myocardial infarction

ACC 2021 | Sacubitril/valsartan no es superior al ramipril luego de un IAM

ACC 2021 | Sacubitril/Valsartan not Superior to Ramipril after AMI

The combination sacubitril/valsartan following high-risk AMI did not reduce the risk of cardiac failure or cardiovascular risk in patients compared against ramipril. These data were provided by the PARADISE-MI presented today during the scientific sessions at ACC 2021. The combination sacubitril/valsartan had gathered prior evidence (basically from the PARADIGM-HF) for its superiority in terms of total...

ACC 2021 | Cirugía de emergencia en el infarto: beneficios a pesar del alto riesgo

ACC 2021 | Emergent CABG for acute MI: Benefits Despite Risk

The latest figures show a lower number of emergency CABG for acute MI, and in turn increased primary PCI.  The combination of surgeons not willing to take risks and interventional cardiologists empowered to treat practically any lesion has resulted in fewer patients receiving emergency CABG. Only a few years ago, interventional cardiologists at least had...

ACC 2021 | El estrés aumentó en los eventos en pacientes jóvenes con IAM previo

ACC 2021 | Stress Increases Events in Young Patients with Prior MI

Young or middle-aged patients who have already suffered a heart attack have almost twice as many adverse events when they continue to be under emotional stress after the initial suffering. The association between psychological factors and events is attenuated after making adjustments that include markers of inflammation such as interleukin-6. It follows that inflammation plays...

Nueva y discrepante información sobre los vasos no culpables en el infarto

New Unexpected Data on Non-Culprit Vessels in MI

Patients with acute myocardial infarction presenting lesions in multiple vessels is not associated with reduced infarct size in non-culprit lesions, even when functionally significant.  Animal models suggest brief periods of ischemia in non-infarct territories (non-culprit) might protect culprit territory thanks to remote ischemic preconditioning.  This pre-conditioning, according to this perspective, would reduce reperfusion injury and...

Beta Bloqueantes

Post MI Betablockers for Good?

Patients receiving optimal medical treatment after MI do not seem to benefit from betablockers in the long term, provided they do not present cardiac failure or systolic function deterioration.  This study looked into the cardio protection effect of betablockers (BB) after long term follow up in stable patients with no cardiac failure and a history...

Esquema corto y monoterapia, una práctica llena de evidencia

Short Therapy and Monotherapy, Plenty of Evidence

A short dual antiplatelet therapy (DAPT) of 1 to 3 months followed by P2Y12 inhibitor monotherapy after second generation drug eluting stent (DES) implantation is safer and as effective as the traditional scheme. The idea is clear, but why hasn’t aspirin monotherapy been tested as follow up? Is aspirin old fashioned? Are there physiopathological reasons...

Las nuevas guías Europeas de Hipertensión contrastan con las Americanas

Diastolic Pressure Could Play a Dirty Trick on Patients Treated for Hypertension

Having too low diastolic pressure could be linked to an increase in cardiovascular events (J-shape phenomenon). However, current guidelines suggest a target blood pressure under 130/80 mmHg with no lower limit for diastolic pressure. This paper, recently published in JAMA, sought to evaluate the J-shape phenomenon of diastolic pressure in treated patients who reached a target...

Desafíos pendientes con el acceso radial

MATRIX: Impact of Crossover from Radial Access to Femoral Access

The new MATRIX trial, recently published in JACC Interv., shows that an access-site crossover from radial to femoral access in patients with acute coronary syndrome cancels out the benefit provided by radial access as regards bleeding.  However, there are no signs of comparative damage between successfully conducted radial or femoral access as a first attempt. ...

Reporte Mensual Febrero Registro LATAM Bif

LATAMBif Registry: February 2021 Report

The Latin American Registry of Percutaneous Coronary Bifurcations continues to develop at a steady pace.  The aim of this prospective multicenter registry is to assess the reality of percutaneous coronary bifurcation to define its needs and establish effective strategies to perfect the daily clinical practice.  Bellow you will find data from February 2021, which includes...

ticagrelor_enfermedad_vascular_periférica

Net Clinical Benefit of Long-Term Ticagrelor

Ticagrelor reduces ischemic risk in patients with a history of acute myocardial infarction, but it increases the risk of bleeding. Keeping a delicate balance is paramount when prescribing long-term ticagrelor to patients with a history of infarction. The PEGASUS-TIMI 54 study randomized 21,162 patients with a history of infarction on a 1:1:1 ratio: some received ticagrelor...

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