This work published simultaneously in The New England Journal of Medicine showed that patients over eighty years may benefit from an aggressive and invasive treatment strategy that could be unnecessarily denied given age. The study was conducted in 16 centers in Norway and included 458 octogenarians patients admitted with acute coronary syndromes without ST-segment elevation...

Antibiotic prophylaxis before dental procedures has been the gold standard in preventing infective endocarditis, despite the lack of supporting evidence. In 2008, the National Institute for Health and Clinical Excellence in the UK recommended the cessation of antibiotic prophylaxis before dental procedures and other invasive procedures.  Prescription rates were drastically reduced after 2008 recommendation and,...

Article The TAXUS Liberté Post Approval study included patients treated with TAXUS paclitaxel DES receiving prasugrel for 12 to 30 months. Primary end point was a combination of death, infarction or stroke that resulted in 3.7% after 30 months vs. 8.8% after 12 months of prasugrel administration (p<0.001). Death and stroke rates were similar between...

Article This multicenter randomized control study with placebo was designed to determine the risks and benefits of double antiaggregation for longer than 12 months post DES stenting. 9961 patients were randomized to continue on placebo or thienopyridine after 12 months. Thienopyridine reduces the incidence of in-stent thrombosis (0.4% vs 1.4%; p<0,001) and cardiovascular events (4.3%...

Article This multicenter study included patients receiving the second generation stent XIENCE V (Abbott Vascular) randomized to 6 and 24 months of double antiaggregation therapy after confirming non-resistance to aspirin.  Primary end point was a combination of death, infarction, emergency revascularization of target vessel, stroke and major bleeding. The study saw early termination due to...

Statin intolerance limits patients’ capacity to reach their LDL goals. This study compared the new drug alirocumab vs. ezetimibe in patients with statin intolerance and muscular symptoms (≥2 statin intolerance at minimum doses). Study design included placebo administration and statin intolerance testing. LDL baseline was 194 mg/dl. Conclusion Alirocumab reduced LDL levels significantly compared to...

This is a multicenter, randomized, double blind study designed to test the hypothesis that the combination of ezetimibe and simvastatin improves outcomes compared to simvastatin alone in ACS patients (ST or non ST elevation AMI in the last 10 days). The study included more than 18000 patients randomized to ezetimibe/simvastatin 10/40 mg vs. simvastatin monotherapy...

In approximately 10% of patients for resynchronization therapy implantation of ventricular lead is not possible for anatomical difficulties, by phrenic hyper-stimulation or low stimulous capture.  This study was designed with the assumption that the quadrupole electrodes will result in fewer interventions both during implantation and during follow-up than bipolar electrodes.  The work included 1068 patients...

180 patients with colchicine 0.5 mg twice daily from 48-72 hs. before surgery versus 180 patients to placebo were randomized. The medication was continued for a month. The aim of the study was to evaluate whether colchicine was able to avoid the post-pericardiotomy syndrome.  The post pericardiotomy syndrome occurred in 19.4% of patients in the...

Therapy in heart failure has been to focus the neurohormonal pathways such as the renin-angiotensin-aldosterone system. Natriuretic peptides are metabolized by neprilysin enzyme. The LCZ696 is a new class of drug that inhibits the enzyme neprilysin. A total of 8436 patients with chronic heart failure functional class II-IV were included, elevated levels of NT-ProBNP and/or...