Should We Use Left Atrial Appendage Occlusion More Frequently? What Real-Life Data Are Available?

Left atrial appendage occlusion (LAAO) is an alternative to prevent atrial fibrillation stroke mainly used in patients at high risk for bleeding. One of the most widely used devices in randomized trials is the Watchman, which yielded promising results. However, its real-life performance had yet to be analyzed. Researchers conducted an analysis of the National<a href="https://solaci.org/en/2022/04/25/should-we-use-left-atrial-appendage-occlusion-more-frequently-what-real-life-data-are-available/" title="Read more" >...</a>

Escándalo con los resultados del EXCEL que hicieron “caer” las últimas guías

Clnical Practice Dissociated from Study Outcomes: Bad News for Our Patients?

Differences in patient characteristics, changes in treatment algorithms, and advances in device technology, together or separately, might limit the applicability of older randomized trials to contemporary clinical practice. In this case, we look at patients and devices used in the contemporary clinical practice vs. those in the EXTEND DAPT. These differences were associated with attenuated<a href="https://solaci.org/en/2022/01/25/clnical-practice-dissociated-from-study-outcomes-bad-news-for-our-patients/" title="Read more" >...</a>

ESC 2021 | ENVISAGE-TAVI AF: sorpresas con el endoxaban en TAVI y fibrilación auricular

ESC 2021 | ENVISAGE-TAVI AF: Surprise with Endoxaban in TAVR and Atrial Fibrillation

The enthusiasm for direct oral anticoagulants after transcatheter aortic valve replacements (TAVR) is waning. At least, when it combines with atrial fibrillation. The ENVISAGE-TAVI AF has shown excessive bleeding with endoxaban vs. the classical vitamin K antagonists. Endoxaban resulted non-inferior to vitamin K antagonists in terms of net clinical adverse events, but major bleeding events<a href="https://solaci.org/en/2021/09/10/esc-2021-envisage-tavi-af-surprise-with-endoxaban-in-tavr-and-atrial-fibrillation/" title="Read more" >...</a>

Complex PCI: Complex Characteristics Impact Results

Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events.  It is important to see past the obvious anatomical challenges (bifurcations, calcification,<a href="https://solaci.org/en/2020/10/14/complex-pci-complex-characteristics-impact-results/" title="Read more" >...</a>

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention

Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure.  This highlights the huge variation in indication and the scarce evidence there is on this matter.  Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does<a href="https://solaci.org/en/2020/09/15/evidence-or-theory-antiaggregation-scheme-after-peripheral-vascular-intervention/" title="Read more" >...</a>

Balancear el riesgo de sangrado vs trombótico para definir el tiempo de doble antiagregación

Antiaggregation vs. Anticoagulation after Peripheral PCI

The truth is this question has no clear answer and what with do with peripheral stenting is transfer the evidence we have on coronary stenting, given the lack of standards and poor reporting on antithrombotic therapy outcomes in randomized studies on endovascular intervention.  Heterogeneity is worse when it comes to venous territory. Some time ago<a href="https://solaci.org/en/2020/06/01/antiaggregation-vs-anticoagulation-after-peripheral-pci/" title="Read more" >...</a>

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The Most Read Scientific Articles of February

01- Alternatives for Patients Allergic to Aspirin The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a recommendation to use monotherapy with the most potent antiaggregant we<a href="https://solaci.org/en/2020/03/11/the-most-read-scientific-articles-of-february/" title="Read more" >...</a>

Vitamin D Supplements for the Prevention of Cancer and Cardiovascular Disease

A supplement (or anything, really) that might reduce simultaneously the risk of cardiovascular disease and of cancer would be truly revolutionary. This work, published in the New England Journal of Medicine (NEJM), sought to prove that vitamin D supplements might reduce the risk for both pathologies (the two most frequent diseases in the world). However,<a href="https://solaci.org/en/2020/01/17/vitamin-d-supplements-for-the-prevention-of-cancer-and-cardiovascular-disease/" title="Read more" >...</a>

TCT 2019 | TWILIGHT: Minimal DAPT in High Bleeding Risk Patients

Courtesy of the SBHCI. Monotherapy with a P2Y12 inhibitor after a minimum period (3 months) of dual antiplatelet antiaggregation (DAPT) is a valid treatment option to reduce bleeding in patients at high risk of bleeding complications.  The present double-blind study presented at TCT 2019 simultaneously published in NEJM analyzed ticagrelor monotherapy (prior 3 months DAPT)<a href="https://solaci.org/en/2019/09/30/tct-2019-twilight-minimal-dapt-in-high-bleeding-risk-patients/" title="Read more" >...</a>

The Most Read Articles of August in solaci website

1-FDA Expands TAVR Indication to Low-Risk Patients Both the self-expandable valve Evolut R and its direct competitor, balloon-expandable valve Sapien 3, received the authorization to be indicated for low-risk patients in a long-awaited announcement made on August 16th, 2019. Read also HERE 2-Mechanisms of Post PCI Persistent Angina Angina persistence or recurrence after PCI can<a href="https://solaci.org/en/2019/09/16/the-most-read-articles-of-august-in-solaci-website/" title="Read more" >...</a>

dual antiplatelet therapy