The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim...
Coronary artery disease in women usually develops 10 years later than in men, and some evidence suggests women have higher mortality, especially when it comes to ST elevation MI (STEMI). Registries have shown higher mortality both in hospital and at one year follow up. In part, this difference is observed because of the gap in...
Percutaneous coronary interventions have improved during the last decade with 15% rate of target vessel failure (TVF) at 5 years according to the latest reports. We are already familiar with the benefits of functional assessment of lesions with FFR and its clinical outcomes. Additionally, low post PCI FFR values (FFR ≤ 0.83-≤0.91) have been associated...
Recent studies on antiplatelet antiaggregation support the use of short dual antiaggregation therapy (DAPT), even in unforeseen scenarios, such as complex PCI. On the contrary, in patients with high ischemic risk, there is still evidence in favor of prolonged antiaggregation, mainly through the DAPT study, which showed lower risk of major ischemic events with DAPT...
Percutaneous coronary intervention of chronic total occlusions (CTO) is currently indicated for symptom improvement, as studies have inadequate randomization of data which hinders the assessment of hard outcomes. However, patient inclusion in randomized controlled trials has been challenging, especially for highly symptomatic and higher risk patients. This causes a selection bias in randomized studies on...
Intervention of chronic total occlusions (CTO) through angioplasty (PCI) can cause complications, even in highly experienced centers. Plenty has been written on the probability of success for the treatment of CTOs using scores such as CL-SCORE, J-CTO, ORA, E-CTO, CASTLE-CTO, etc. (some of which are usually used when preparing these cases). However, besides estimating success...
Currently, the number of nonagenarian patients undergoing angioplasty (whether elective, urgent or emergency) has increased. This population is linked to more comorbidities and has barely been included in most randomized studies or registries. As such, we do not have robust evidence on this group. Researchers conducted an analysis of the J-PCI OUTCOME Registry, in which...
At present, percutaneous coronary intervention (PCI) is the most common coronary revascularization strategy. One of its benefits is that patients can be safely discharged when procedures are programed, which helps decompress hospital capacity. However, this strategy has not been validated for acute coronary syndromes; the evidence gathered for non-ST elevation ACS is far from robust,...
We all know the benefits of ultravascular ultrasound (IVUS) in the development of percutaneous coronary intervention, such as more accurate vessel measurement, improved stent expansion and apposition, and complication identification. This is why the use of IVUS is a class IIa recommendation in AHA and ESC guidelines. The aim of this retrospective study was to...
The MASTER DAPT study analyzed the results of an abbreviated (mean 34 days) vs. conventional dual antiplatelet therapy (DAPT) in 4579 patients treated with angioplasty and a biodegradable polymer sirolimus-eluting stent. This recent publication on the same study analyzed the evolution within the same strategies of the subgroup of patients with complex angioplasty and compared...