Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding. This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk. The XIENCE Short...
How To De-Escalate Prasugrel After Acute Coronary Syndrome?
Patients who undergo coronary angioplasty after acute coronary syndrome could de-escalate dual antiplatelet therapy with prasugrel to maintain the protection against ischemic events while lowering their hemorrhagic risk. The HOST-REDUCE-POLYTECH-ACS study (recently published in The Lancet) included 2338 patients who underwent coronary angioplasty in a setting of acute coronary syndrome. Patients were randomized to a year-long...
Diabetes Could Decide between Ticagrelor and Prasugrel
Diabetes has an impact on the relative effect of ticagrelor and prasugrel in patients undergoing acute coronary syndrome (ACS) according to a recent analysis of the ISAR-REACT 5 published in JACC Intv. Similarly to the main study outcomes, this sub-analysis of the ISAR-REACT 5 has shown that the combined end point of death, MI or...
Complex PCI: Complex Characteristics Impact Results
Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events. It is important to see past the obvious anatomical challenges (bifurcations, calcification,...
Post TAVR ASA Monotherapy Consolidates
This meta-analysis to be published in J Am Cardiol supports the use of aspirin monotherapy (ASA) after transcatheter aortic valve replacement (TAVR). The use of aspirin alone is associated to less bleeding without increased ischemic events such as strokes or mortality. The combined outcomes of four studies, including the recently published POPular TAVI (cohort A),...
SOLACI PERIPHERAL | 4th Clinical Case: Thoracic Aortic Dissection in Patient with Complex Arch
A new clinical case to keep learning with colleagues! Today, we present a Thoracic Aortic Dissection in Patient with Complex Arch. This is the 4th case for SOLACI Peripheral, which continues its mission: to deepen knowledge exchange among Latin American interventional cardiologists. Tell us what you think about this case using the comments section in this...
Considerations for Optimal Device Selection in TAVR
Many studies have tried to answer the question about whether there is a superior device in transcatheter aortic valve replacement (TAVR). Today, there is no evidence to support such claim, and most patients will likely find operator experience more beneficial than any device per se. However, there are certain patients with specific characteristics that might...
The Fellow’s Corner | 2nd Clinical Case: An Explosive Mission
Read the case presentation and join the conversation through the comments in this post! Case Introduction: An Explosive Mission! 56-year-old male patient Severe smoker Hypertension Dyslipidemia Sedentary lifestyle and stress A sibling suffered from an acute myocardial infraction Cardiac markers: Standard angina, intensity of 8-9/10, 3-to-4-h long, and dyspnea (on and off for the past...
Same Contrast Dose, Different Risk of Kidney Injury, Depending on Procedure
The risk of contrast induced kidney injury is significantly lower in patients receiving transcatheter aortic valve replacement (TAVR) compared against patients getting a coronary angiography or angioplasty. This is true even for valvular heart disease patients with higher risk profiles. Differences in contrast-induced acute kidney injury between TAVR or coronary patients had not been previously...
Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention
Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure. This highlights the huge variation in indication and the scarce evidence there is on this matter. Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does...