Patients undergoing primary angioplasty for ST-segment elevation acute myocardial infarction have similar clinical outcomes at 1 year regardless of whether they are treated with ticagrelor or prasugrel, according the PRAGUE-18 study. This new substudy adds an interesting detail: patients who switched from prasugrel and ticagrelor to clopidogrel, citing economic reasons for the “de-escalation” of therapy, were...
A new analysis from the POISE-2 study suggests that aspirin should not be withheld prior to noncardiac surgery in patients with a history of coronary angioplasty, even if their coronary procedure occurred several years earlier. Patients with a history of coronary angioplasty who need cardiac surgery are more likely to benefit from continued aspirin therapy,...
Compared to surgery, endovascular repair of ruptured abdominal aorta aneurysms has better clinical results, survival and quality of life for patients (in addition to being cost-effective), according to mid-term outcomes of the IMPROVE study, recently published in the British Medical Journal. Even though the initial outcomes had not shown differences between both strategies in terms of...
Several cases have shown an association between patent foramen ovale and cryptogenic shock, particularly in patients under 55 and in those with atrial septal aneurysm or a significant right-to-left shunt. Using PFO closure for stroke prevention has been controversial and, so far, no randomized studies have shown the superiority of this strategy compared to anti-thrombotic...
Courtesy of Dr. José Álvarez. This is a multicenter randomized study on patients with patent foramen ovale (PFO) and a first episode of cryptogenic stroke. It only included patients with moderate to large shunt based on the number of bubbles observed in the left atrium within the first three beats after being noticed in the...
Courtesy of Dr. José Álvarez. The RESPECT trial is a multicenter randomized trial with blinded adjudication of end-point events. It randomly assigned patients from 18 to 60 years of age who had a patent foramen ovale (PFO) and a history of cryptogenic ischemic stroke to undergo closure of the PFO with the Amplatzer device plus medical...
A small hole in the atrial septum can cause any severe neurological disorders, patent foramen ovale (PFO) – a cause or trigger that today can be given safe treatment without drug therapy for a long duration. Before birth there is a connection between the two atria, which closes immediately after birth, but for approximately 20%...
About 25% of patients with multivessel disease undergoing myocardial revascularization surgery or PCI have diabetes. In this subgroup, the benefit of surgery in terms of mortality has long been shown: in the BARI study (Bypass Angioplasty Revascularization Investigation) patients undergoing PCI had close to double the mortality rate at 5 years compared to those...