Transcatheter aortic valve replacement (TAVR) keeps growing in terms of the development of new devices, more extensive operator experience, and enhanced procedure planning. Nowadays, there are multiple device options, which depend on patient characteristics and operator experience. Two-arm studies compared these devices, analyzing the potential benefits of a certain valve over the others. This multicenter...
The use of intravascular imaging helps improve diagnosis in situations where a conventional coronary angiography might not be conclusive. That is the case of patients with myocardial infarction with non-obstructive coronary artery lesions (MINOCA). The largest MINOCA cohort reported so far has shown 5%-7% prevalence. This pathology, initially considered benign, presents a remote mortality rate...
Currently, many randomized studies have suggested that short-term dual antiplatelet therapy (DAPT) followed by monotherapy reduces bleeding without increasing major cardiovascular events after percutaneous coronary intervention (PCI). A meta-analysis of six randomized studies has shown this benefit using ticagrelor monotherapy after short DAPT. However, there is no data on the results of clopidogrel monotherapy. Researchers...
The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such...
Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management. A subanalysis of...
The degeneration of bioprostheses in aortic position occurs at approximately after 10 to 15 years. In this scenario, the treatment of choice used to be redo surgery, but with the evolution of transcatheter aortic valve replacement (TAVR), it became a valid alternative with a level IIa B evidence. While there are currently multiple analyses of...
Critical lower limb ischemia (CLLI) is associated with a major deterioration in quality of life and a significant increase in morbidity and mortality. Its estimated annual incidence is 220 to 3500 cases per million people, with an expected prevalence of 11% of patients with peripheral arterial disease. CLLI is the “terminal” stage of peripheral artery...
Many studies have shown there is higher mortality and complications among women after acute myocardial infarction (AMI) vs. men, especially after 30 days. Even though the mechanism driving higher mortality remains uncertain, recent studies have seen differences in thrombus formation with increased platelet count among women. In STEMI patients, intracoronary thrombus burden is a predictor...
Spontaneous coronary artery dissections (SCD) are more frequent in women and account for about 25% of all acute myocardial infarctions (AMI) before the age of 50. While the presence of cardiogenic shock due to AMI is infrequent, its evolution is still somewhat unclear and it has not been fully analyzed. Researchers conducted an analysis in...
Left atrium appendage closure (LAAC) is a major strategy to prevent stroke in patients with nonvalvular atrial fibrillation (AF). LAAC registries to date show that women present twice the risk for major events and higher rates of in-hospital complications and hospital re-hospitalization at 30 days when compared with men. However, long-term results according to sex are...