Diabetes does not seem to alter the results of a fractional flow reserve (FFR) measurement in a given lesion. Recently, expert opinions and small studies had questioned the reliability of FFR in this specific patient subgroup. This new observational study soon to be published in JAMA vanquishes all doubts and confirms the efficacy of this...
The results of this great multicenter “real-life” registry are similar to those of randomized clinical trials that studied fractional flow reserve (FFR). Lesion deferral based on FFR is a very safe strategy, even for lesions located in the proximal anterior descending artery. Randomized controlled studies FAME and DEFER convincingly showed the safety of lesion revascularization...
This meta-analysis is an update on the role of drug-coated balloons in the treatment of infrapopliteal arterial disease, a difficult pathology for all strategies. The primary endpoint of this meta-analysis was treated lower limb salvage at 12 months. The secondary endpoints included survival at 12 months, amputation free survival, restenosis, and target lesion repeat revascularization rate. This...
Physical activity has been shown to reduce mortality in a dose/response manner, just like any drug. But many still wonder: are there any minimal requirements in terms of amount or intensity? Is there such a thing as “toxic exercise”? And finally, is exercising equally beneficial to all? This study, conducted by Dr Sang-Woo Jeong from...
Courtesy of Dr. Carlos Fava. Around half the treated lesions in peripheral disease are femoropopliteal lesions. Long lesions are among the challenges faced: they are associated with higher mortality and morbidity, and revascularization in that setting always entails some degree of difficulty. Nowadays, with the development of nitinol stents and more operator experience, angioplasty is becoming...
A supplement (or anything, really) that might reduce simultaneously the risk of cardiovascular disease and of cancer would be truly revolutionary. This work, published in the New England Journal of Medicine (NEJM), sought to prove that vitamin D supplements might reduce the risk for both pathologies (the two most frequent diseases in the world). However,...
The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required...
Observational studies (with their subsequent limitations) show a possible increase in adverse events and costs with the use of the Impella device. Two large observational studies stirred doubts regarding the good performance of new circulatory support devices in real-world daily clinical practice. There were more adverse events, including in-hospital death and major bleeding, and more...
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 study. The NOBLE study randomized patients with left main disease to compare PCI vs...
Courtesy of Dr. Carlos Fava. Advanced peripheral vascular disease is frequently associated with cardiovascular events and amputation. It has been proven that mono-antiplatelet therapy (MAPT) offers some benefit (with either aspirin or clopidogrel), but there are scarce data on the role of dual antiplatelet therapy (DAPT) in these patients. Researchers analyzed 404 patients who received MAPT for...