Background: Octogenarian patients represent an increasingly growing population. In addition, this age group has a higher proportion of co-morbidities with more extensive and complex coronary disease. However, they have often been excluded from major studies, whose average age is usually 60 years. Despite having a more complex coronary anatomy, the role of pharmacological stent (DES)...
Fundamentals: Etiology of cryptogenic stroke stills a major challenge for medicine. Paradoxical embolism remains one of the possible causes. Undoubtedly, adults between 20 and 54 years represent a significant proportion of this population, and this is associated with a high morbidity and high costs not only in relation to the pathology itself but also to...
Summary: Second-generation drug-eluting stents have shown better results than their predecessors. In this study we compare two second-generation drug stents in patients with unprotected left coronary trunk injuries. Methods and results: 650 patients with unprotected trunk injury were randomized to either XIENCE V (everolimus eluting) or RESOLUTE (zotarolimus eluting) stents. The primary endpoint was the...
Given the individual variability of response to antiplatelet therapies, measuring platelet function and designing tailored therapies could be beneficial. The ARTIC study tested the superiority of bedside platelet function monitoring with drug adjustment vs. the conventional post DES therapy without monitoring and drug adjustment. It included 2466 patients with stable coronary disease or Non-ST Elevation...
Background: Oral antiplatelet agents have a limitation in their duration of action and bioavailability. Cangrelor is an intravenous adenosine diphosphate (ADP) inhibitor that has a powerful effect, is rapid and reversible within one hour and with the advantage of intravenous administration that reduces variability in the bioavailability of the drug. The study was designed to...
There is still concern about the safety of drug-eluting stents (DES) due to the possibility of late and very late thrombosis. Dual antiplatelet aggregation for a year is recommended for patients receiving DES. The objective of this study was to test the non-inferiority of a new drug-eluting stent in terms of endothelial coverage after 3...
This non-inferiority design study compared the sirolimus-eluting stent with biodegradable polymer versus everolimus-eluting stent with permanent polymer in de novo coronary lesions. The primary endpoint was late lumen loss at nine months. We Included 440 patients with stable coronary lesions randomized 2:1 to receive the new sirolimus eluting stent with biodegradable polymer versus everolimus eluting...
This study randomized 1259 patients to receive one year versus 2 years of double anti anti-platelet after implantation of a drug-eluting stent. The primary end point was a composite of death, myocardial infarction, stroke, stent thrombosis, and urgent revascularization that were equivalent between the two schemes. There was a trend to a higher rate of...
The ideal therapy for treating in-stent restenosis continues to be debated . The pharmacological balloons showed good results in this context, but no direct comparisons available of pharmacological balloonsversus second-generation DES.This prospective, multicenter randomized 189 patients with in-stent restenosis of conventional stents receiving pharmacological balloon or everolimusDES.The primary endpoint was angiographicat 9 months spotting a...
Bivalirudin reduced mortality and bleeding compared to heparin and glycoprotein IIbIIIa in HORIZONS- AMI study. However there was a higher rate of acute stent thrombosis in patients receiving bivalirudin. This randomized study (> 90 % randomized in the ambulance) enrolled 2218 patients with ASTEMIto prolonged infusion of bivalirudin compared with heparin -associated glycoprotein inhibitors. The...