This is the largest and newest study to compare drug eluting stents with durable polymers vs. biodegradable or bioresorbable polymers. As is usually the case, the theory clashes with reality. The study has shown that the polymer does not seem to play an important role in the performance of drug eluting stents, or at least...
Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding. This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk. The XIENCE Short...
The self-expanding Acurate Neo (Boston Scientific) did not meet non-inferiority vs. the self-expanding CoreValve Evolut (Medtronic) in the SCOPE 2 study published in Circulation simultaneously and presented at the virtual TCT 2020. These are bad news for the Acurate Neo, that had already failed to show non-inferiority vs. the Sapien 3 in the SCOPE 1...
There is evidence in favor of complete revascularization in the context of ST elevation MI with multivessel disease where primary PCI has been successful. However, the small print in these studies should be read carefully. Should revascularization be completed during index intervention, index hospitalization or after discharge? Should complete revascularization be based on visual assessment,...
Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure. This highlights the huge variation in indication and the scarce evidence there is on this matter. Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does...
New guidelines for the diagnosis and treatment of atrial fibrillation (AF) were released at the 2020 European Society of Cardiology (ESC) virtual congress. This document incorporates several findings from the latest clinical trials, but also represents a great shift in terms of how physicians from different specialties should classify and manage arrhythmia after confirming the...
Patients included in the ISCHEMIA trial who had a history of cardiac failure or ventricular function deterioration will benefit from revascularization vs. optimal medical treatment. This is a pre-specified analysis of the paradigmatic ISCHEMIA trial. The ISCHEMIA was published in March 2020 in NEJM and went somewhat unnoticed due to the COVID-19 pandemic. At the...
The DAPA-CKD trial has shown dapagliflozin, a SGLT2 receptor inhibitor, improves function, and reduces cardiovascular events and mortality. The latter is true regardless being or not diabetic. Patients with chronic kidney failure randomized to dapagliflozin saw improved kidney function, reduced cardiovascular events and increased survival rate. Primary end point, a combination of glomerular filtration deterioration...
Data of this “real world” study have confirmed that diabetic patients with multivessel disease will benefit from coronary artery bypass grafting (CABG). According to Dr. Douglas S. Lee, main author of this study, the evidence is fairly conclusive, enough to recommend CABG as first option in this particular subgroup of patients similar to FREEDOM patients. ...
Four years ago, we published a summary of the SMART-STRATEGY Study saying that, with bifurcation lesions, “less is more.” Last month, the DEFINITION Study published in the European Heart Journal suggested that things were about to change. Today, the DK-crush technique seems to have rendered both title and article obsolete. According to this recent analysis...