The DAPT study concluded that continued thienopyridine plus aspirin beyond a year after coronary angioplasty is associated with a decrease in the rate of stent thrombosis and major cardiovascular events. In contrast, there is a significant increase in moderate to severe bleeding when compared with continued aspirin alone. Based on the outcomes of this and<a href="https://solaci.org/en/2017/11/21/angioplasty-complexity-may-define-the-duration-of-dual-antiplatelet-therapy/" title="Read more" >...</a>
Important Study Detects Radiation-Induced DNA Damage in Operators After an Endovascular Procedure
In recent years, we have seen (both as witnesses and actors) an exponential increase in the number of fluoroscopically-guided cardiovascular interventions carried out by interventional cardiologists, electrophysiologists, and vascular surgeons. Not long ago, most pathologies treated with these procedures were the exclusive domain of open surgery. Now, a large number of patients can be treated<a href="https://solaci.org/en/2017/11/08/important-study-detects-radiation-induced-dna-damage-in-operators-after-an-endovascular-procedure/" title="Read more" >...</a>
REDUCE Trial: Patients with PFO and cryptogenic stroke at lower risk of recurrent stoke when treated with APT and closure device
Courtesy of Dr. José Álvarez. This is a multicenter randomized study on patients with patent foramen ovale (PFO) and a first episode of cryptogenic stroke. It only included patients with moderate to large shunt based on the number of bubbles observed in the left atrium within the first three beats after being noticed in the<a href="https://solaci.org/en/2017/09/18/reduce-trial-patients-with-pfo-and-cryptogenic-stroke-at-lower-risk-of-recurrent-stoke-when-treated-with-apt-and-closure-device/" title="Read more" >...</a>
Long-term results of the RESPECT study favor closure with the Amplatzer device
Courtesy of Dr. José Álvarez. The RESPECT trial is a multicenter randomized trial with blinded adjudication of end-point events. It randomly assigned patients from 18 to 60 years of age who had a patent foramen ovale (PFO) and a history of cryptogenic ischemic stroke to undergo closure of the PFO with the Amplatzer device plus medical<a href="https://solaci.org/en/2017/09/15/long-term-results-of-the-respect-study-favor-closure-with-the-amplatzer-device/" title="Read more" >...</a>
Polymer-Free DES Also Show Efficacy in Anticoagulated Patients with High Risk for Bleeding
Patients who receive chronic anticoagulation therapy and then undergo angioplasty are frequently discharged on a triple anti-thrombotic scheme that usually includes aspirin, clopidogrel, and warfarin. The optimal duration of this indication remains unclear, particularly for patients at high bleeding risk. According to expert consensus, patients receiving chronic anticoagulation may receive from 1 to 12 months of dual<a href="https://solaci.org/en/2017/09/08/polymer-free-des-also-show-efficacy-in-anticoagulated-patients-with-high-risk-for-bleeding/" title="Read more" >...</a>
COMPASS: A New Place for Rivaroxaban in Chronic Ischemic Heart Disease
Combining low doses of rivaroxaban and aspirin seems to be the best strategy for patients with stable chronic ischemic heart disease, according to this new study presented at the European Society of Cardiology Congress 2017, which was published simultaneously in the New England Journal of Medicine. Compared with low-dose aspirin alone, the combination of aspirin<a href="https://solaci.org/en/2017/09/07/compass-a-new-place-for-rivaroxaban-in-chronic-ischemic-heart-disease/" title="Read more" >...</a>
RE-DUAL PCI: Anti-Thrombotic Management in Patients with Atrial Fibrillation and PCI
RE-DUAL PCI outcomes have been published by the New England Journal of Medicine along with their presentation at ESC 2017. The traditional triple anti-thrombotic scheme with dual antiplatelet therapy and warfarin for patients with atrial fibrillation undergoing coronary angioplasty seems to have been left behind. This new study showed that the combination of dabigatran with a P2Y12<a href="https://solaci.org/en/2017/09/04/re-dual-pci-anti-thrombotic-management-in-patients-with-atrial-fibrillation-and-pci/" title="Read more" >...</a>
Risk of Thrombosis and Bleeding with Peripheral Artery Disease and Concomitants
Peripheral artery disease (PAD) is no longer a systemic manifestation of atherosclerosis. In fact, 2 in 3 people with PAD have concomitant heart disease, and 1 in 3 people has concomitant PAD. To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction<a href="https://solaci.org/en/2017/08/22/risk-of-thrombosis-and-bleeding-with-peripheral-artery-disease-and-concomitants/" title="Read more" >...</a>
Dual Antiplatelet in TAVR: Is Single Better?
Courtesy of Dr. Agustín Vecchia. As TAVR is expanded to lower risk patients, complications become more relevant. As regards stroke, the PARTNER 2 and SURTAVI one year outcomes are 8.0% and 8.2% respectively. The mechanisms behind this complication have not yet been clarified and, therefore, neither have guideline recommendations in this regard (as we can tell<a href="https://solaci.org/en/2017/08/02/dual-antiplatelet-in-tavr-is-single-better/" title="Read more" >...</a>
Early Endarterectomy Seems Superior to Carotid Stenting in Symptomatic Patients
Patients with symptomatic stenosis of the internal carotid artery benefit from early intervention. The challenge lies in what intervention to choose. Most studies comparing endarterectomy to carotid stenting are fairly heterogeneous as regards timing of intervention. This element is key to comparing between procedures, since there is no doubt timing will directly affect results. <a href="https://solaci.org/en/2017/06/06/early-endarterectomy-seems-superior-to-carotid-stenting-in-symptomatic-patients/" title="Read more" >...</a>