Indicating statins to reach more aggressive LDL goals in patients that have suffered transient ischemic attack or ischemic stroke driven by atherosclerosis significantly reduces major cardiovascular events according to this study presented in the AHA 2019 scientific sessions simultaneously published in NEJM. The study was prematurely ended because of lack of funding, but its outcomes...
This new review, recently published in BMJ, questions the benefit of statins in low-risk primary prevention patients. Authors argue that statins should be more cautiously indicated in primary prevention, considering that their absolute benefit is almost marginal in low-risk patients. Changes in the European guidelines have translated into a wide expansion of patients eligible for...
While the guidelines do not recommend a specific treatment target, they suggest additional therapy in high-risk patients with LDL 70 mg/dL or higher. These new guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) start recommending ezetimibe or PCSK9 inhibition in select high-risk patients and proposing noninvasive coronary artery calcium screening...
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...
The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors...
Peripheral vascular diseases affect over 20% of the population and can affect up to 30% of people with cardiovascular risk factors. The most important treatment points include modification of risk factors, exercise, optimal medical treatment, and timely revascularization. Given its lower risk of peri-procedural complications (when compared to surgery), endovascular therapy is generally the first...
Recent randomized studies have shown that the rates of combined peri-procedural events for carotid artery stenting and carotid endarterectomy are similar. While the final numbers are similar, the actual events are different: more infarction events for endarterectomy and more stroke (particularly minor stroke) events for carotid artery stenting. The reduction of these rates of stroke has been the aim of...
The use of non-invasive imaging can identify or rule out subclinical atheromatosis and help reduce the number of elderly patients unnecessarily treated with statins without increasing the risk of cardiovascular events. Using calcium score and carotid ECG to find elderly patients without atheromatosis helps to safely avoid the use of statins with no clinical...
All studies on diabetics have shown these patients have higher risk rates of thrombotic events. This study sought to determine the optimal antiaggregation therapy with ticagrelor to prevent thrombotic events in diabetic patients with prior MI. The study analyzed diabetic patient and non-diabetic patient subgroups (n=6806 and n=14355, respectively) from the PEGASUS–TIMI 54...