Transcatheter aortic valve replacement (TAVR) in low-risk patients has been shown to be superior or noninferior in randomized studies, but the presence of valvular thrombosis, in its different forms, has not been well analyzed, nor is there much information on its impact on evolution. Researchers conducted an analysis of the LTR study that included 200...
Among patients undergoing percutaneous coronary intervention (PCI), there is a need for risk stratification for successful planning and post procedural management. Risk stratification is paramount for effective decision making. For a long time, the SYNTAX score has been the preferred tool for complex PCI patient risk assessment. However, it has important limitations, such as inter-observer...
Acute coronary syndromes (ACS) involve high mortality risk, especially ST elevation ACS. Their treatment is based on reperfusion, dual antiplatelet therapy (DAPT) and anticoagulation, with enoxaparin (1 mg/kg twice a day) as the preferred anticoagulant according to the contemporary guidelines. 2.5 mg or 5 mg doses of rivaroxaban might be valid alternative treatments for this...
Monotherapy in patients with complex angioplasty: meta-analysis of 5 randomized studies. Even though prolonged dual antiplatelet therapy (DAPT) might reduce the risk of important ischemic complications, this reduction will come at the expense of a significant increase of bleeding risk, which makes us reassess the cost benefit ratio of this decision. This is also why...
The duration of percutaneous aortic valve implants can be increasingly observed over time, regardless of their corresponding surgical risk. In the follow-up of different registries, the presence of subclinical valvular thrombosis, evidenced in tomographic studies as an increase in valvular thickness with hypoattenuation (a term known as HALT), was observed from protocolized images. This subclinical...
Revascularization and antiaggregation guidelines have typically recommended aspirin (AAS) as first choice for secondary prevention of cardiovascular events after DES stenting. However, these past few years this strategy has been called into question, seeing as studies have shown the superiority of P2Y12 inhibitor monotherapy (IP2Y12) with clopidogrel or ticagrelor. There is little data comparing both...
Atrial fibrillation is a very frequent type of arrythmia that affects both men and women alike. This entity is associated to higher mortality seeing as it favors stroke and hospitalization for cardiac failure. At present, one of its valid treatment strategies is left atrial appendage closure, to reduce or prevent stroke and anticoagulation driven bleeding. ...
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...
This study, presented by Dr. Valentin Fuster, focused on the importance of medical treatment compliance, initially showing data from the FOCUS study where the poor compliance observed in patients after an acute myocardial infarction (AMI) event was improved by creating a polypill (aspirin, simvastatin, and ramipril). Based on this, the SECURE randomized study was conducted...
The TIME study, presented by Dr. Thomas MacDonald, is a randomized study of over 21,000 patients with high blood pressure with a follow-up beyond 5 years. As is widely known, high blood pressure is the leading global cause of early death, accounting for nearly 10 million deaths in 2015, of which 4.9 million were caused by...