This study compared 6 vs 12 or more months of dual antiplatelet therapy (DAPT) in patients undergoing acute coronary syndrome (ACS) receiving contemporary DES, and it did not find differences in combined endpoint. However, looking at primary endpoint components separately, there were more infarctions in patients with a short DAPT scheme that we cannot ignore. Prolonging antiaggregation...
The transradial access is the preferred access site for patients undergoing acute coronary syndrome. Compared to the transfemoral access site, it reduces the risk of all cause death, vascular complications and major bleeding. Radial artery occlusion is the most frequent vascular complication associated to this approach, though it rarely results in clinical consequences such as ischemia, given the...
Long-term follow-up of patients under 50 with multivessel coronary artery disease suggests surgery outcomes are significantly better than angioplasty outcomes. This study, presented at the Society of Thoracic Surgeons’ (STS) Annual Meeting, concludes that surgery should continue as plan A when it comes to young patients with three-vessel disease. Surgeons complain that many patients never actually...
Routine invasive physiology assessment at time of angiography reclassifies treatment strategies in a big number of patients with lesions in 2 or 3 vessels, according to the multicenter prospective study DEFINE REAL, recently published in JACC Cardiovascular Interventions. The information obtained by measuring fractional flow reserve (FFR) or instantaneous wave free ratio (iFR) made interventionists modify their original plans in...
St elevation acute coronary syndromes are typically caused by thrombotic obstruction of a coronary artery due to ruptured atherosclerosis plaque. However, there is a significant number of patients with similar clinical presentations but no evidence of obstructive coronary artery disease (CAD). Read also: CTO in patients with acute myocardial infarction increases long term mortality. In general, patients without...
Despite the evidence, most stable patients continue to be managed based on coronary angiography and, worse, often without a prior non-invasive functional study. With the introduction of the FFR, we left the “anatomical” era for the “functional” era in the catheterization room, which has been proven to improve patients prognosis and, as if that were...
1) The 10 Commandments of ESC’s New STEMI Guidelines The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. Read more 2) Burnout Syndrome among Cardiologists For the first time, the American College of Cardiology (ACC) has carried out a survey on this phenomenon,...
Critical ischemia is the most advanced form of peripheral arterial disease, and it is characterized by ischemic rest pain and ulcers or gangrene. Revascularization is obviously positioned as the first-line treatment, and guidelines recommend both possible strategies (surgery or angioplasty) largely based on the findings of the BASIL trial (British Angioplasty versus Surgery in Ischemic...
The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. The article features 10 points resembling the ten commandments, which makes it easy to read, compared to the tedious task of reading the complete guidelines. 1) The emergency systems should help...
Whether a second arterial conduit improves outcomes in patients undergoing myocardial revascularization surgery is and will remain unclear until the 10-year results of the ART (Arterial Revascularization Trial) are published. Consequently, arterial conduits other than the left internal thoracic artery are seldom used in daily practice. Using a database including 126 non-federal hospitals in California, researchers...