Patients with peripheral artery disease (PAD) have higher rates of cardiovascular events after DES implantation, which could be explained partly by higher platelet reactivity. The present work studies the relationship between platelet reactivity and clinical events after PCI in patients with and without a history of peripheral artery disease. The ADAPT-DES study (Assessment of...
Courtesy of Dr. Leiva. Bioresorbable scaffolds with drug-eluting stents (bioresorbable vascular scaffolds, BVS) have been added to the list of endovascular treatment options for coronary disease. The ABSORB III trial showed the non-inferiority of this stent type to everolimus-eluting metallic stents as regards target-lesion revascularization (TLR) at one year. However, reports have suggested a higher...
Courtesy of Dr. Agustín Vecchia. In the last few years, new percutaneous treatment options for mitral regurgitation have emerged. Transcatheter mitral annuloplasty with various devices is a relatively simple procedure that could compress the origin of circumflex artery branches due to the different orientation of mitral corners and the coronary sinus. The following work by Park...
This study evaluated the safety and efficacy of the new drug eluting stents (Medtronic, Santa Rosa, California) to treat de novo coronary lesions. These new polymer free drug filled stents have the potential to improve clinical outcomes and allow a shorter dual antiplatelet therapy. In addition, they have been made with three layers of continuous...
In patients with atrial fibrillation undergoing coronary angioplasty with stents, standard anticoagulation with vitamin K antagonists plus dual antiplatelet therapy with a P2Y12 inhibitor and aspirin reduces the risk of stent thrombosis and stroke, but increases the risk of bleeding. The effectiveness and safety of anticoagulation with rivaroxaban plus one or two antiplatelet agents...
Courtesy of Dr. Agustín Vecchia. Nearly 10% of patients with acute coronary syndrome (ACS) require surgery. Managing periprocedural dual antiplatelet therapy (DAPT) in ACS patients is controversial and, to date, there are no randomized trials in this regard. Guidelines recommend ticagrelor discontinuation five days prior surgery and in the most emblematic work on this drug...
Much of the speculation around the way of individualizing dual antiplatelet therapy (DAPT) duration after coronary angioplasty has focused on clinical parameters (e. g., diabetes), but a new study published by the Journal of the American College of Cardiology (JACC) and presented at the last European Society of Cardiology (ESC) Congress warns about anatomical factors as...
A comprehensive analyzis of cerebrovascular events in major randomized controlled studies on transcatheter aortic valve replacement (TAVR) has shown some interesting data on both risks and timing of stroke in this setting. The study carried out by Dr. Neal Kleiman, reviewed data on stroke and stroke predictors among 3,687 patients included in the CoreValve...
This small study presented at ESC and simultaneously published in the European Heart Journal evaluated patients undergoing acute coronary syndrome caused by plaque erosion identified by optical computed tomography (OCT). The study showed it can be managed with conservative antithrombotic therapy and without stenting. Patients with plaque erosion can receive dual antiplatelet therapy, ticagrelor and aspirin...
Patients treated with A9 biolimus eluting stent with biodegradable polymer (Nobori, Terumo) can receive only six months of dual antiplatelet therapy (DAPT) with no increase in adverse events, compared against more prolonged treatments. The net adverse clinical and cerebrovascular events that included all cause death, MI, cerebrovascular events and major bleeding was: 1.92% for...