Symptomatic patients undergoing PCI with no residual ischemia confirmed by iFR have superior symptom improvement at one year vs. patients who did not receive the optimization. In addition to symptoms, patients receiving iFR optimization (final value ≥ 0.95) presented lower cardiac mortality, spontaneous MI or clinically justified revascularization vs. patients with <0.95 final value. ...
TCT 2020 | The Myth of Biodegradable Polymers Seems to Have Come to an End
This is the largest and newest study to compare drug eluting stents with durable polymers vs. biodegradable or bioresorbable polymers. As is usually the case, the theory clashes with reality. The study has shown that the polymer does not seem to play an important role in the performance of drug eluting stents, or at least...
TCT 2020 | Crushed Prasugrel Administration prior PCI
Prehospital administration of crushed tablets of prasugrel loading dose in the ambulance while patient is on his way to primary PCI does not improve reperfusion markers compared against uncrushed tablet administration according to the COMPARE CRUSH, presented at the virtual TCT 2020 and simultaneously published in Circulation. There were no differences in TIMI flow of...
TCT 2020 | Prophylactic Angioplasty for Vulnerable Plaques
Patients with vulnerable plaque identified by means of intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) are at a significantly increased risk of adverse cardiovascular events. Revascularization of these vulnerable lesions could prevent clinical events. That is the theory behind prophylactic angioplasty, which still needs to be proven in clinical practice. The PROSPECT ABSORB study, nested...
Not All Coronary Spasms Are the Same: Benefits of Acetylcholine
Patients with documented spasm to the coronary arteries present increased risk of myocardial infarction (MI) and repeat angiography, while patients with microvascular spasm are associated to recurrent angina. Globally, the prognosis of all these patients continues to be favourable, even though acetylcholine testing might help distinguish one-another. Coronary spasm shows in up to 60% of...
Computerized Tomography as First Coronary Study?
According to this new document recently published in JACC, a computerized tomography (CT) coronary angiography should be the first study done to diagnose a stable coronary artery disease. A multidisciplinary group of experts recommends using computerized tomography as first-line diagnosis in stable patients. According to these professionals, guidelines should be updated soon. Given the accruing...
The Most Read Scientific Articles of July in Interventional Cardiology
01- SOLACI PERIPHERAL | 2nd Clinical Case: Juxtarenal Abdominal Aortic Aneurysm SOLACI’s Department of Peripheral Endovascular Interventions brings a new challenging clinical case for the whole Latin American medical community so as to continue fostering and sharing scientific knowledge and experience among peers. Read more HERE 02- EuroPCR 2020 | A Trick to Find the Perfect...
Differences in Plaque Progression Depending on its Characteristics
The pattern of growth for each plaque differs according to the presence of certain risk factors. Atheroma volume at baseline was the most important predictor of plaque developing into obstructive lesions, as opposed to other characteristics historically considered as “dangerous.” The aim of this study was to analyze whether the pattern of non-obstructive lesion progression...
EuroPCR 2020 | FABOLUS FASTER: In the Quest for the Fastest, Most Potent Platelet Inhibition
This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor...
Compare-Acute Sub-Study: Natural History of Non-Culprit Lesions in MI
The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients. We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically. The treating...