Courtesy of Dr. Carlos Fava. Carotid artery disease is an important cause of stroke and is associated to coronary artery disease. When patients need myocardial revascularization surgery (Carotid Artery Bypass Graft) and cannot wait one month or more for carotid revascularization, the optimal management strategy is still controversial. The aim of this study was...
MitraClip: Impact of Sinus Rhythm and Heart Rate
Courtesy of Dr. Carlos Fava. Atrial fibrillation (AF) and fast heart rate (>70 lpm) have been shown to increase the risk of mitral valve repair surgery. The MitraClip has shown benefits in high risk patients, but its relation to abnormal heart rhythm has not yet been established. 760 patients were analyzed; 315 (52.4%) presented...
How Important Is Controlling Risk Factors for the Prevention of a Stroke?
There has been a recent decline of about 20% to 40% in the incidence of cerebrovascular accidents (stroke). Although this is attributed to the improvement of risk factor control, the reason behind it is not utterly clear. This study estimated the impact of modifiable cardiovascular risk factors on the incidence of stroke between 1995 and...
Sinus Aspiration against Contrast Induced Kidney Injury: Yes or No?
Contrast induced kidney injury incidence is in direct correlation to the administered contrast. The aim of this study was to assess the safety and efficacy of sinus aspiration immediately after PCI as a measure to reduce the volume of contrast arriving in the kidneys. The study included 43 patients with diabetes and renal impairment...
Prasugrel vs. Ticagrelor in Diabetics with Heart Disease
Diabetic patients are increased risk of thrombotic events, which is why an effective antiplatelet therapy is crucial for these patients. Both prasugrel and ticagrelor have shown to reduce thrombotic complications further than clopidogrel. Subgroup analyzes of the most important studies testing prasugrel and ticagrelor vs. clopidogrel have shown that diabetic patients receiving the new...
Procedural Complexity Affects Decision-Making Regarding DAPT Duration
Much of the speculation around the way of individualizing dual antiplatelet therapy (DAPT) duration after coronary angioplasty has focused on clinical parameters (e. g., diabetes), but a new study published by the Journal of the American College of Cardiology (JACC) and presented at the last European Society of Cardiology (ESC) Congress warns about anatomical factors as...
Paravalvular Insufficiency After TAVR: A Better Predictor of Endocarditis
Data from this large international registry associate endocarditis after a transcatheter aortic valve replacement (TAVR) with high rates of early and late mortality, and might help find predictors identifying patients with the highest risk of developing this rare but dangerous complication. So far, information on endocarditis after TAVR was limited to small populations. In...
Xience V: Safe in “Real-Life” Bifurcation Lesions
Courtesy of Dr. Rodrigo Abreu. INTRODUCTION Bifurcation lesion treatment has evolved considerably in the last years: from balloon angioplasty (with high occlusion and restenosis rates) to bare metal stent angioplasty (with a procedural success around 86% and major adverse cardiac events [MACE] at 1 year around 32%). The subsequent emergence of drug-eluting stents (DES) reduced...
Coronary Perforation in PCI: Associated to Negative Outcomes
Courtesy of Dr. Guillermo Migliaro. Coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) with an estimated incidence of 0.5%. Arterial blood entering the pericardium may cause a rapid elevation of intrapericardial pressure and collapse the right cavities (tamponade) creating hemodynamic compromise. Historically, surgical drainage has been the...
Intracoronary Abciximab reduces events in diabetics during PPCI
Diabetic patients have an increased risk of future cardiovascular events after an ST elevation MI. Administration of an intracoronary abciximab bolus during primary PCI could be beneficial for this high risk subgroup of patients. This study reports one year clinical outcomes and CMR imaging of patients randomized to intracoronary vs. intravenous abciximab during primary...