Stroke is one of the leading causes of death and disability. It produces great morbidity by causing marked post-event cognitive impairment. Recurrence of an ischemic event may vary according to the cause of the stroke. Complicated non-stenotic carotid plaque (CCP) type VI (according to the American Heart Association [AHA] classification) has been described as an...
When is the Ideal Timing for NSTE-ACS Percutaneous Intervention?
According to the European Society of Cardiology (ESC Guidelines 2021) an early invasive strategy is recommended (<24h) for high-risk patients with acute coronary syndrome with no ST elevation (NSTE-ACS), namely patients presenting a rise or fall in cardiac troponin, dynamic ST- or T-wave changes and GRACE risk score >140. Early intervention (<2h) is reserved for...
Post-PCI Ticagrelor Monotherapy in High-Risk Bleeding
In patients at high risk of bleeding undergoing coronary PCI and after completing 3-month DAPT with no events, you may discontinue aspirin and follow up with ticagrelor monotherapy. This will significantly reduce bleeding without increasing ischemic events. With this strategy, the greater the risk of bleeding, the greater the absolute reduction of bleeding. Patients at...
Empagliflozin: Better Quality of Life for Patients with Cardiac Failure and Preserved Ejection Fraction
Empagliflozin has shown early and sustained improved quality of life (at least for a year) in patients with cardiac failure and preserved function. Patients with cardiac failure and preserved ejection fraction present a deteriorated quality of life. The EMPEROR-Preserved assessed the efficacy of Empagliflozin in several baseline health status assessments. HRQoL was measured using the...
First Guidelines Focused Specifically on Chest Pain Management
Many years of developing and waiting have led us to the latest guidelines published by ACC/AHA together with other societies. This is the first document exclusively dedicated to the assessment and diagnosis of acute chest pain. In this regard, we can safely say this is no mere update of a previous set of guidelines, but...
STOPDAPT-2 ACS: One-Month DAPT NOT Enough in acute patients
One-month dual antiplatelet therapy (DAPT) in patients undergoing acute coronary syndrome (ACS) did not reach the safety and efficacy results observed in the general population of the original trial STOPDAPT-2. The STOPDAPT-2 ACS compared one-month DAPT followed by clopidogrel monotherapy for one year vs. one-year DAPT after PCI. Initially, the study enrolled mostly stable patients...
ESC 2021 | COVERT-MI: Colchicine Attempts to Reduce Infarct Size
Colchicine does not offer protection against myocardial injury in ST-segment elevation myocardial infarction when administered during reperfusion and in the following five days, according to the randomized study COVERT-MI. It could even generate signs of damage with 3x the amount of thrombi in the ventricle. The results presented at the European Society of Cardiology 2021...
Vaccine Efficacy against the Delta COVID-19 Variant
COVID-19 B.1.617.2 (delta) Variant, first detected in India, has contributed to a significant increase in the number of COVID cases and has inexorably spread all across the world. The relative efficacy of BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (AstraZeneca) vaccines against this new variant was unclear Vaccine efficacy against the delta symptomatic infection vs. the predominant...
Efficacy of the Sinopharm Vaccine Against COVID-19
Vaccines developed with two different inactivated strains of SARS-CoV-2 (Sinopharm) significantly reduced the risk of symptomatic cases of COVID-19 with an excellent safety profile. Its proven technology—already used against other virus (influenza, hepatitis, polio, rabies)—and the fact that they can be stored at 2-8 °C mean that they are easily (and cheaply) produced, stored, and administered....
FLOWER-MI: FFR vs. Angiography for Complete Revascularization in Infarction
Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)...