acute myocardial infarction

Complete revascularization in one procedure is more cost effective and as safe as in stages.

Original title: Staged Versus One-time Complete Revascularization With Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease Patients Without ST-Elevation Myocardial Infarction. Reference: Edward L. Hannan et al. Circ Cardiovasc Interv 2013;6;12-20. There is evidence that in patients with multi-vessel disease affected by an acute coronary syndrome (ACS) with ST segment elevation, only the cause lesion should be treated...

Ischemic preconditioning reduces infarct size in patients treated with primary angioplasty

Original title: Preinfarction Angina Reduces Infarct Size in ST-Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention Reference: Ronald Reiter et al. Circ Cardiovasc Interv. 2013;6:00-00. Ischemic preconditioning (IPC) is a phenomenon whereby transitory ischemia episodes protect the myocardium against a more prolonged episode.  Until now, IPC has been the most effective approach to protect the myocardium. Pre infarction...

Intracoronary enalaprilat reduces periprocedural injury.

Original title: Intracoronary Enalaprilat to Reduce Microvascular Damage During Percutaneous Coronary Intervention (ProMicro) Study. Reference: Fabio Mangiacapra et al. J Am Coll Cardiol 2013. Article in press Angiotensin converting enzyme (ACE) inhibitors improve clinical outcomes in patients with coronary artery disease and improve epicardial flow in patients with acute ST-segment elevation.  Beyond the long-term protective effect of oral...

Serum fibrinogen is a better predictor of periprocedural events than platelet reactivity.

Original title: Elevated Plasma Fibrinogen Rather Than Residual Platelet Reactivity After Clopidogrel Pre-Treatment Is Associated With an Increased Ischemic Risk During Elective Percutaneous Coronary Intervention. Reference: Lawrence Ang et al. J Am Coll Cardiol 2013;61:23–34. Platelet function tests have identified differences in the response of each patient to clopidogrel and minor platelet inhibition has been associated with thrombotic...

Ticagrelor, even better than we thought

Original title: Reduction in First and Recurrent Cardiovascular Events with Ticagrelor Compared with Clopidogrel in the PLATO Study. Reference: Payal Kohli et al. CIRCULATION AHA.112.124248. In analyzing randomized and monitored study outcomes, we usually observe that after the occurrence of any primary outcome event patients are typically blocked for further analysis.  This practice limits the information on subsequent...

Complex angioplasty with ventricular assist

Original title: Real-Word of the Impella 2.5 Circulatory Support System in Complex High-Risk Percutaneous Coronary Intervention: The USpella Registry Reference: Brijeshwar maini, et al. Catheterization and Cardiovscular Intervention For about a decade angioplasty has begun to be performed in increasingly complex patients (PE) such as those with left coronary trunk injury, 3-vessel injury, poor ventricular function and surgically...

In patients with stroke history, Ticagrelor is superior to Clopidogrel

James SK, Storey RF, Khurmi N, et al. Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes and a History of Stroke or Transient Ischemic Attack. Circulation 2012. A sub-analysis of the PLATO study demonstrated similar superiority and the safety of ticagrelor in all patients, regardless of any previous history of stroke. Ticagrelor versus clopidogrel:...

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