1) New High Blood Pressure Guidelines The wait is finally over: the high blood pressure guidelines that have been in the works for the past 3 years saw the light of day at the American Heart Association (AHA) 2017 Scientific Sessions. Read more 2) Nearly half of interventional cardiologists may have pre-cataract lesions This statement is based on eye...
Intravascular imaging, which includes ultrasound intravascular (IVUS) and optical coherence tomography (OCT), shows live details that better characterize post stenting plaque, anatomy and outcomes. The already familiar limitations of the angiography has lead us to think that IVUS and OCT could improve clinical outcomes; however, we should still find the evidence to support this claim. To shed some...
In recent years, angioplasty with drug-eluting stents (DES) has emerged as an alternative to myocardial revascularization surgery in patients with left main coronary artery disease. Both European and American guidelines offer a Class IIa recommendation for left main coronary artery (LMCA) angioplasty in selected patients. The EXCEL (Evaluation of Xience Versus Coronary Artery Bypass Surgery for...
Courtesy of Dr. Carlos Fava. Spontaneous Coronary artery dissection (SCAD) was first described in 1931 and, even though its prevalence according to different studies is roughly between 0.07% and 1.1%, it is more frequent in women and is associated to acute coronary syndrome and sudden death. The study looked at 752,352 women presenting acute myocardial infarction (AMI)...
Courtesy of Dr. Carlos Fava. Severe left main coronary artery (LMCA) lesions have a bad prognosis in coronary disease. In that scenario, current guidelines recommend surgery as the treatment of choice. However, due to the current development of second-generation drug-eluting stents (DES) and greater operator expertise, left main coronary artery angioplasty appears as a valid alternative...
Patients undergoing primary angioplasty for ST-segment elevation acute myocardial infarction have similar clinical outcomes at 1 year regardless of whether they are treated with ticagrelor or prasugrel, according the PRAGUE-18 study. This new substudy adds an interesting detail: patients who switched from prasugrel and ticagrelor to clopidogrel, citing economic reasons for the “de-escalation” of therapy, were...
During primary angioplasty, it is not uncommon to see several other lesions in coronary arteries. Current guidelines advise against the treatment of these lesions in the same primary angioplasty procedure, although there is evidence supporting such a course of action that may warrant changes in these recommendations. The functional assessment of these nonculprit lesions may...
Courtesy of Dr. Pablo Baglioni. This is a prospective observational study with a 1-year follow-up analyzing 2062 patients with acute coronary syndrome (ACS) who have been treated with coronary angioplasty using new-generation drug-eluting stents (DES). Patients were included between December 21, 2012 and August 25, 2015. On May, 2014, due to changes in international guidelines, clopidogrel...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has been proven to reduce mortality and improve the quality of life of patients with pure severe aortic stenosis (PAS). However, there is a significant number of patients who experience mixed aortic stenosis associated with moderate/severe aortic regurgitation (MAS). These subjects were excluded from the PARTNER...
In the subgroup of patients with ST-segment elevation myocardial infarction who fail thrombolysis, transradial access reduces both bleeding and mortality, according to the results of this new study recently published in JACC Cardiovascular Interventions. Overall, transradial access following failed thrombolysis was associated with a 70% reduction in vascular complications, a 28% reduction in combined in-hospital...