Coronary sinus reduction (CSR) is a relevant area of study for the treatment of refractory angina, with hopes of improving myocardial perfusion. However, to date, there are no conclusive data. The ORBITA-COSMIC study is a randomized, double-blind, placebo-controlled trial conducted at six centers in the UK. Researchers recruited patients with angina and chronic ischemia who...
A study by the Northern New England Cardiovascular Disease Group Consortium recently published online identified all patients with aortic valve stenosis treated with surgical or transcatheter aortic valve replacement between 2016 and 2022 in Maine, New Hampshire, and Vermont (USA). These patients were divided for analysis into three age groups: under 65 years old, 65...
The international guidelines recommend the use of dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor during 12 months in patients receiving percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), to prevent events such as MI and stent thrombosis. This was a multicenter, placebo controlled, double blind study to determine whether ticagrelor alone,...
Severe persistent calcification of the coronary arteries has been associated with different factors, such as advanced age, hypertension, dyslipidemia, smoking, and kidney failure, among others, and continues to be one of the challenges to stent implantation because of it impact on device advancing, drug release and adequate positioning. Intravascular lithotripsy (IVL) is a technique that...
Septal reduction therapies are used to mitigate the symptoms caused by dynamic left ventricular outflow tract (LVOT) obstruction and the associated mitral regurgitation (MR) that can surge in hypertrophic cardiomyopathy (HCM). Alternative therapies to treat LVOT obstruction include surgical procedures, i.e. surgical myotomy or myomectomy, or alcohol and radiofrequency septal ablation (intracardiac, transthoracic and endocardial,...
Individual randomized studies have shown variable results regarding the mortality risk following treatment of left main coronary artery disease (LMCAD), either through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). However, upon assessment of the latest meta-analyses (with matched data), similar risks of all-cause and cardiovascular mortality have been reported for both groups....
We are well aware of CAD physiopathological disparities and how it manifests differently in men and women. The ISCHEMIA study (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) has revealed that during 3.2 years no differences were seen in the incidence of ischemic events when comparing an invasive strategy (INV) vs a...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Proximal optimization technique (POT) has been recommended as a standard strategy in bifurcation lesions because it facilitates proper stent implantation and apposition in the proximal main vessel, according to the European Bifurcation Club. Percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has specific characteristics, and the long-term impact of this strategy...
Patients suffering from immune-mediated chronic inflammatory disease (CID) face a high risk of developing heart disease, including aortic valve disease. Inflammatory vascular disease when triggered by an autoimmune condition, can prompt a harmful response leading to valve degeneration, with increased calcification and fibrosis, and the associated progression of stenosis, failure or both. Prior research has...