The ISCHEMIA trial enables countless sub-studies. Many of them have made part of the virtual ACC 2020, and among them you will find the present study. This analysis finds it is the anatomy — rather than ischemia — which predicts events. And even more interesting is the fact that revascularizing this particular anatomy will not...
In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed out of a science-fiction tale. The world has changed...
In patients with peripheral artery disease undergoing revascularization, the combination of rivaroxaban (Xarelto) and low doses of aspirin are superior to aspirin alone in the prevention of acute low limb ischemic events, amputation, cardiovascular events and strokes. The outcomes of VOYAGER PAD add to the COMPASS outcomes, showing the combination of therapies can benefit risk...
The ISCHEMIA trial will keep shedding light. The latest data show important differences between men and women as regards disease severity and its correlation with symptoms. Women have more angina than men but have less extensive ischemia. These findings were presented virtually at the ACC 2020, cancelled by COVID19, and suggest that, in addition to...
The revascularization of tibial arteries in patients with critical lower limb ischemia using drug-coated balloons vs. conventional angioplasty resulted in comparable long-term outcomes in terms of both safety and efficacy. Paclitaxel exposure was not related to a higher risk of amputation or all-cause mortality at 5 years (which is the good news for much questioned drug-coated...
01- Alternatives for Patients Allergic to Aspirin The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a recommendation to use monotherapy with the most potent antiaggregant we...
Long after AHA 2019 had presented observational studies showing adverse events associated to Impella, JAMA is finally publishing the official results including all charts and small print. The controversial analysis of the American registry had suggested worse outcomes with the intravascular microaxial left ventricular assist device Impella vs. the intra-aortic balloon pump in acute myocardial...
Since November 2015, when the LEADERS FREE was published in NEJM, polymer-free drug coated stents had undoubtedly been the best treatment for patients at high risk of bleeding. The benefit was owed to the safety and efficacy of the polymer-free biolimus coated stent (also called umirolimus) vs. bare metal stents in the context of just...
Clinical practice guidelines are usually tedious and, frankly, while a lot of people make an enormous effort to write them, they are ultimately read in full by just a few. These new European Guidelines on the Management of Lower Limb Acute Ischemia represent a special team effort, since they include physicians, cardiologists, surgeons, and interventionists,...
01- Soon after the EXCEL “Scandal” the NOBLE 5-year Outcomes Come Out: Mere Coincidence? 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...