Around half of all cases of ST-segment elevation acute myocardial infarction (STEMI) come alongside lesions in another vessel, for which the current strategy is complete revascularization in one or two steps. However, there are no large-scale studies analyzing patients who also present cardiogenic shock; we only have observational studies with inconclusive results influenced by several...
Both prasugrel and ticagrelor showed superiority in terms of efficacy, reducing the number of major cardiovascular events at the expense of increased bleeding. This is an affordable cost, and the net clinical benefit supports these new antiplatelet therapies. The one-year follow-up of the PRAGUE-18 study focused on a comparison of efficacy and safety between prasugrel...
St elevation acute coronary syndromes are typically caused by thrombotic obstruction of a coronary artery due to ruptured atherosclerosis plaque. However, there is a significant number of patients with similar clinical presentations but no evidence of obstructive coronary artery disease (CAD). Read also: CTO in patients with acute myocardial infarction increases long term mortality. In general, patients without...
The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors...
Courtesy of Dr. Carlos Fava. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men....
Several studies show that patients with multivessel lesions who undergo angioplasty with incomplete revascularization experience more events, including higher mortality, than a cohort of patients who have undergone complete revascularization. In most cases, the analysis was dichotomic (complete vs. incomplete revascularization), but more recent studies show that there may be a gradient, a continuum, in...
During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked for almost 20 years the treatment strategy for patients with infarction complicated...
The current guidelines point out a class I recommendation to the use of distal embolic protection devices for angioplasty in venous bridges, in fact, the evidence is controversial to support this recommendation. The goal of this meta-analysis was to compare mortality from any cause, major cardiovascular events, acute myocardial infarction, and target vessel revascularization of...
The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. The article features 10 points resembling the ten commandments, which makes it easy to read, compared to the tedious task of reading the complete guidelines. 1) The emergency systems should help...
Whether a second arterial conduit improves outcomes in patients undergoing myocardial revascularization surgery is and will remain unclear until the 10-year results of the ART (Arterial Revascularization Trial) are published. Consequently, arterial conduits other than the left internal thoracic artery are seldom used in daily practice. Using a database including 126 non-federal hospitals in California, researchers...