While the rate of stroke has decreased since the early days of transcatheter aortic valve replacement (TAVR), it remains non-negligible, reaching up to 1%-3% at 30 days. As TAVR progressively expands to low-risk populations and younger patients, identifying risk factors for patient selection and management in stroke prevention becomes crucial. While researchers have identified predictors...
CAPTIS, a Novel Cerebral Embolic Protection System in TAVR
The incidence of stroke after TAVR ranges between 2 and 5%, depending on the series, which has been associated with higher morbimortality, affecting patient quality of life and their psycho-social environment. Many cerebral embolic protection systems have been developed in response, and even though they have been shown beneficial in many studies, their role in...
Prognostic Impact of SYNTAX and SYNTAX II Scores in Patients with Acute Myocardial Infarction
Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX...
AMI and Multivessel Disease: Can We Perform a Single Procedure?
Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery....
Is Complete Revascularization Really Necessary after AMI in the Elderly?
The population over 75 is growing gradually, which entails an increase in acute myocardial infarction (AMI) in this group. As we all know, it is fairly common for AMI to present with multivessel disease. It has been shown that younger patients will benefit from complete revascularization vs. a simple resolution of the culprit vessel. However,...
Crisis and Socioeconomic Disparities: Relationship with Recurrent Events After Myocardial Infarction
Socioeconomic status (SES) has been linked to recurrent atherosclerotic cardiovascular disease events (rASCVD) after myocardial infarction (MI). However, patients with low SES are underrepresented in most randomized studies. This may be largely due to a higher incidence of metabolic syndrome, insufficient use of recommended medication, such as statins, for secondary prevention and insufficient participation in...
No Reflow after Primary PCI in STEMI: An Angiographic Analysis of the TOTAL Study
In the early days of percutaneous coronary intervention (PCI) in patients with ST elevation acute myocardial infarction (STEMI), no reflow phenomenon was known as an indicator of the worst possible outcomes in terms of left ventricular remodeling, infarct size, ejection fraction and mortality, at long term. The TOTAL study (Routine Aspiration Thrombectomy with PCI Versus...
Mitral Valve Edge to Edge Repair for Papillary Muscle Rupture after Acute Myocardial Infarction
With an approximate incidence of 0.05% to 0.25%, post-acute myocardial infarction (AMI) mitral valve failure caused by papillary muscle rupture is not exactly common. However, it is associated to high mortality rate, ranging between 36% and 80%. Current guidelines recommend surgical treatment, but more often than not surgery involves prohibitive or extremely high risk, with...
What Is the Prognosis of an Acute Myocardial Infarction in the Presence of Moderate Aortic Stenosis?
Aortic stenosis (AS) is a common condition that shares risk factors with coronary artery disease. Many patients can suffer from both diseases simultaneously, something that increases the risk of acute myocardial infarction in the presence of aortic stenosis. AS can cause ischemia even in the absence of coronary artery disease, due to ventricular hypertrophy, increased...
Cerebrovascular Events in the COAPT Study
Transcatheter edge-to-edge repair (TEER) with MitraClip has demonstrated its benefit compared with complete guideline-directed medical therapy (GDMT), according to the results of the COAPT Study. While cerebrovascular events (CVE), such as stroke or transient ischemic attack (TIA), are rare, they can occur during the procedure (transseptal puncture, device positioning, or device release) or during follow-up...