An hour before the presentation of the PREVAIL study, the ACC announced the cancellation of the release of the study results. Due to an error in the email system, results of the study were reported a few hours before his presentation. The ACC in an unprecedented decision cancelled the presentation of the study as well...
Alan Wilson and Szeto Zajarias show that vascular complications of the trans-femoral path remain an important factor because of the high profile of the catheters used in TAVI and the appearance of smaller devices, as well as the experience of surgeons, will progressively reduce complication rates. Josep Rodes-Cabau commented about the negative impact a stroke...
Percutaneous aortic valve replacement (TAVI) is a new treatment option for patients that are inoperable or present a high surgical risk. Some studies have shown that the stroke rate may be higher with TAVI than with medical treatment or surgical replacement. Embolic protection has been used successfully for the carotids, but there is not much...
We evaluated 41,537 patients admitted with myocardial infarction without ST elevation on the SCAAR register and who had not received IIBIIIB glycoprotein inhibitors and divided them into two groups: 31,351 patients who received heparin versus 10,186 who received bivalirudin. We adjusted baseline characteristics of the two groups using the Propensity score with the exception of...
The HORIZONS AMI trial showed the usefulness of bivalirudin in reducing mortality and bleeding compared with the use of heparin plus glycoprotein IIBIIIA. However, some questions remained unanswered: What is the utility of starting the infusion during the ambulance journey? Is it possible to reduce the risk of acute thrombosis by extending bivalirudin infusion or...
Currently the recommendation is 12 months of dual antiplatelet after a drug-eluting stent angioplasty. This study compared the 3 – months versus 12 months of dual antiplatelet after angioplasty with zotarolimus-eluting stent in real-world patients. This was a prospective, multicenter study randomized 1563 patients to receive aspirin and clopidogrel for 3 months and 1556 to...
This study randomized 1259 patients to receive one year versus 2 years of double anti anti-platelet after implantation of a drug-eluting stent. The primary end point was a composite of death, myocardial infarction, stroke, stent thrombosis, and urgent revascularization that were equivalent between the two schemes. There was a trend to a higher rate of...
Bivalirudin reduced mortality and bleeding compared to heparin and glycoprotein IIbIIIa in HORIZONS- AMI study. However there was a higher rate of acute stent thrombosis in patients receiving bivalirudin. This randomized study (> 90 % randomized in the ambulance) enrolled 2218 patients with ASTEMIto prolonged infusion of bivalirudin compared with heparin -associated glycoprotein inhibitors. The...
Radial access is associated with a lower rate of vascular and bleeding complications however female patients with smaller diameter arteries such access might be technically more difficult. This prospective, randomized, multicenter study compared both approaches in the context of coronary angioplasty in female patients. 1787 patients were randomized (893 in the radial group and 894...
The cessation of dual antiplatelet treatment increased the risk of post coronary intervention adverse events. It is unclear whether the risk varies through time or if it depends on the reason for the interruption or both. The PARIS (patterns of non-adherence to anti-platelet regimens in stented patients) register is a prospective, observational study in patients...