No randomized head-to-head study comparing the efficacy and safety of ticagrelor and prasugrel has been carried out in the last 7 years since these newer P2Y12 inhibitors first showed a higher efficacy relative to clopidogrel. This study was designed to compare the efficacy and safety of prasugrel and ticagrelor in patients with acute myocardial infarction...
The FUTURE study, testing the utility of functional revascularization by measuring the fractional flow reserve (FFR), was halted early by its safety committee due to an increased mortality rate at 1 year among patients guided by FFR. In this unexpected unprecedented outcome, 17 patients in the FFR-guided group died at a year of follow-up, compared with 7 patients...
Performing coronary angioplasties at hospitals without surgical backup seems to be safe for a wide variety of patients, from those presenting ST-segment elevation myocardial infarction to those undergoing elective procedures. This work responds to a long-running debate over whether centers without on-site surgery capabilities in case of complications can be considered as referral centers...
A minimalist approach to transcatheter aortic valve replacement (TAVR) involving local anesthesia appears to have several advantages, according to this new meta-analysis. In addition to shortening times for procedures and lengths of stay in the critical care unit and hospital, lighter sedation may lower the need for transfusions or treatment with inotropes or vasopressors....
New findings from the GARY (German Aortic Valve Registry) registry show that intermediate-risk patients with severe aortic stenosis presented significantly higher mortality at 1 year when treated with transcatheter aortic valve replacement (TAVR) rather than with conventional surgery. Results reflect everyday realities, which might include various bias tipping the scales towards one strategy or the...
Courtesy of Dr. Agustín Vecchia. Despite current technological advancements and improvement in reperfusion rates in a setting of infarction, cardiogenic shock still is a relatively frequent complication with a mortality rate close to 50%. The need to augment cardiac output in these patients and the fact that the popular intraaortic balloon counterpulsation has not been able to...
There is little evidence to support the safety and efficacy of bioresorbable scaffolds (BRS) for the treatment of chronic total occlusions (CTO). This multicenter registry included consecutive patients with CTO receiving BRS (Absorb; Abbott Vascular) vs. 2nd generation drug eluting stents (DES). Primary end point was target vessel failure at long term (composite...
The aim of this study was to evaluate if the residual thrombus burden after aspiration thrombectomy may affect the outcome of primary angioplasty in patients with acute coronary syndrome with ST-segment elevation. The most recent studies on aspiration thrombectomy failed to show clinical benefit in patients with ST-segment elevation. This study is based on...
Courtesy of Dr. Agustín Vecchia. Since 1990, radial access has progressively gained ground, currently becoming the default technique in most endovascular intervention centers. One of its few associated complications is radial artery occlusion. While most frequently clinically silent and non-serious, this complication could hinder the performance of future procedures in the patient and, in some...
Between 10% and 15% of patients admitted with ST-segment elevation myocardial infarction present concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery, which is associated with increased morbidity and mortality. The EXPLORE (Evaluating Xience and Left Ventricular Function in Percutaneous Coronary Intervention on Occlusions After ST-Elevation Myocardial Infarction) trial evaluated whether patients admitted...