Despite major advances in secondary prevention and reperfusion strategies, acute myocardial infarction (AMI) still causes morbidity and mortality. A significant portion of acute events arise from mild to moderate lesions identified months to years before the index event. Early detection of lesions at higher risk of progression and rupture may allow for more targeted treatment...
Benefits of abbreviated antiaggregant treatment in high bleeding risk patients. Dual antiplatelet therapy (DAPT), established by different guidelines, reduces the risk of ischemic events at the expense of increased bleeding. This habitual APT strategy cannot be applied to patients at high risk of bleeding, which is why this populations are treated with shorter DAPT schemes...
This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography...
Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk. The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis. Prolonged DAPT has been associated with...
Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management. A subanalysis of...
Many randomized studies and systematic revisions have shown that an early invasive approach (within 24hrs. after diagnosis) will not reduce mortality across the non-ST elevation acute coronary syndrome (NST-ACS) population, hence the relevance of NST-ACS; patients with a GRACE score higher than 140 were the ones showing improved outcomes. Roughly 40% of NST-ACS patients have...
The 44th SOLACI Regional Sessions – 15th South Cone Region took place in a hybrid setting (F2F and online) in Asuncion, Paraguay, between June 30 and July 1, 2022. It was a successful event that featured prestigious national and international guests and a world class scientific program. Next, we share some of the presentations held...
Since its inception, transcatheter aortic valve replacement (TAVR) has improved greatly. However, there still are five big challenges to be solved: paravalvular leak, conduction disturbances, debilitating stroke, impaired kidney function, and major vascular complications and bleeding. Most cases of stroke are periprocedural and ischemic. So far, they have not been well analyzed in terms of...
For over a decade, TAVR has been showing great benefits, but conduction abnormalities such as RBBB and prior A-V block, continue to be one of the biggest challenges, since in different series the need for definite pacemaker implantation (PPM) varies between 17 to 30% in the large, randomized studies of self-expanding valves. Even though we...
The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim...