The aim of this study was to evaluate if the residual thrombus burden after aspiration thrombectomy may affect the outcome of primary angioplasty in patients with acute coronary syndrome with ST-segment elevation. The most recent studies on aspiration thrombectomy failed to show clinical benefit in patients with ST-segment elevation. This study is based on...
The choice of prasugrel or ticagrelor for patients with acute myocardial infarction undergoing primary angioplasty makes no difference, at least in the short term. This study was terminated prematurely and thus lost statistical power, which means that any interpretation of the lack of difference between the two antiplatelet drugs must take into account such...
The aim of this study was to compare the usefulness of primary angioplasty only to culprit vessel versus complete revascularization guided by fractional flow reserve (FFR) in patients admitted pursuing an acute myocardial infarction with ST-segment elevation and have multiple injuries vessels. After a successful primary angioplasty to culprit artery, patients were randomized 1:1 to...
In patients undergoing ST segment elevation myocardial infarction (STEMI) who received primary angioplasty, the strategy of manual thromboaspiration routine does not reduce the risk of cardiovascular death, recurrent infarction, or cardiogenic shock within 180 days compared with standard primary angioplasty with thromboaspiration only if necessary. This work was published simultaneously in The New England Journal...
Prospective, multicenter, randomized, double-blind study evaluated intravenous infusion of TRO40303 versus placebo administered immediately before balloon dilation of the culprit artery during primary angioplasty. Infarct size was evaluated using the CK Mb levels and troponin together with magnetic resonance imaging. 163 patients were included; no significant differences were observed in the area under the curve...
The HORIZONS-AMI and EUROMAX studies, had already shown that bivalirudin is superior to heparin plus inhibitors IIB / IIIA glycoprotein in reducing adverse clinical events in patients suffering an ST-segment elevation myocardial infarction undergoing primary angioplasty, at the expense of increase in the rate of acute stent thrombosis. This study included 2194 patients undergoing an...
There are clinics hypothesis that systemic hypothermia (≤34.9) could reduce infarct size if set before reperfusion. Peritoneal lavage had a well-established safety profile and given the large surface area of the bowel may cause rapid hypothermia reducing infarct size. The aim of this study was to evaluate the safety and efficacy of hypothermia induced by...
This study included 201 patients suffering ST-segment elevation acute coronary syndrome and randomized to the use of optical coherence tomography (OCT) versus conventional angiography for the procedure. OCT-guided group used more stents per patient (1.4 versus 1.2, p = 0.03) and greater release pressure. During control OCT suboptimal results were found in a third of...
This work aimed to evaluate the use of optical coherence tomography (OCT) to guide the drug-eluting stent implantation during primary angioplasty. 201 patients experiencing STEMI to use or not OCT during primary angioplasty were randomized. The clinical and angiographic characteristics were well balanced, and no differences in MACE, cardiac death, TLR, or stent thrombosis at...
There are experimental studies suggesting that metformin admin before and during ischemia and reperfusion could help to preserve left ventricular function regardless of glycometabolic state.In observational studies, the concomitant use of metformin is associated with a lower peak CK MB and troponin.380 nondiabetic patients undergoing primary angioplasty for acute coronary syndrome study with ST segment...