primary angioplasty

Low cardiac mortality with bivalirudin beyond the reduction in major bleeding

Original title: Reduction in Cardiac Mortality with Bivalirudin in Patients With and Without Major Bleeding: The HORIZONS-AMI Trial. Reference: Gregg W. Stone et al. J Am Coll Cardiol. Epub ahead of print The HORIZONS -AMI study included 3602 patients experiencing ST  segment elevation myocardial infarction received primary angioplasty, resulting in lower mortality at 30 days and three years...

Infarct size reduction to 30 days could result in clinical benefit at one year

Original title: Intralesional abciximab and thrombus aspiration in patients with large anterior myocardial infarction: One-year results from the INFUSE-AMI trial. Reference: Stone GW et al. Circ Cardiovasc Interv. 2013;Epub ahead of print.   The intra-coronary infusion of Abciximab added to thromboaspiration seems to improve outcomes at one year in patients undergoing primary angioplasty for ST-segment elevation with anterior...

Thromboaspiration in AMI, without benefit to 30 days.

Original title: Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction. TASTE trial. Reference: Ole Fröbert et al. N Engl J Med 2013. DOI: 10.1056/NEJMoa1308789 One of the biggest challenges of primary angioplasty is to restore normal coronary flow. Thromboaspiration is a relatively simple, quick and cheap it can improve the flow and resolution of ST , however , the...

Complete revascularization in acute myocardial infarction. 1 culprit lesion , then all the others

Original title: Randomized Trial of Preventive Angioplasty in Myocardial Infarction (PRAMI trial). Referencia: David S. Wald et al. N Engl J Med 2013.DOI: 10.1056/NEJMoa1305520. Patients developing ST segment elevation myocardial infarction are effectively treated with primary angioplasty to responsible artery . It is unclear whether revascularized other significant lesions in other non culprit vessels  will prevent future events...

Prasugrel is not as effective as Ticagrelor in acute myocardial infarction. 

Original title: Comparison of Prasugrel and Ticagrelor loading doses in STEMI patients: The Rapid Activity of Platelet Inhibitor Drugs (RAPID) primary PCI Study. Reference: Guido Parodi et al. J Am Coll Cardiol 2013. Article in press. Current guidelines recommend the use of prasugrel or ticagrelor in patients with ST elevation acute coronary syndromes who are due to receive...

The radial artery is the default access for Europe.

Original title: Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. Reference: Martial Hamon et al. EuroIntervention 2013; 8-online publish-ahead-of-print January 2013. The European Society of Cardiology (ESC) recently published a consensus...

Hyperglycemia on admission, an excess risk for infarction

Reference: Planer et al. International Journal of Cardiology 2012 (in press) Prognosis of patients enrolled in acute myocardial infarction with ST segment elevation (STEMI) has improved markedly, particularly as a result of reperfusion therapy. Despite these improvements, patients with diabetes mellitus (DM) are a high risk group in the short and long term compared with...

Ticagrelor vs. Clopidogrel in ST elevation MI: Pros and cons

Platelet Inhibition in the PLATO study: insights from the ECG substudy. En el Estudio PLATO quedó evidenciado que el Ticagrelor disminuyó la mortalidad a 12 meses en comparación con el Clopidogrel en el tratamiento de pacientes post-angioplastía por un síndrome coronario agudo o por un cuadro estable (4,5 vs. 5,9%; P<0.001). Estos resultados fueron del...

Revascularization Timing in Acute Coronary Syndrome

Multivessel disease is often present in ST elevation acute myocardial infarction (STEMI) patients. The AHA/ACC 2021 revascularization guidelines recommend staged complete revascularization as class I, single-setting complete revascularization as class 2b, and recommend against culprit only revascularization. At present, we have more randomized studies (BIOVASC, FIRE and MULTISTAR) comparing staged vs single-setting complete revascularization, but...

QFR Analysis of Coronary Lesions with TAVR

While transcatheter aortic valve replacement (TAVR) has shown benefits, significant coronary artery disease affects 50% or more of patients who undergo such procedure. However, it is still unclear which is the best treatment strategy or how to handle this condition. Quantitative flow ratio (QFR) could be a non-invasive option to assess the severity of coronary...

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