01- Coronavirus and the Heart: How Should Cardiologists Prepare? As the number of confirmed cases increases throughout the globe, a picture is emerging as to what the direct cardiovascular effects of this pandemic may be. Read more HERE 02- TAVR: Should Transradial Approach be the Second Access Site? Courtesy of Dr. Carlos Fava. One of...
The DANish Acute Myocardial Infarction 2 (DANAMI-2) trial showed the 30-day superiority of patient transport to a primary angioplasty site vs. fibrinolysis at the hospital where the patient had been originally admitted. Those 30-day results became a landmark in the history of interventional cardiology. However, some suspected that such initial benefit could fade away over...
A large proportion of patients undergo primary angioplasty beyond the timelines recommended by clinical practice guidelines. These patients have poorer 5-year outcomes compared with those subjected to a pharmaco-invasive strategy. ST-segment elevation myocardial infarction guidelines recommend primary angioplasty as the strategy of choice within 120 min after a diagnostic electrocardiography. If that is not possible, thrombolytic...
Long after AHA 2019 had presented observational studies showing adverse events associated to Impella, JAMA is finally publishing the official results including all charts and small print. The controversial analysis of the American registry had suggested worse outcomes with the intravascular microaxial left ventricular assist device Impella vs. the intra-aortic balloon pump in acute myocardial...
01- Soon after the EXCEL “Scandal” the NOBLE 5-year Outcomes Come Out: Mere Coincidence? There is no such thing as coincidence, at least not for the evidence-based medical science. This is what the NOBLE 5-year outcomes, soon to be published in the Lancet, seem to say, in line with the BBC exposé of the EXCEL...
Courtesy of Dr. Carlos Fava. In modern studies, carotid artery stenting (CAS) has been shown equal to surgery in terms of the composite end point of periprocedural stroke, death, acute myocardial infarction and late ipsilateral stroke. This was tested in different groups and by trained operators. In the CREST-2 Registry (C2R) 2141 patients were included,...
The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required...
There is no such thing as coincidence, at least not for the evidence-based medical science. This is what the NOBLE 5-year outcomes, soon to be published in the Lancet, seem to say, in line with the BBC exposé of the EXCEL study. The NOBLE study randomized patients with left main disease to compare PCI vs...
Courtesy of Dr. Carlos Fava. Advanced peripheral vascular disease is frequently associated with cardiovascular events and amputation. It has been proven that mono-antiplatelet therapy (MAPT) offers some benefit (with either aspirin or clopidogrel), but there are scarce data on the role of dual antiplatelet therapy (DAPT) in these patients. Researchers analyzed 404 patients who received MAPT for...
1- Consensus on How to Conduct Follow-Up in Peripheral Vascular Disease Peripheral vascular disease involves multiple areas and, therefore, can have very different presentations (from complete lack of symptoms to disabling symptoms). Depending on clinical presentation, general condition, anatomical localization, and lesion extension, revascularization can be indicated alongside optimal medical treatment. Read also HERE 2-...