Nowadays, evidence from studies and meta-analyses has demonstrated the benefits of complete revascularization compared to culprit-vessel-only revascularization in patients with acute myocardial infarction (AMI). The identification and treatment of non-culprit lesions can be guided by conventional angiography, intracoronary imaging, or coronary physiology; the optimal modality, however, is still unclear. Quantitative flow ratio (QFR) is a...
Coronary artery disease is common among patients considered for transcatheter aortic valve implantation (TAVI). With the expansion of the indication for TAVI to a population with lower surgical risk, and therefore younger, there has been a gradual increase in the incidence of coronary events. However, there is limited data on treatment strategy and outcomes in...
Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX...
Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery....
The population over 75 is growing gradually, which entails an increase in acute myocardial infarction (AMI) in this group. As we all know, it is fairly common for AMI to present with multivessel disease. It has been shown that younger patients will benefit from complete revascularization vs. a simple resolution of the culprit vessel. However,...
In the early days of percutaneous coronary intervention (PCI) in patients with ST elevation acute myocardial infarction (STEMI), no reflow phenomenon was known as an indicator of the worst possible outcomes in terms of left ventricular remodeling, infarct size, ejection fraction and mortality, at long term. The TOTAL study (Routine Aspiration Thrombectomy with PCI Versus...
With an approximate incidence of 0.05% to 0.25%, post-acute myocardial infarction (AMI) mitral valve failure caused by papillary muscle rupture is not exactly common. However, it is associated to high mortality rate, ranging between 36% and 80%. Current guidelines recommend surgical treatment, but more often than not surgery involves prohibitive or extremely high risk, with...
Aortic stenosis (AS) is a common condition that shares risk factors with coronary artery disease. Many patients can suffer from both diseases simultaneously, something that increases the risk of acute myocardial infarction in the presence of aortic stenosis. AS can cause ischemia even in the absence of coronary artery disease, due to ventricular hypertrophy, increased...
Despite major advances in secondary prevention and reperfusion strategies, acute myocardial infarction (AMI) still causes morbidity and mortality. A significant portion of acute events arise from mild to moderate lesions identified months to years before the index event. Early detection of lesions at higher risk of progression and rupture may allow for more targeted treatment...
Many randomized studies and systematic revisions have shown that an early invasive approach (within 24hrs. after diagnosis) will not reduce mortality across the non-ST elevation acute coronary syndrome (NST-ACS) population, hence the relevance of NST-ACS; patients with a GRACE score higher than 140 were the ones showing improved outcomes. Roughly 40% of NST-ACS patients have...