The goal of this study was to assess all available revascularization strategies for patients undergoing ST elevation acute myocardial infarction and multivessel disease. Among the strategies to treat this group of patients, there were: culprit vessel intervention only, culprit vessel intervention and, in case of success, multivessel intervention, culprit vessel intervention with staged revascularization,...
ACS and Multivessel Disease: How to proceed
Gentileza del Dr. Javier Castro In the daily practice, a high percentage of ST elevation myocardial infarction patients (STEMI) present multivessel disease (40-65%). This group of patients presents worse clinical evolution and higher mortality than patients with one culprit lesion. When PCI is indicated to a patient with significant lesions in more than...
Surgery vs. PCI in Diabetic Patients with Multivessel Disease
Original Title: Revascularization in diabetics with multivessel disease: a population-based evaluation of outcomes. Presenter: Ramanathan K. Real-world data support the role of CABG over PCI in diabetic patients with multivessel disease. However, PCI continues to be a common option for this patient population, according to an analysis of 2 Canadian registries. Sourcing data from 2...
FREEDOM trial: CABG versus angioplasty treatment for diabetic patients with multivessel disease
The trial included 1,900 patients followed for at least 2 years, (mean 3.8 years), randomized 1:1 to pharmacological angioplasty stents, (sirolimus or paclitaxel at surgeon discretion), or CABG. We excluded acute coronary syndromes and left coronary trunk injury. The primary endpoint was death, myocardial infarction or stroke and the secondary main was the sum of...
Is the 2nd generation DES an alternative to surgery in multivessel coronary disease?
The benefits of 2nd generation drug-eluting stents (DES) are being compared with Coronary artery bypass graft surgery (CABG), looking to achieve a safe, effective, less invasive and as complete as possible revascularization. As background of SYNTAX, the stent thrombosis (ST) with Taxus, reached 25% of the events in the group of intervention (PCI), so that...
Diabetics with multivessel, must keep waiting.
Original title: Strategies for Multivessel Revascularization in Patients with Diabetes. The FREEDOM Trial. Reference: Michael E. Farkouh et al. N Engl J Med 2012. DOI: 10.1056/NEJMoa1211585 This study was designed to determine the best revascularization strategy in diabetic patients with multivessel using current techniques of angioplasty (PCI) and surgery (CABG). Randomized 1:1 diabetic patients with injuries > 70%...
Global Risk Score for stratification of patients with multivessel coronary artery disease: A wider look
Reference: Serruys et al J Am Coll Cardiol Intv 2012;5:606–17 SYNTAX Analysis study demonstrates the utility of a new risk score for patients stratification with left main coronary artery or multivessel disease. Numerous studies have demonstrated the value of SYNTAX score to stratify risk of angioplasty and decision-making (angioplasty versus surgery) in patients with multivessel...
ACC 2024 | DanGer-Shock Trial
Cardiogenic shock will develop in approximately 10% of patients with ST elevated acute MI (STEMI), and unfortunately, only half of these patients will survive. Researchers have been looking into the Impella system to manage this severe complication. It consists of an aortic transvalvular pump designed to deliver blood from the left ventricle into the systemic...
Interventional Cardiology: The Most Read Articles of 2023
Discover the most read scientific articles on interventional cardiology of 2022 in our website. No Reflow after Primary PCI in STEMI: An Angiographic Analysis of the TOTAL Study 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...
Is Complete Revascularization Really Necessary after AMI in the Elderly?
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,...