A new ISCHEMIA analysis has shown its outcomes are highly dependent on MI definition. The original conclusion had shown a significant difference between invasive and conservative strategies using the most sensible definition of MI: troponin elevation. When looking at events using MI definition as troponin elevation, we will see the conservative treatment reduces primary end...
Pleiotropic Effect of Metoprolol: Different From other B-blockers
The clinical practice guidelines recommend the early use of endovenous B-blockers in patients undergoing acute myocardial MI, taking for granted that all B-blockers have a similar class effect. This experimental study might show metoprolol has other benefits that could make it superior to the rest of the B-blocker family. Using an animal model with 45-minute...
High Risk Anatomy Challenges ISCHEMIA Outcomes
According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization at long term vs. the conservative treatment. This goes against the study presented by Reynolds H et al at AHA 2020. Dr. Reynold’s was a sub-study of the ISCHEMIA trial which had observed that even...
Pending Challenges in Transradial Access
The recent SAFARI-STEMI study compared transradial and femoral access in patients with ST-segment elevation myocardial infarction, and no significant differences were found. These results have a sour taste for those in favor of transradial access, as they are convinced of its benefits and unwilling to go back to previous practices. This bitter taste is based...
Suboptimal Recanalization Results Worse than Procedural Failure
This large cohort of patients undergoing PCI for chronic total occlusion has shown suboptimal recanalization is associated with cardiac death and myocardial infarction at long term compared against procedural failure. The link between acute outcomes and long-term events in recanalizations has been overlooked. Mainly when it comes to suboptimal results, is doing something more trouble...
SOLACI PERIPHERAL | 5th Clinical Case: Abdominal Aortic Aneurysm with Hostile Neck
New clinical case from SOLACI PERIPHERAL! This time, we present a case featuring an abdominal aortic aneurysm with hostile neck. With this, we wrap up an intense year during which we published 5 clinical cases to deepen and stimulate the exchange between Latin American interventionist colleagues. Tell us what you think about this case using...
The most relevant articles in pharmacology in 2020
In this selection, we summarize for you the most important scientific news of 2020 in the field of pharmacology. 01- 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...
The Transradial Approach Continues to Be the Best for Primary PCI
The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI. This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral. The transradial...
The Most Read Articles in Interventional Cardiology
01- Ticagrelor or Prasugrel in ST Elevation MI In patients undergoing ST elevation acute myocardial infarction (STEMI) receiving primary PCI, no significative differences between prasugrel and ticagrelor were found. However, the latter was associated to a significantly higher number of repeat MI when considered separately. Read more HERE 02- Number of Hours of Sleep and...
AHA 2020 | In Most Cases, Imaging Can Determine What Causes MINOCA
Intravascular imaging with coronary optical coherence tomography (OCT) and magnetic resonance imaging allow for the identification of the cause of heart attack in 85% of women without coronary obstructions in angiography. Myocardial infarction with non-obstructive coronary arteries (MINOCA) affects women disproportionately and we have considered these events as “false positives” for far too long. The...