Original title: Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: A collaborative meta-analysis of contemporary randomized clinical trials. Reference: Stergiopoulos K el al. JAMA Intern Med 2013; DOI:10.1001/jamainternmed.2013 The amount in ischemic patients with stable coronary heart disease is associated with poor prognosis. However, it is unclear whether revascularization to reduce...
Original title: Complete Versus Culprit-Only Revascularization for Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis. Reference: Kevin R et al. American Heart Journal, article in press. Primary angioplasty is the preferred reperfusion strategy in patients experiencing a STEMI as it has proven superior to fibrinolysis in reducing...
Original title: Impact of Periprocedural Bleeding on Incidente of Constrast-Induced Acute Kidney Injury in patients treated with Percutaneous Coronary Intervention. Reference: Yohei Ohno, et al. J Am Coll Cardiol 2013;62:1260-6 Contrast induced acute kidney injury (CI-AKI) is a serious complication associated to higher morbimortality rates and higher costs, but its correlation to bleeding remains controversial. This study included...
Original title: Comparison of coronary artery bypass surgery and percutaneous coronary intervention in patients with diabetes: A meta-analysis of randomized controlled trials. Reference: Verma S. et al. Lancet Diabetes Endocrinol. 2013;Epub ahead of print. The FREEDOM study was the last of the randomized studies that compared the results of surgery versus coronary angioplasty in diabetic multivessel patients showing a...
Original title: A direct comparison of intravenous enoxaparin with unfractionated heparin in primary percutaneous coronary intervention (from the ATOLL trial). Reference: Collet et al. Am J Cardiol. 2013; Epub ahead of print. ATOLL study analysis suggests that enoxaparin is superior to unfractionated heparin in reducing ischemic events and mortality in patients suffering ST elevation acute myocardial infarction (STEMI)...
Original title: Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. Reference: Vincent Dangoisse et al. EuroIntervention 2013;9:345-352. Although the transfemoral approach has clear disadvantages when it comes to bleeding complications, it continues to be the preferred approach...
Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are...
Original title: Outcomes After Primary Percutaneous Coronary Intervention in Octogenarians and Nonagenarians With ST-Segment Elevation Myocardial Infarction: From the Western Denmark Heart Registry. Reference: Lisbeth Antonsen et al. Catheterization and Cardiovascular Interventions 81:912–919 (2013) With increasing life expectancy worldwide, older patients will become increasingly referred to us for angioplasty in the context of a heart attack with ST...
Original title: Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non–ST-Segment Elevation Myocardial Infarction Results of the SELECT-ACS Trial. Reference: Jean-Claude Tardif et al. J Am Coll Cardiol 2013;61:2048–55. The pathophysiology of myocardial injury after angioplasty is multifactorial but it is clear that inflammation and platelet activation play a major role. P-selectin...
Original title: Pre-Procedural Estimate of Individualized Bleeding Risk Impacts Physicians’ Utilization of Bivalirudin During Percutaneous Coronary Intervention. Reference: Seshu C. Rao et al. J Am Coll Cardiol 2013;61:1847–52 While safety of coronary angioplasty has improved over time, post-procedure bleeding is still frequent with a large variability between centers. Bleeding is associated with increased mortality, myocardial infarction, stroke, increased...