myocardial infarction

enfermedad de múltiples vasos síndrome coronario agudo

ACS and Multivessel Disease: How to proceed

Gentileza del Dr. Javier Castro   In the daily practice, a high percentage of ST elevation myocardial infarction patients (STEMI) present multivessel disease (40-65%). This group of patients presents worse clinical evolution and higher mortality than patients with one culprit lesion.   When PCI is indicated to a patient with significant lesions in more than...

acv angioplastia carotidea

Carotid PCI at Long Term: Effective in Stroke Prevention?

There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients.   This registry included prospective data with a strict follow up protocol on 901...

angioplastia primaria estrategia farmacoinvasiva

Are Pharmacoinvasive Strategy and Primary PCI Comparable?

The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute Myocardial Infarction 2015 suggest that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PCI).   This study compared the impact of pharmacoinvasive strategy with the impact of primary angioplasty in real-world patients admitted with acute coronary syndrome with ST-segment elevation.   The...

duración terapia de doble antiagregación plaquetaria

Procedural Complexity Affects Decision-Making Regarding DAPT Duration

Much of the speculation around the way of individualizing dual antiplatelet therapy (DAPT) duration after coronary angioplasty has focused on clinical parameters (e. g., diabetes), but a new study published by the Journal of the American College of Cardiology (JACC) and presented at the last European Society of Cardiology (ESC) Congress warns about anatomical factors as...

reserva fraccional de flujo sindrome coronario agudo

Deferring Lesions by FFR in ACS: Yes or No?

Deferring treatment through angioplasty in non-ischemic lesions by fractional flow reserve (FFR) is associated with excellent long-term prognosis in patients with chronic ischemic heart disease.   FFR is beginning to be used for clinical decision-making in patients with acute coronary syndromes, and its long-term effect on stable chronic patients has not been established.   This...

doble antiagregacion plaquetaria sexo

Dual Antiplatelet Therapy in Men and Women: Are There Differences?

Courtesy of Dr. Agustín Vecchia.   Currently, the duration of dual antiplatelet therapy (DAPT) after stent placement is one of the most highly debated topics in Cardiology. On the one hand, women are usually underrepresented in trials in our specialty; on the other, the fact that symptoms of coronary disease are different in women is well-known.   The aim...

Primary PCI: Similar Results During Day and Night

Patients with ST-segment elevation myocardial infarction included in the CHAMPION PHOENIX trial admitted during nights, weekends, and holidays presented the same prognosis and good clinical outcomes as those who were admitted during regular daytime hours.   Prior studies had indicated that off-hours admission was associated with worse outcomes; however, this particular analysis contradicts such a...

Prasugrel vs. Ticagrelor in Primary Angioplasty

The choice of prasugrel or ticagrelor for patients with acute myocardial infarction undergoing primary angioplasty makes no difference, at least in the short term.   This study was terminated prematurely and thus lost statistical power, which means that any interpretation of the lack of difference between the two antiplatelet drugs must take into account such...

terapia antitrombótica triple

Anticoagulation and PCI: How Long Should Triple Therapy Last?

The aim of this study was to compare clinical outcomes in relation to the duration of triple antithrombotic therapy in patients with indications for oral anticoagulation undergoing coronary angioplasty. The optimal period for the prescription of these three drugs has not been studied.   Between 2009 and 2013, 8772 consecutive patients undergoing coronary angioplasty were included...

ticagrelor vs. aspirina

Ticagrelor: Similar to Aspirin in Patients with Stroke or TIA

Ticagrelor might be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients admitted for acute cerebral ischemia.   This double-blind, controlled trial randomized 13,199 patients from 33 countries. Subjects presented a non-severe stroke or a high-risk transient ischemic attack (TIA) (not considered as cardioembolic) and had not received...

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