Review: Stable coronary disease remains a scenario where percutaneous coronary intervention, (PCI), has not cleared the edges. In a study conducted in 28 centers in Europe and the United States, a design model was created where all patients enrolled consecutively, (all comers trial in order to avoid selection bias), received an invasive functional assessment using...
XIMA: Randomized prospective study comparing everolimus eluting stents versus conventional stent implantation in octogenarians.
Background: Octogenarian patients represent an increasingly growing population. In addition, this age group has a higher proportion of co-morbidities with more extensive and complex coronary disease. However, they have often been excluded from major studies, whose average age is usually 60 years. Despite having a more complex coronary anatomy, the role of pharmacological stent (DES)...
ADAPT-DES: Results at 1 year of the clinical impact of hypo-responders to aspirin and clopidogrel.
Background: The ADAPT-DES registry showed a strong correlation between hypo-responders to clopidogrel and the likelihood of stent thrombosis at 30 days, while the impact of aspirin response has not been evaluated so far. This presentation focuses on the aspirin response impact in the clinical course of one year. Methods and Results: A total of 8,583...
AIDA STEMI MRI: Intracoronary versus intravenous abciximab in primary angioplasty. MRI analysis in AIDA study
Basics: Recent meta-analysis showed benefits of intracoronary abciximab administration compared with intravenous (A-EV). Although the AIDA study showed no such benefit when analyzing the combined endpoints of death, reinfarction and congestive heart failure, it did show a decrease of CHF in isolation over the group receiving intracoronary abciximab. This time, the study authors of AIDA...
SWISS AMI: Stem cells infusion after primary angioplasty
The trial enrolled 200 patients post AMI treated with successful PCI, with LVEF ≤45% randomized to placebo, to receive early (before 7 days) or late (after 7 days) stem cells infusion. Primary end point was LVEF at 4 months. At follow up, stem cells infusion, both early and late, did not improve LVEF, compared to...
FREEDOM trial: CABG versus angioplasty treatment for diabetic patients with multivessel disease
The trial included 1,900 patients followed for at least 2 years, (mean 3.8 years), randomized 1:1 to pharmacological angioplasty stents, (sirolimus or paclitaxel at surgeon discretion), or CABG. We excluded acute coronary syndromes and left coronary trunk injury. The primary endpoint was death, myocardial infarction or stroke and the secondary main was the sum of...
DALCETRAPIB: Dalcetrabib for the treatment of ACS
High levels of HDL are known to exert a protective effect. In previous studies, dalcetrapib administration increased HDL 30% from baseline. The objective was to test dalcetrapib in the context of acute coronary syndrome (ACS). 15,871 ACS patients were randomized to receive dalcetrapib or placebo. Primary end point was cardiac death, myocardial infarction, ictus, new...
CABG off-pump, same results at one year-pump surgery.
The relative benefits and risks of off-pump coronary artery bypass grafting (CABG) as compared with the use of CBP are not clearly defined. The CORONARY trial in 79 centers randomized 4,752 patients in whom CABG was planned with or without CBP. There was no significant difference in the primary end point which was a composite...
GOPCABE: similar results for in-pump or off-pump surgery in elderly patients
Background: There is much debate about a possible benefit of coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) compared with on-pump surgery. However, a randomized study could not confirm this benefit. The objective of these studies was to compare the MACCE, (death, MI, stroke, revascularization repeated and a new dialysis), of surgical revascularization with...
PRATO ACS: Rosuvastatin reduces the incidence of contrast nephropathy in patients with acute coronary syndrome who receive early invasive strategy
The aim of this study was to determine whether patients without ST-segment elevation acute coronary syndromes who were not taking statins previously, can receive high doses of rosuvastatin before coronary angiography or angioplasty and if this action could exert protection in renal function and reduce the incidence of contrast-induced nephropathy (CIN). This prospective study randomized...