Original title: Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy. Reference: S.S. Jolly et al. for the TOTAL Investigators. N Engl J Med. 2015 Apr 9;372(15):1389-98. Manual thrombectomy is a routine procedure with ST elevation AMI patients. This common practice proved to reduce mortality in the TAPAS study. However, the TASTE study did not observe...
Risks and benefits of extending dual antiplatelet therapy in patients with and without MI
Original title: Benefits and Risks of Extended Duration Dual Antiplatelet Therapy after PCI in Patients With and Without Acute Myocardial Infarction. The DAPT Study. Reference: Robert W. Yeh et al. J Am Coll Cardiol. 2015, online before print. The risks and benefits of prolonged antiplatelet therapy after PCI could be different in patients presenting with AMI compared to...
Long term ticagrelor after an acute myocardial infarction
Original title: Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction. PEGASUS-TIMI 54. Referencia: Marc P. Bonaca et al. N Engl J Med. 2015 Mar 14. Patients with acute myocardial infarction (AMI) have an increased risk of recurrent events suggesting that this population could benefit from intensive secondary prevention. Current guidelines recommend adding to aspirin an...
Positive result of intraarterial thrombolysis in acute ischemic stroke
Original title: A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. MR CLEAN Investigators. Reference: O.A. Berkhemer et al. N Engl J Med 2015;372:11-20. In patients undergoing acute ischemic stroke caused by a proximal intracranial artery occlusion, intraarterial endovascular treatment is effective; however, there is no evidence of clinical or functional benefits. This study randomized patients undergoing...
Patent Foramen Ovale: when to indicate closure
References: Matthew Nayor et al. Contemporary Approach to Paradoxical Embolism. Circulation. 2014;129:1892-1897. Marco Hernandez-Enrıquez et al. Current Indications for Percutaneous Closure of Patent Foramen Ovale. Rev Esp Cardiol. 2014;67(8):603–607. The debate on patent foramen ovale behavior in different clinical contexts remains open, no pun intended. Based on numerous observational studies and expert recommendations, when facing the...
Higher event rate in those with non-ST elevation ACS who received revascularization at PLATO study. Beyond this, ticagrelor reduced mortality.
Original title: Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Reference: Lindholm D et al. Eur Heart J. 2014; Epub ahead of print. The PLATO study randomized 18624 patients with ACS to aspirin and ticagrelor (180 mg loading dose followed by 90 mg every 12 hours) versus...
Multivessel angioplasty in acute myocardial infarction improves prognosis
Original title: Acute multivessel revascularization improves 1 year outcomes in ST-elevation myocardial infarction. A nationwide study from AMIS plus registry. Reference: Raban Jeger, et al. International journal of Cardiology 2014;172:76-81 The presence of multiple vessel lesions is present in about 50% of patients referred for primary angioplasty. The accepted strategy is to treat the culprit artery even...
Predilation with smaller valvuloplasty balloon diameter could reduce the need for permanent pacemaker after CoreValve
Original title: Reduction of pacemaker implantation rates alter CoreValve implantation by moderate predilatation Reference: Philipp Lange, et al. EuroIntervention 2014;9:1151-1159 Aortic valve implantation has been proven a valid strategy to treat high risk patients. The CoreValve self-expanding transcatheter aortic valve is associated with a relatively high rate of permanent pacemaker implantation and, until now, no efforts have been...
Unprotected trunk in diabetics: angioplasty with good long-term results but more revascularization
Original title: Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected left main coronary artery disease: D-DELTA registry. Reference: Meliga Emanuele, et al. EuroIntervention 2013; 9:803-808 Diabetes increases cardiovascular risk events because of their involvement in diffuse form of the vessels, thereby generating more events and changes in revascularization strategy...
TAVI: emergency surgery is rare
Original title: Emergent cardiac surgery during transcatheter aortic valve implantation (TAVI): insight from Edwards SAPIENS Aortic Bioprótesis European Outcome (SOURCE) registry Reference: Holger Eggebrecht, et; al. Eurointervention 2013; 9online publish-ahead of print november 2013 Percutaneous aortic valve implantation has grown significantly since its inception, to be a safe procedure. The need for emergency cardiac surgery is rare, its...