There is no such thing as coincidence, at least not for the evidence-based medical science. This is what the NOBLE 5-year outcomes, soon to be published in the Lancet, seem to say, in line with the BBC exposé of the EXCEL study. The NOBLE study randomized patients with left main disease to compare PCI vs<a href="https://solaci.org/en/2020/01/08/soon-after-the-excel-scandal-the-noble-5-year-outcomes-come-out-mere-coincidence/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Advanced peripheral vascular disease is frequently associated with cardiovascular events and amputation. It has been proven that mono-antiplatelet therapy (MAPT) offers some benefit (with either aspirin or clopidogrel), but there are scarce data on the role of dual antiplatelet therapy (DAPT) in these patients. Researchers analyzed 404 patients who received MAPT for<a href="https://solaci.org/en/2020/01/07/we-should-indicate-more-than-6-months-of-dapt-in-lower-limb-disease/" title="Read more" >...</a>
1- Consensus on How to Conduct Follow-Up in Peripheral Vascular Disease Peripheral vascular disease involves multiple areas and, therefore, can have very different presentations (from complete lack of symptoms to disabling symptoms). Depending on clinical presentation, general condition, anatomical localization, and lesion extension, revascularization can be indicated alongside optimal medical treatment. Read also HERE 2-<a href="https://solaci.org/en/2020/01/06/the-most-read-articles-of-december-in-solaci-org/" title="Read more" >...</a>
The European Association for Cardio-Thoracic Surgery (EACTS) formally withdrew its support for the latest coronary revascularization guidelines following a BBC investigation suggesting that data from the EXCEL trial might have been manipulated. The recommendations for left main coronary artery revascularization featured in the 2018 guidelines, which were written jointly with the European Society of Cardiology<a href="https://solaci.org/en/2020/01/06/latest-guidelines-dropped-after-scandal-over-excel-results/" title="Read more" >...</a>
Peripheral vascular disease involves multiple areas and, therefore, can have very different presentations (from complete lack of symptoms to disabling symptoms). Depending on clinical presentation, general condition, anatomical localization, and lesion extension, revascularization can be indicated alongside optimal medical treatment. In 2017, guidelines with indications for revascularization were published; however, maintaining long-term patency can be<a href="https://solaci.org/en/2019/12/27/consensus-on-how-to-conduct-follow-up-in-peripheral-vascular-disease/" title="Read more" >...</a>
After coronary angioplasty, the use of drugs whose efficacy for the reduction of major events has been proven declines over time, which is associated with worse patient prognosis. Sometimes, without meaning to, we convey to patients the idea that, once the stent has been implanted, the artery is “cured” or that the only potential future<a href="https://solaci.org/en/2019/12/26/secondary-prevention-a-responsibility-we-should-not-delegate/" title="Read more" >...</a>
Guidelines recommend oral anticoagulation for all ≥ 75-year-old patients with atrial fibrillation. However, there is little evidence as to its net clinical benefit in the elderly population. This study looked at the life net clinical benefit in atrial fibrillation patients over 75 years of age treated with warfarin or apixaban vs. no treatment. Researchers observed<a href="https://solaci.org/en/2019/12/09/benefit-of-anticoagulation-in-the-elderly-with-atrial-fibrillation/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2019/12/02/the-most-read-articles-of-november-at-solaci-org/" title="Read more" >...</a>
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)<a href="https://solaci.org/en/2019/11/20/aha-2019-colcot-colchicine-and-the-return-of-the-anti-inflammatory-theory/" title="Read more" >...</a>
Contemporary data of a recently published large registry show that mechanical complications after infarction are not frequent but maintain a very high mortality rate that does not seem to improve over time. Our information on mechanical complications was outdated and we did not have current data on their incidence and prognosis. Such is precisely the<a href="https://solaci.org/en/2019/11/15/current-mechanical-complications-of-infarction/" title="Read more" >...</a>