1- AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment After a several year follow up, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) has shown that an invasive approach in addition to optimal medical treatment (OMT) does not offer benefits when it...
AHA 2019 | COMPLETE: Complete Revascularization Is Superior since It Treats Other Vulnerable Plaque
This COMPLETE sub-study using optical coherence tomography (OCT) showed the prevalence of vulnerable lesions other than the culprit which should provide a physiopathological explanation of the benefit of complete revascularization observed in the original study. STEMI patients with multivessel disease will benefit from complete revascularization in terms of reduced cardiovascular death and repeat MI according...
AHA 2019 | ISCHEMIA-CKD: Chronic Kidney Disease and Stable Coronary Disease
Among patients in the main ISCHEMIA trial, those with chronic kidney disease are a particularly high-risk subgroup. However, an invasive strategy with coronary angiography and revascularization did not improve the rate of events, similarly to what happened in the general population for the aforementioned trial. The rate of death or acute myocardial infarction was 36.4%...
AHA 2019 | COLCOT: Colchicine and the Return of the Anti-Inflammatory Theory
Low-dose colchicine seems to reduce the risk for new cardiovascular events in patients with a history of infarction. This drug is usually indicated for anti-inflammatory therapy in gout and pericarditis. Now, it could also reduce the rate of ischemic events as secondary prevention according to the COLCOT trial presented during the American Heart Association (AHA)...
Regional Course of Interventionism for the Clinical Cardiologist | with SOLACI’s Support
On November 30, 2019, the “I Regional Course of Interventionism for the Clinical Cardiologist” will take place in Chiclayo, Peru. The event will be held in the Muchick Room at Costa del Sol Hotel, organized by the Peruvian Society of Hemodynamics and Endovascular Interventionism (SOPHIE) with the support of SOLACI. The activity will be oriented to...
Should Post-PCI Biomarkers Elevation Be of Concern?
Elevated markers after PCI in stable patients treated with the latest generation stents continues to happen. However, only the association between biomarker elevation with creatine kinase-myocardial band (CK-MB) should be of concern, sin it was associated with mortality at one year. Post procedural cardiac troponin (cTn) elevation was not associated to future events, according to...
Venous Pulmonary Waveforms in MitraClip Have Prognostic Value
Courtesy of Dr. Carlos Fava. The MitraClip has been shown to benefit a certain group of patients and it is a well-known fact that a ≥5 mmHg is associated to a more torpid evolution. However, there is little evidence when it comes to venous pulmonary waves, changes in left atrial pressure and V wave. 121...
THEMIS: Ischemic and Hemorrhagic Events in Delicate Balance for Chronic Ticagrelor
The THEMIS study published this week in NEJM, tested chronic ticagrelor + aspirin in diabetic patients with stable coronary artery disease (CAD), but with no prior history of Myocardial infarction (MI) or stroke. The tempting hypothesis behind this study is that reducing ischemic events might increase bleeding events, and this calls for careful cost/benefit assessment. ...
TCT 2019 | IVUS-XPL: 5-Year Follow-up for Angiography-vs. IVUS-Guided Angioplasty
Courtesy of SBHCI. The aim of this work, which was presented during the TCT 2019 Scientific Session and simultaneously published in JACC Intv, was to prove the benefit of intravascular ultrasound (IVUS) in angioplasty. The IVUS-XPL trial randomized 1400 patients with long coronary lesions (≥28 mm) to IVUS-guided angioplasty (n = 700) vs. angiography-guided angioplasty (n = 700). All procedures were...
TCT 2019 | COMPLETE: Sub-Study to Find Out Complete Optimal Revascularization Timing in STEMI
Courtesy of SBHCI. The COMPLETE study was carried out to assess the benefit of complete revascularization vs culprit vessel revascularization in the context of ST elevation acute myocardial infarction. This COMPLETE sub-study presented at TCT 2019 scientific sessions simultaneously published in JACC assessed the optimal timing of complete revascularization. The general study had already shown...