A short dual antiplatelet therapy (DAPT) of 1 to 3 months followed by P2Y12 inhibitor monotherapy after second generation drug eluting stent (DES) implantation is safer and as effective as the traditional scheme. The idea is clear, but why hasn’t aspirin monotherapy been tested as follow up? Is aspirin old fashioned? Are there physiopathological reasons...
The most common cause of myocardial necrosis in patient undergoing COVID-19 infection is microthrombi. These microthrombi resulted quite different in composition vs. thrombi obtained from COVID-19 negative patients and thrombi obtained from infected patients with ACS. Myocardial injury is common in patients hospitalized for COVID-19 and has worse prognosis. Regardless its frequency, the mechanism and...
This study, published in the Lancet, looks into the vaccine resulting from the collaboration of the Oxford University and AstraZeneca, among others. Data include interim results from 4 ongoing blind randomized controlled studies currently carried out in the UK, Brazil and South Africa. All participants over 18 years of age were assigned 1:1 to the...
Should elderly patients stick to clopidogrel? The first large study on prasugrel showed an unacceptable increase of bleeding in elderly patients, suggesting the use of 5 mg (although the sample size was small, which hindered the determination of dose efficacy). Later, ticagrelor showed better efficacy than clopidogrel without apparent safety concerns. However, specific evidence on elderly...
In 2020, the European Society of Cardiology guidelines for the management of patients with acute coronary syndromes without ST-segment elevation (Non-ST-Segment Elevation Myocardial Infarction, NSTEMI) were presented. This document went somewhat unnoticed in the context of the COVID-19 pandemic, so this seems a good time to review it and set out some practical “commandments” (something...
Information on the natural history of asymptomatic infection with the new coronavirus (COVID-19) remains scarce. We are just beginning to understand what happens with patients with severe disease. The outbreak of COVID-19 on the cruise ship Diamond Princess provided a unique opportunity to study contacts and patients with asymptomatic infection within a closed population. This...
Data from recent observational randomized studies suggest that most patients with asymptomatic severe aortic stenosis will eventually receive an indication for valve replacement. Mortality in this “asymptomatic” population is caused not only by sudden death, but also by cardiac death. Early intervention may prevent these deaths as a consequence of aortic stenosis symptoms. Researchers...
In many places worldwide, the worst part of the pandemic is still to come. Meanwhile, in other areas, the number of cases is rising again. In this context, the long-term effects of COVID-19 are starting to show. Many believe this is not a current issue, but it will definitely be a problem in the future....
In anemic patients undergoing acute myocardial infarction, a restrictive transfusion strategy is as safe as a more liberal approach, in addition to saving costs. The cutoff value to decide for a transfusion would be < 8 g/dl hemoglobin. The REALITY outcomes were presented during the virtual ESC 2020 sessions. Anemia is relatively common in patients...
According to this new study, colchicine offers some benefit to patients with chronic ischemic heart disease. Similar to COLCOT, this is the second large randomized study with results confirming the inflammatory hypothesis. Colchicine taken at a daily dose of 0.5 mg reduces cardiovascular events in patients with stable coronary disease, according to data from the LoDoCo2...