Nowadays, evidence from studies and meta-analyses has demonstrated the benefits of complete revascularization compared to culprit-vessel-only revascularization in patients with acute myocardial infarction (AMI). The identification and treatment of non-culprit lesions can be guided by conventional angiography, intracoronary imaging, or coronary physiology; the optimal modality, however, is still unclear. Quantitative flow ratio (QFR) is a...
Many of the studies comparing TAVR against SAVR in low risk patients included patients between 70-75 years, excluding those with tricuspid valves. This study included low surgical risk patients with severe aortic stenosis and symptoms, 75 years or younger. Participants were randomized 1:1 to receiving TAVR or SAVR, stratified according to sex, need for new...
Despite primary angioplasty, many patients with ST elevation acute myocardial infarction with (STEMI) show evidence of microvascular dysfunction. This dysfunction can be characterized by two main factors: A new specific index has recently been identified to assess microcirculation called microvascular resistance reserve (MRR), which allows measuring vasodilatory capacity independent of the epicardium. The purpose of...
Aortic stenosis is an increasingly common valvulopathy because people are living longer now. A present, the main treatment consists of surgical (SAVR) or transcatheter aortic valve replacement. (TAVR). One of the main challenges of this disease is its progression. The European guidelines recommend Doppler echocardiograms every 2 to 3 years for mild cases, mildly calcified,...
Venous thromboembolism represents one of the main causes of cardiovascular death. Pulmonary embolism (PE) can vary from asymptomatic to manifesting with shock and sudden death, with a wide clinical spectrum. Patient followup is crucial, seeing as survival PE patients usually experience residual symptoms at long term, such as dyspnea or functional capacity deterioration. For decades,...
Atrial fibrillation is common in elderly people and is associated with a higher risk of ischemic stroke. Left atrial appendage occlusion (LAAO) is a valid strategy, especially in patients at high risk of bleeding. The presence of peridevice leak (PDL) has been linked to stroke, although some analyses, such as the PROTEC-AF Study, suggest that...
For years, treating dyslipidemia mainly focused on reducing LDL cholesterol (LDL-C) with statins, which had shown benefits in reducing atherosclerotic cardiovascular disease (ASCVD). Lipoprotein(a) [Lp(a)] is a form of apoB-containing lipoprotein bound to a hydrophilic, highly glycosylated protein called apolipoprotein(a) [apo(a)]. Circulating levels of Lp(a) are genetically determined, and are hardly affected by eating habits...
In-stent restenosis (ISR) remains the main limitation in the percutaneous treatment of coronary artery disease, with a prevalence between 5% and 10% after implantation of latest-generation drug-eluting stents (DES). Therapeutic recommendations for it include the implantation of a new DES and the use of drug-coated balloons (DCB). The rate of recurrent ISR ranges from 10%...
Regardless of whether it is attempted through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS), complete revascularization (CR) is not always achieved. Overall, it is more frequent with surgery than with percutaneous treatment. Additionally, incomplete revascularization (IR) has proven to be associated with worse outcomes compared to CR. Researchers conducted an analysis of the...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....