FFR in non-ST elevation myocardial infarction

Original Title: Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-St segment elevation myocardial infarction: the British Heart Foundation FAMOUS–NSTEMI randomized trial. Reference: Jamie Layland et al. European Heart Journal (2015) 36, 100–111 Courtesy of Dr. José Amadeo Guillermo Álvarez. Several studies have established the value of fractional flow reserve (FFR) in<a href="https://solaci.org/en/2016/02/19/ffr-in-non-st-elevation-myocardial-infarction/" title="Read more" >...</a>

Incomplete Revascularization in the Long Term

Original Title: Long-Term Outcome of Incomplete Revascularization after Percutaneous Coronary Intervention in SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Reference: Kristina Hambraeus et al. J Am Coll Cardiol Intv. 2016;9(3):207-215.   The aim of this study was to describe the evolution of patients with multivessel disease undergoing PCI with incomplete revascularization, and its probable association to<a href="https://solaci.org/en/2016/02/18/incomplete-revascularization-in-the-long-term/" title="Read more" >...</a>

PRAGUE 13 trial

Fundamentos e objetivos: A intervenção coronária percutânea (PCI) primária da artéria culpada pelo infarto agudo do miocárdio com supra de ST (STEMI) é o método de escolha no tratamento deste quadro clínico. O objetivo do presente estudo foi encontrar a gestão ótima dos doentes com STEMI que apresentavam pelo menos mais uma estenose de artéria<a href="https://solaci.org/en/2015/06/24/prague-13-trial-2/" title="Read more" >...</a>

BEST: Similar mortality among angioplasty with DES (everolimus) and surgery

This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the study was mortality from any cause. Side end points were infarction, stroke, and revascularization. Propensity score was used to compare populations. Between 34819 patients were eligible 9223 patients in each group<a href="https://solaci.org/en/2015/06/24/best-similar-mortality-among-angioplasty-with-des-everolimus-and-surgery/" title="Read more" >...</a>

RENAL DES: reduction of restenosis in patients with kidney failure

Coronary angioplasty in patients with kidney failure is associated with an increased occurrence of events. This study compared the efficacy of preventing clinical restenosis using an everolimus-eluting stent versus a conventional stent, both implanted in the same patient with lesions in more than one vessel and suffering from kidney failure. The primary endpoint was target<a href="https://solaci.org/en/2015/06/24/renal-des-reduction-of-restenosis-in-patients-with-kidney-failure/" title="Read more" >...</a>

HYBRID: Hybrid revascularization in patients with multi-vessel

We included 200 patients (100 with hybrid revascularization and 100 with conventional surgery). The complete revascularization rate was similar between both groups (70%). Also, the event-free survival was similar with 92% for conventional surgery group and 89% for the hybrid. The revascularization of the anterior descending artery with breast bridge and angioplasty to the rest<a href="https://solaci.org/en/2015/06/24/hybrid-hybrid-revascularization-in-patients-with-multi-vessel/" title="Read more" >...</a>

Shall we change our daily practice to introduce complete revascularization during AMI? Another study contributes for preventive PCI in AMI.

Original title: Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease: The CvLPRIT Trial.  Reference:  Gershlick AH et al. J Am Coll Cardiol. 2015 Mar 17;65(10):963-72.   Recent studies such as the PRAMI and the one we summarize here show complete revascularization of AMI patients before discharge<a href="https://solaci.org/en/2015/03/25/shall-we-change-our-daily-practice-to-introduce-complete-revascularization-during-ami-another-study-contributes-for-preventive-pci-in-ami/" title="Read more" >...</a>

Hybrid Revascularization in Multiple Vessels

Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83   According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications.   This study randomized 102<a href="https://solaci.org/en/2014/12/18/hybrid-revascularization-in-multiple-vessels/" title="Read more" >...</a>

The SYNTAX Score II: a tool that should be used

Original title: Validation and Comparison of the Long-Term Prognostic Capability of SYNTAX Store-II Among 1528 Consecutive Patients Who Underwent Left Main Percutaneous Coronary Intervention. Reference: Bo Xu, et al. JACC Cardiovascular Intervention 2014;7:1128-37.   The SYNTAX angiography score is useful when deciding revascularization in multivessel, but with the addition of clinical variables in the second version, SYNTAX score<a href="https://solaci.org/en/2014/12/03/the-syntax-score-ii-a-tool-that-should-be-used/" title="Read more" >...</a>

FFR results could change over the years

Original title: The impact of age flow reserve-guided percutaneous coronary intervention: A FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) trial substudy. Reference: Hong-Seok Lim et al. International Journal of Cardiology 2014; 177:66-70 The FAME study has shown the benefit of FFR guided PCI, but the question as to whether age affects lesion evaluation remains unclear. A<a href="https://solaci.org/en/2014/11/17/ffr-results-could-change-over-the-years/" title="Read more" >...</a>