Fundamentos e objetivos: A reserva de fluxo fracionada (FFR) Invasiva é uma ferramenta bem validada e reprodutível para a detecção de lesão causadora de isquemia. Em pacientes com doença multiarterial uma estratégia PCI FFR-dirigida é associada a melhores resultados clínicos em comparação à PCI angiografia- dirigida. No estudo prévio RIPCORD, quando a FFR invasiva estava...
This multicenter, prospective, randomized controlled study was designed to evaluate the noninferiority of guided angioplasty by optical frequency domain (OFDI) compared to IVUS. 800 elective patients randomized 1: 1 were included. The diameter of the stent in the IVUS group was higher than in the OFDI group (p = 0.03). Post implant angiography showed a...
This work included 18144 patients from 39 countries that were admitted pursuing an acute coronary syndrome (with or without ST segment elevation) randomized 1: 1 to receive the combination of simvastatin 40 mg / ezetimibe 10 mg (n = 9067) or simvastatin 40 mg alone (n = 9077). Of the total, 88% received a coronary...
Two separate works are part of the MATRIX study investigating strategies to reduce bleeding and mortality in patients with acute coronary syndrome. The first part of the work that was simultaneously published in The Lancet found a significant reduction in major bleeding and mortality in patients undergoing coronary angiography and angioplasty using radial versus femoral...
This is the first randomized controlled trial to compare the effectiveness of a functional test versus angiography by tomography (≥64 cuts) to diagnose coronary artery disease. The study included 10003 patients from 193 centers who were symptomatic but no previous diagnosis of coronary artery disease. The study found no difference in prognosis between patients who...
This work published simultaneously in The New England Journal of Medicine showed that patients over eighty years may benefit from an aggressive and invasive treatment strategy that could be unnecessarily denied given age. The study was conducted in 16 centers in Norway and included 458 octogenarians patients admitted with acute coronary syndromes without ST-segment elevation...
This study included 329 consecutive patients derived to coronary angiography based on myocardial perfusion tests or PET scan (positron emission tomography). The extension and severity of heart disease was assessed by angiography, and coronary flow reserve (CFR) was measured non-invasively by PET. After adjusting risk factors, ejection fraction, revascularization, etc, both the severity of angiographic...
The new generation drug-eluting everolimus or biolimus stents have proved superior to the first generation. However, neo intimal proliferation and late thrombosis remains a problem not yet solved same for all drug-eluting stents. The Absorb (Abbott Vascular, Abbott Park, IL, USA) is the first absorbable vascular support approved for clinical use. The EVERBIO II study...
Mild refractory hypertension patients were defined as those with daytime systolic BP 135-149 and diastolic BP 90-94 mmHg in ambulatory monitoring. They were randomized to renal denervation (n = 35) versus control invasive procedure (n = 36). The primary end point was the change in systolic pressure of 24 hours ambulatory monitoring at 6 months....
While the use of intravascular ultrasound (IVUS) during coronary intervention proved useful in multiple studies, there is limited evidence in the literature regarding its use in specifically in chronic total occlusions. The IVUS may help guide in recognizing the true lumen and better distal positioning, better coverage of stent, an optimal apposition and expansion, diagnose...