The coronavirus pandemic has had a negative impact on the most pressing cardio and neurological emergencies, such as strokes or aortic dissection. These emergencies are normally treated in high complexity centers, which is why it is relatively simple to analyze the number of transfers before and after the pandemic. For some time, care centers have...
Temporary Emergency Guidelines for Infarction During the Pandemic
Several United States societies (the American Heart Association [AHA] among them) have answered the question of many physicians in the front lines: what is the ideal strategy for the treatment of ST segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic? This document intends to ensure that patients with STEMI continue to receive adequate, proven...
Management of Infarction During the COVID-19 Pandemic
Patients with cardiovascular disease infected with COVID-19 are at a particular risk for morbidity and mortality. In any case, it should be noted that most patients requiring cardiovascular care due to ischemic heart disease, peripheral vascular disease, or structural heart disease are not infected. Being prepared to face this pandemic is as important as guaranteeing...
ST-Segment Elevation Myocardial Infarction in the Time of COVID-19
This study cites the experience of 6 sites during the first month of the COVID-19 pandemic in New York. All patients included had a confirmed diagnosis of coronavirus infection and also ST-segment elevation on electrocardiography. Eighteen patients met these criteria. We are used to large randomized studies; consequently, this small registry of less than 20 people seems to...
Virtual ACC 2020 | Colchicine After Infarction: Good Results and Cost-Effectiveness
Low doses of colchicine reduce the risk of ischemic events after an acute myocardial infarction, according to the COLCOT trial, originally presented at the American Heart Association (AHA) 2019 Scientific Session and simultaneously published in the New England Journal of Medicine (NEJM). The new information featured at the virtual ACC 2020 refers to its cost-effectiveness. Colchicine...
Virtual ACC 2020 | “Dangerous” Plaques by CT Effectively Predict Infarction
This post-hoc analysis of the SCOT-HEART shows low-attenuation plaque burden might successfully predict events. A greater number of low-attenuation plaques seems to be synonymous with greater risk which makes them better predictors than clinical scores, coronary calcification and stenosis degree. IVUS, CT and carotid ultrasound are the accepted tools to diagnose plaque burden and predict...
Mechanisms of Infarction in Coronary Arteries with Non-Significant Lesions
Infarctions with non-obstructive coronary artery disease, also known as MINOCA (myocardial infarction with nonobstructive coronary arteries), often present plaque rupture and thrombi associated with the affected myocardial territory. In these patients, optical coherence tomography (OCT) is of great value to identify the “culprit”. Even though atherosclerosis has been identified as a potential MINOCA mechanism, the...
Current Mechanical Complications of Infarction
Contemporary data of a recently published large registry show that mechanical complications after infarction are not frequent but maintain a very high mortality rate that does not seem to improve over time. Our information on mechanical complications was outdated and we did not have current data on their incidence and prognosis. Such is precisely the...
Hours of Sleep and Myocardial Infarction Risk
This is one of the first studies to prospectively assess this association, and its outcomes support the idea that poor sleep is a potential MI risk factor. Even though we need further data to be able to modify the current sleep duration standards as part of life-style change recommendations, it seems reasonable to start bearing...
Revascularization in Spontaneous Coronary Artery Dissection Causing ST-Segment Elevation Myocardial Infarction
Spontaneous coronary artery dissection is an increasing cause of acute myocardial infarction, particularly in younger women. These infarctions are frequently treated conservatively given the risks entailed by revascularization, due to the possibility of causing an antegrade or retrograde expansion of the dissection. The uncertainty around treatment for these patients gave way to this study (recently...