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...
1- Consensus on How to Conduct Follow-Up in Peripheral Vascular Disease Peripheral vascular disease involves multiple areas and, therefore, can have very different presentations (from complete lack of symptoms to disabling symptoms). Depending on clinical presentation, general condition, anatomical localization, and lesion extension, revascularization can be indicated alongside optimal medical treatment. Read also HERE 2-...
Do to an investigation carried out by the BBC that led to the withdrawal of EACTS support from the latest coronary revascularization guidelines, the authors of the EXCEL study (indicated by this research) provided the following answers. -Defining Peri-Procedural Infarction: All researchers involved (including surgeons) agreed that the universal definition of infarction was not right...
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could...
There has been a significant decline in vascular complications in the last few years due to improvements in device profiles and operator experience on transcatheter aortic valve replacement (TAVR). Unilateral vascular access for transfemoral TAVR is as safe as bilateral access and it could be more comfortable for patients according to this study recently published...
1- AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment After a several year follow up, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) has shown that an invasive approach in addition to optimal medical treatment (OMT) does not offer benefits when it...
This COMPLETE sub-study using optical coherence tomography (OCT) showed the prevalence of vulnerable lesions other than the culprit which should provide a physiopathological explanation of the benefit of complete revascularization observed in the original study. STEMI patients with multivessel disease will benefit from complete revascularization in terms of reduced cardiovascular death and repeat MI according...
Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality. The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both...
Among patients in the main ISCHEMIA trial, those with chronic kidney disease are a particularly high-risk subgroup. However, an invasive strategy with coronary angiography and revascularization did not improve the rate of events, similarly to what happened in the general population for the aforementioned trial. The rate of death or acute myocardial infarction was 36.4%...
This study recently published in JACC paves the way to identifying higher risk patients among those with no epicardial coronary artery disease (CAD) that present angina symptoms. Evidence of coronary spasm and increased microcirculation resistance in patients with angina (but with no epicardial obstructive CAD) is associated with increased risk of adverse cardiac events. AT...