Original title: Acute kidney Injury in Patients UIT Chronic Kidney Disease Undergoing Internal Carotid Artery Stent Implantation. Reference: Michael Donahue, et al J Am Coll Cardiol Interv 2015;8:1506-14 Post procedural acute kidney injury (AKI) in patients with chronic kidney disease has been associated with major events; however, the cause is still unclear. This study analyzed 126...
Stent farmacológico em pacientes com risco de sangramento elevado
Fundamentos e objetivos: O uso de stent farmacológico (DES) ao invés de stent “convencional” não farmacológico (BMS) em pacientes com risco de sangramento elevado (HBR) continua controverso devido a necessidade de maior duração da terapia de anti-agregação plaquetária dupla (DAPT), fato que causa preocupação em relação à segurança. O DES eluidor de zotarolimus Endeavor Sprint...
A localização da lesão coronária associada ao risco de sangramento pode direcionar a duração da dupla terapia antiplaquetária
Fundamentos: A duração ideal da terapia antiplaquetária dupla (DAPT) após implante de stent ainda é controversa e gera muita discussão. As diretrizes internacionais sugerem a avaliação da duração da DAPT de acordo com o risco de isquemia e sangramento do paciente. No entanto, ainda não foi proposto um método de quantificação adequada desses riscos. Objetivos:...
MATRIX: The radial access reduces events, bivalirudin with mixed results
Two separate works are part of the MATRIX study investigating strategies to reduce bleeding and mortality in patients with acute coronary syndrome. The first part of the work that was simultaneously published in The Lancet found a significant reduction in major bleeding and mortality in patients undergoing coronary angiography and angioplasty using radial versus femoral...
NOTION: TAVR in low-risk patients
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...
PEGASUS-TIMI 54: Ticagrelor plus ASA in stable patients
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...
Reduction of ischemic events after 30 months of prasugrel following TAXUS stent implantation
Article The TAXUS Liberté Post Approval study included patients treated with TAXUS paclitaxel DES receiving prasugrel for 12 to 30 months. Primary end point was a combination of death, infarction or stroke that resulted in 3.7% after 30 months vs. 8.8% after 12 months of prasugrel administration (p<0.001). Death and stroke rates were similar between...
ISAR-SAFE: 6 vs. 12 month clopidogrel administration after DES implantation
The aim of this randomized double blind control trial was to validate the safety and efficacy of 6 months vs. 12 months clopidogrel treatment in patients receiving DES. Primary end point was a combination of death, infarction, in-stent thrombosis, stroke and major bleeding. Secondary end point was the individual analysis of each one of the...
DAPT TRIAL: double antiaggregation remains controversial
Article This multicenter randomized control study with placebo was designed to determine the risks and benefits of double antiaggregation for longer than 12 months post DES stenting. 9961 patients were randomized to continue on placebo or thienopyridine after 12 months. Thienopyridine reduces the incidence of in-stent thrombosis (0.4% vs 1.4%; p<0,001) and cardiovascular events (4.3%...
ITALIC PLUS: 6 months of double antiaggregation for no less than 24 months
Article This multicenter study included patients receiving the second generation stent XIENCE V (Abbott Vascular) randomized to 6 and 24 months of double antiaggregation therapy after confirming non-resistance to aspirin. Primary end point was a combination of death, infarction, emergency revascularization of target vessel, stroke and major bleeding. The study saw early termination due to...