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,...
Cardiogenic shock (CS) represents the main cause of death in patients hospitalized for acute myocardial infarction (AMI). Despite advances in its management, mortality continues to be high, between 40-50% within the first 30 days. In an attempt to improve survival, early extracorporeal life support (ECLS) is being increasingly used to stabilized hemodynamics in cases of...
Short Dual antiplatelet therapy (DAPT), one to three months, followed by P2Y12 inhibitor monotherapy has been shown to reduce bleeding events without increased cardiovascular events vs. standard DAPT, according to guidelines. However, the rate of major bleeding within the first month after procedure remains significant when using these strategies. The use of aspirin-free therapies (ASA)...
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...
Dual antiplatelet therapy (DAPT) is the current standard for preventing thrombotic events in high-risk patients with coronary artery disease, as well as in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). However, this approach increases the risk of bleeding. To reduce this risk, there have been studies that discontinued the use of...
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 clinical importance of severe tricuspid regurgitation (TR) has been underestimated for many years now. However, studies and registries have shown that, when left untreated, this pathology significantly increases morbidity and mortality. Patients in need of treatment are often older individuals with higher surgical risk due to the prevalence of this condition. Contemporary data has...
The second day of the SOLACI/SBHCI 2023 Congress, the largest interventional cardiology meeting in Latin America, organized by the Latin American Society of Interventional Cardiology (SOLACI) and the Brazilian Society of Hemodynamics and Interventional Cardiology (SBHCI), held in Rio de Janeiro, featured various national and international guests, along with important sessions on the main topics...
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...