org/en/2018/06/28/cardiovascular-events-during-world-cup-soccer-an-old-article-worth-remembering/" title="Read more" >...</a>
In the daily practice and in randomized studies such as Syntax or Freedom, most cardiovascular surgeons across the world use angiography guided CABG to teat 50% coronary stenosis. Many of these lesions might not be functionally significant. There is abundant evidence in favor of fractional flow reserve (FFR) guided PCI, but FFR guided CABG is<a href="https://solaci.org/en/2018/06/27/ffr-vs-angiography-guided-cabg/" title="Read more" >...</a>
Courtesy of Dr. Alejandro Lakowsky, MTSAC (Full Member of the Argentine Society of Cardiology) The New England Journal of Medicine (NEJM) recently published an article about the POINT trial (simultaneously presented at the European Stroke Organisation Conference), a long-awaited randomized clinical trial to assess the efficacy and safety of dual antiplatelet therapy (DAPT) with aspirin<a href="https://solaci.org/en/2018/06/06/what-antiplatelet-therapy-should-we-use-in-patients-with-stroke-tia-interesting-results-for-the-point-trial/" title="Read more" >...</a>
Patients undergoing acute coronary syndrome (ACS) loaded with a high dose of statins prior diagnostic catheterization do not seem to benefit from this strategy. However, when looking at those undergoing PCI alone (excluding all patients who had received surgery or medical treatment), the benefit appears as a reduction of combined major events. The benefit of atorvastatin loading<a href="https://solaci.org/en/2018/04/09/acc-2018-secure-pci-high-dose-of-statins-pior-pci-could-help/" title="Read more" >...</a>
This study compared 6 vs 12 or more months of dual antiplatelet therapy (DAPT) in patients undergoing acute coronary syndrome (ACS) receiving contemporary DES, and it did not find differences in combined endpoint. However, looking at primary endpoint components separately, there were more infarctions in patients with a short DAPT scheme that we cannot ignore. Prolonging antiaggregation<a href="https://solaci.org/en/2018/04/08/acc-2018-smart-date-6-month-dapt-results-suboptimal-in-acs/" title="Read more" >...</a>
At 5 years, there were no differences in all-cause death, stroke, acute myocardial infarction, or all of these combined between low-risk, elderly patients who underwent transcatheter aortic valve replacement (TAVR) or conventional surgery. Taking into account reports from previous years, these results are not at all surprising. NOTION enrolled an all-comers population that was 70 years old<a href="https://solaci.org/en/2018/04/04/notion-5-year-outcomes-of-tavr-vs-surgery-in-low-risk-patients-are-promising/" title="Read more" >...</a>
Both prasugrel and ticagrelor showed superiority in terms of efficacy, reducing the number of major cardiovascular events at the expense of increased bleeding. This is an affordable cost, and the net clinical benefit supports these new antiplatelet therapies. The one-year follow-up of the PRAGUE-18 study focused on a comparison of efficacy and safety between prasugrel<a href="https://solaci.org/en/2018/03/07/what-is-the-best-antiplatelet-therapy-in-primary-angioplasty-at-12-months/" title="Read more" >...</a>
The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. The article features 10 points resembling the ten commandments, which makes it easy to read, compared to the tedious task of reading the complete guidelines. 1) The emergency systems should help<a href="https://solaci.org/en/2018/01/30/the-10-commandments-of-escs-new-stemi-guidelines/" title="Read more" >...</a>