La cirugía parece superior a la angioplastia en pacientes jóvenes

Complete Revascularization Improves Long-Term Prognosis in Acute Coronary Syndromes

Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty.   This study, published online before<a href="https://solaci.org/en/2018/11/01/complete-revascularization-improves-long-term-prognosis-in-acute-coronary-syndromes/" title="Read more" >...</a>

Sorpresivo pronóstico para los infartos con coronarias normales

High-Sensitivity Troponins Turned All Events into Infarctions; the 4th Universal Definition Clarifies Things

Myocardial infarction or myocardial injury? The Fourth Universal Definition of Myocardial Infarction (an update of the 2012 version) is here to clarify that not all cases of elevated cardiac troponin values are acute myocardial infarctions. This document was presented a few days ago at the European Society of Cardiology (ESC) Congress in Munich and simultaneously<a href="https://solaci.org/en/2018/09/21/high-sensitivity-troponins-turned-all-events-into-infarctions-the-4th-universal-definition-clarifies-things/" title="Read more" >...</a>

EuroPCR 2018 | Compare-Acute: FFR o angioplastia primaria en el seguimiento a 2 años de la revascularización completa

EuroPCR 2018 | Compare-Acute: FFR or Primary Angioplasty at a 2-Year Follow-Up After Complete Revascularization

Recent studies in patients undergoing acute myocardial infarction showed that a complete revascularization strategy in an acute or subacute setting, whether it be guided through angiography (PRAMI, CvLPRIT) or fractional flow reserve (FFR) (PRIMULTI, COMPARE-ACUTE), improves the combined endpoint of major adverse cardiac events (MACE) when compared with treatment of the culprit artery only. Based<a href="https://solaci.org/en/2018/05/29/europcr-2018-compare-acute-ffr-or-primary-angioplasty-at-a-2-year-follow-up-after-complete-revascularization/" title="Read more" >...</a>

El FFR reduce la muerte y el infarto comparado con el tratamiento médico

EuroPCR 2018 | FFR Reduces Death and Infarction Rates Compared with Medical Treatment

Pooled data from the most important recently published studies (FAME 2, Compare-Acute, and DANAMI3-PRIMULTI) conclude that there is a significant difference in favor of fractional flow reserve (FFR) as regards hard endpoints. Coronary revascularization guided by FFR reduces the risk of death and infarction when compared with optimal medical treatment in patients with stable and<a href="https://solaci.org/en/2018/05/28/europcr-2018-ffr-reduces-death-and-infarction-rates-compared-with-medical-treatment/" title="Read more" >...</a>

Complete Revascularization Is Beneficial in Acute MI with Cardiogenic Shock

Around half of all cases of ST-segment elevation acute myocardial infarction (STEMI) come alongside lesions in another vessel, for which the current strategy is complete revascularization in one or two steps. However, there are no large-scale studies analyzing patients who also present cardiogenic shock; we only have observational studies with inconclusive results influenced by several<a href="https://solaci.org/en/2018/03/16/complete-revascularization-is-beneficial-in-acute-mi-with-cardiogenic-shock/" title="Read more" >...</a>

Does a Combination of Diabetes and Acute Coronary Syndrome Change the Revascularization Strategy?

The results of the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial have shown a lower rate of events in patients with diabetes and stable multivessel disease who were randomized to undergo myocardial revascularization surgery, compared to those who underwent angioplasty. Surgery even showed a mortality reduction that<a href="https://solaci.org/en/2018/01/22/does-a-combination-of-diabetes-and-acute-coronary-syndrome-change-the-revascularization-strategy/" title="Read more" >...</a>

Clopidogrel or Ticagrelor in Patients with Acute Coronary Syndrome Treated with New-Generation DES: CHANGE DAPT

Courtesy of Dr. Pablo Baglioni. This is a prospective observational study with a 1-year follow-up analyzing 2062 patients with acute coronary syndrome (ACS) who have been treated with coronary angioplasty using new-generation drug-eluting stents (DES). Patients were included between December 21, 2012 and August 25, 2015. On May, 2014, due to changes in international guidelines, clopidogrel<a href="https://solaci.org/en/2017/12/15/clopidogrel-or-ticagrelor-in-patients-with-acute-coronary-syndrome-treated-with-new-generation-des-change-dapt/" title="Read more" >...</a>

¿Beneficio adicional del bypass radial en la cirugía de revascularización miocárdica?

Additional Benefit from Radial Artery Graft in Myocardial Revascularization Surgery

Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal<a href="https://solaci.org/en/2017/09/21/additional-benefit-from-radial-artery-graft-in-myocardial-revascularization-surgery/" title="Read more" >...</a>

Infarto agudo de miocardio y lesiones de múltiples niveles

DETO2X-AMI: Supplemental O2 Provides No Benefit for Patients with Suspected Infarction

According to this study simultaneously presented at the European Society of Cardiology Congress 2017 and published in the New England Journal of Medicine, routinely providing supplemental oxygen therapy to patients without hypoxemia with suspected acute myocardial infarction did not result in a reduction in the 1-year risk of all-cause mortality when compared with patients receiving<a href="https://solaci.org/en/2017/09/13/deto2x-ami-supplemental-o2-provides-no-benefit-for-patients-with-suspected-infarction/" title="Read more" >...</a>

COMPARE-ACUTE: FFR para guiar la revascularización de vasos no culpables en la angioplastia primaria

COMPARE-ACUTE: FFR-Guided Non-Culprit Vessel Revascularization in Primary Angioplasty

Courtesy of the SBHCI. About 50% of patients admitted with acute ST-segment elevation myocardial infarction also present lesions in another vessel. Whether to treat these or not, and the optimal moment to treat non-culprit infarction-related vessels are still controversial issues.   The COMPARE-ACUTE study was recently published and showed that fractional flow reserve (FFR)-guided complete<a href="https://solaci.org/en/2017/06/02/compare-acute-ffr-guided-non-culprit-vessel-revascularization-in-primary-angioplasty/" title="Read more" >...</a>