The FREEDOM has clearly established the benefit of myocardial revascularization surgery (CABG) over percutaneous coronary intervention (PCI) in diabetic patients with multivessel disease. Coronary physiology as guideline for revascularization works best precisely in this kind of patients and its impact has never been studied in diabetics. This study, published in Circ Cardiovasc Interv, assessed the...
According to a recent study published in Circ. Cardiovasc Interv, after a scheduled angioplasty, the rate of arrhythmia requiring some kind of treatment is very low, low enough to deem unnecessary the routine monitoring of all patients. The standard policy at many institutions is continuous cardiac monitoring for several hours after undergoing coronary angioplasty, with...
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...
Myocardial revascularization surgery is still one of the most effective treatment strategies against coronary disease. One of the most important advantages of surgery over angioplasty is the chance to reach complete revascularization. This has proven to improve the survival of patients and to reduce the number of cardiovascular events. The choice of conduit for the...
In Paris, during the European Society of Cardiology (ESC) Congress 2019 Scientific Sessions, new guidelines for the diagnosis and treatment of chronic coronary syndromes were presented. This document, simultaneously published in Euro Heart J, updates the 2013 guidelines on stable ischemic heart disease and takes out the word “stable” so as to emphasize that the...
Staged complete revascularization in patients with acute myocardial infarction and multivessel coronary disease is superior to culprit PCI only at five-year follow-up. The outcomes of this retrospective analysis show the benefit of staged PCI, though it might be attenuated in diabetic patients. Outcomes are consistent with previously published randomized studies. Nevertheless, we should remain cautious...
Despite our high hopes for new-generation drug-eluting stents (DES), patients with diabetes still have a different prognosis, both clinical and angiographic, compared with non-diabetic patients. Authors sought to investigate the impact of diabetes on patients who underwent drug-eluting stent implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial. This...
1- What Antiplatelet Therapy Should We Use in Patients with Stroke/TIA? Interesting Results for the POINT Trial The New England Journal of Medicine (NEJM) recently published an article about the POINT trial (simultaneously presented at the European Stroke Organisation Conference), a long-awaited randomized clinical trial to assess the efficacy and safety of dual antiplatelet therapy...
Sirolimus-eluting stents with biodegradable polymer did not offer better outcomes compared with instant-classic (and undoubtedly valid) everolimus-eluting stents with durable polymer such as Xience. New-generation drug-eluting stents (DES) offer better outcomes than first-generation devices after a 10-year follow-up, according to the ISAR-TEST 4 trial presented at the American Heart Association (AHA) Congress Scientific Sessions and published...
Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty. This study, published online before...