Ticagrelor might be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients admitted for acute cerebral ischemia. This double-blind, controlled trial randomized 13,199 patients from 33 countries. Subjects presented a non-severe stroke or a high-risk transient ischemic attack (TIA) (not considered as cardioembolic) and had not received...
Original Title: Long-Term Outcome after Carotid Artery Stenting. A Population-Based Matched Cohort Study. Reference: Stroke. 2016 Jul 12. [Epub ahead of print]. In the prevention of stroke, carotid artery stenting (CAS) is far less invasive than endarterectomy, but its long term outcomes remain unclear. This large cohort study compared the long term outcomes of...
Original Title: Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence. Reference: North Noelck et al. Circ Cardiovasc Qual Outcomes. July 2016. Published ahead of print. Atrial fibrillation is an important cause of stroke. Oral anticoagulation reduces the risk of stroke but, on the...
Original Title: Predictors of Restenosis Following Carotid Angioplasty and Stenting. Reference: Elena Zapata-Arriaza et al. Stroke. 2016 Jun 21. Epub ahead of print. Restenosis after carotid PCI is associated to an increase of stroke and death risk. The purpose of this study was to determine the risk and predicting factors associated to carotid restenosis...
Original Title: Optimal P2Y12 inhibitor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a network meta-analysis. Reference: Rafique AM et al. J Am Coll Cardiol Intv 2016;9:1036–46. Courtesy of Dr. Alejandro Lakowsky. Researchers drew up a network meta-analysis incorporating 37 trials with more than 88,000 patients undergoing ST elevation...
Original Title: LAA occlusion vs. standard care in patients with atrial fibrillation and intracerebral hemorrhage – A propensity score matched follow-up study. Presenter: Jens Erik Nielsen-Kudsk Patients with atrial fibrillation and a history of intracerebral hemorrhage, have an elevated risk of both ischemic and hemorrhagic stroke. There is no consensus on how to treat...
Original Title: Meta-analysis of the long-term effect of routine aspiration thrombectomy in patients undergoing primary percutaneous coronary intervention. Reference: Mancini JG et al. Am J Cardiol. 2016; Epub ahead of print. A large meta-analyzis confirms routine aspiration thrombectomy in the context of primary PCI has no clinical benefit and could increase the risk of...
Original Title: Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. PARTNER 2A. Reference: Martin B. Leon et al. NEJM April 2, 2016 Courtesy of Dr. Juan A. Terré Studies have shown mortality rates after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in high risk patients are similar (PARTNER 2 – Cohort B). This is...
There are many doubts about the benefit of manual thromboaspiration, not only in terms of improvement of the clinical end point but also the potential risk of stroke. The TOTAL (n = 10732) was a randomized study of routine manual thrombectomy versus angioplasty only in the context of ST segment elevation acute myocardial infarction and...
This double-blind study included 21162 patients with a history of acute myocardial infarction randomized to ticagrelor 90 mg e/12 h, ticagrelor 60 mg e/12 h or placebo. All patients received aspirin and had additional risk factors such as age or diabetes. The history of infarction should be between one and three years before being included...