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....
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,...
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...
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...
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...
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...
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...
Despite major advances in secondary prevention and reperfusion strategies, acute myocardial infarction (AMI) still causes morbidity and mortality. A significant portion of acute events arise from mild to moderate lesions identified months to years before the index event. Early detection of lesions at higher risk of progression and rupture may allow for more targeted treatment...
Benefits of abbreviated antiaggregant treatment in high bleeding risk patients. Dual antiplatelet therapy (DAPT), established by different guidelines, reduces the risk of ischemic events at the expense of increased bleeding. This habitual APT strategy cannot be applied to patients at high risk of bleeding, which is why this populations are treated with shorter DAPT schemes...
This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography...