The aim of this study was to compare the results of transcatheter aortic valve replacement (TAVR) versus surgery in unselected patients with severe degenerative aortic stenosis. Patients were randomized 1:1 to TAVR (n = 145) or surgical replacement (n = 135). Those of TAVR group received Medtronic CoreValve self-expanding valve. The femoral access was used...

The aim of this study was to evaluate treatment with alirocumab a monoclonal antibody against PCSK9 receptor, compared with placebo in patients with heterozygous familial hypercholesterolemia or high cardiovascular risk who were at the maximum tolerated dose of statins and LDL >70 mg/dl. A total of 2341 patients randomized to 150 mg alirocumab administered subcutaneously...

The aim of this study was to evaluate the safety and efficacy of long-term Evolocumab, an inhibitor of PCSK9 added to standard therapy versus standard therapy alone. Patients of five works in phase two and seven works in phase three were invited to participate in the extended program. These patients were randomized 2:1 to Evolocumab...

This work published simultaneously in The New England Journal of Medicine showed that patients over eighty years may benefit from an aggressive and invasive treatment strategy that could be unnecessarily denied given age. The study was conducted in 16 centers in Norway and included 458 octogenarians patients admitted with acute coronary syndromes without ST-segment elevation...

This double-blind study included 21162 patients with a history of acute myocardial infarction randomized to ticagrelor 90 mg e/12 h, ticagrelor 60 mg e/12 h or placebo. All patients received aspirin and had additional risk factors such as age or diabetes. The history of infarction should be between one and three years before being included...

Article Up to 50% of acute myocardial infarctions are associated to mitral regurgitation of some degree and 10% of these cases present, at least, moderate regurgitation. Ischemic mitral regurgitation is associated to an increase of mortality and morbidity. For surgical patients with moderate regurgitation, the benefits mitral valve repair remain unclear.  301 patients were randomized...

This study included 1504 patients with atrial fibrillation and indication for elective electrical cardioversion who were randomized to rivaroxaban (n = 1002) versus Marevan (n = 502).  The safety end point, major bleeding occurred in 0.61% of rivaroxaban group versus 0.8% of Marevan (95% IC 0.21-2.67, p = NS). The rate of stroke, embolic events,...

Current guidelines suggest treating only the culprit artery of myocardial infarction with ST-segment elevation. This prospective and randomized work included 296 patients in 7 centers suffering ST-segment elevation acute myocardial infarction referred for primary angioplasty randomized to treat only the culprit artery (n = 146) versus complete revascularization (n = 150).  In the culprit artery...

Prospective, multicenter, randomized, double-blind study evaluated intravenous infusion of TRO40303 versus placebo administered immediately before balloon dilation of the culprit artery during primary angioplasty. Infarct size was evaluated using the CK Mb levels and troponin together with magnetic resonance imaging. 163 patients were included; no significant differences were observed in the area under the curve...

The platelet P2Y12 receptor antagonist ticagrelor is shown to reduce the incidence of cardiovascular events when administered in hospital admission to patients suffering an ST-segment elevation acute myocardial infarction. Pre-hospital management that could improve coronary reperfusion and events like death or stent thrombosis was not studied. 1862 patients were included suffering ST-segment elevation acute myocardial...