myocardial infarction

Deferred Stenting in Primary Angioplasty could reduce No Reflow Risk and Infarct Size.

Original: A Randomized Trial of Deferred Stenting versus Immediate Stenting to Prevent No-or Slow Reflow in Acute ST-Elevation Myocardial Infarction (DEFER-STEMI). Reference: David Carrick et al. J Am Coll Cardiol. 2014. Epub ahead of print. No Reflow physiopathology involves microvascular obstruction secondary to thrombus embolization, spasm or microvascular thrombosis, and happens in approximately 10% of PCI procedures. The...

Best results of angioplasty with DES guided by IVUS versus angiography only

Original title: Intravascular Ultrasound-Guided Implantation of Drug-Eluting Stents to Improve Outcome. A Meta-Analysis. Reference: Jae-Sik Jang et al. J Am Coll Cardiol Intv 2014, epub ahead of print. Several previous studies and meta-analysis showed that implantation of conventional stents (BMS) intravascular ultrasound (IVUS) guided may decrease restenosis and clinical events. This information was not yet clear to drug-eluting...

The length of the stent is not an event predictor with the new generation of DES. It is the end of the Spot stenting?

Original title: Impact of the Stent Length on Long-Term Clinical Outcomes Following Newer-Generation Drug-Eluting Stent Implantation. Reference: Ik Jun Choi et al. Am J Cardiol 2014;113:457-464. Completely cover the lesion with a sufficiently long stent has been the preferred strategy that emerged from drug-eluting stents (DES). However, for the first-generation DES stent length has been a predictor of...

Hybrid revascularization versus conventional surgery. Advantages and disadvantages for choosing ideal patients.

Original title: Clinical Outcomes after Hybrid Coronary Revascularization versus Coronary Artery Bypass Surgery: A Meta-Analysis of 1,190 Patients. Reference: Ralf E. Harskamp et al. American Heart Journal (2014), epub ahead of print.   Hybrid revascularization combines long-term patency of the mammary artery connected to the left anterior descending with minimally invasive drug-eluting stents to other injuries. This in...

3rd generation zotarolimus-eluting stent non- inferior to everolimus

Original title: Third-generation zotarolimus-eluting and everolimus-eluting stents in all-comer patients requiring a percutaneous coronary intervention (DUTCH PEERS): a randomized, single-blind, multicentre, non-inferiority trial. Reference: Von Birgelen C et al. The Lancet. 2014; Epub ahead of print. In the 3rd generation zotarolimus-eluting stent, platform was modified to increase flexibility and make implant easier in complex lesions. This study was...

The FFR changes the treatment strategy in almost half of patients

Original title: Outcome impact of coronary revascularization strategy reclassification with fractional flow reserve at time of diagnostic angiography. Reference: Van Belle E et al. Circulation. 2014 Jan 14;129(2):173-85. Any comprehensive registry has not been yet published that evaluates the impact of fractional coronary flow reserve (FFR) to change the strategy of revascularization on individual patients referred for diagnostic...

Malapposition in drug-eluting stents. Much more common and much less serious than we thought

Original title: Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation Reference: Im E. et al. CircCardiovascInterv. 2014 Jan 14. [Epubahead of print]   This paper analyzed the imaging of 351 patients by optical coherence tomography (OCT) who received drug-eluting stents over 356 lesions between 2009 and...

Ischemic versus anatomical risk. Is anyone better to help us decide therapeutically?

Original title: Predicting Outcome in the COURAGE Trial. Coronary Anatomy Versus Ischemia. Reference: G. B. John Mancini et al. J Am Coll Cardiol Intv 2013, Article in press.   Anatomical risk, ischemic amount or a combination of both, are often factors taken into account for estimating the prognosis or choose a treatment strategy. The COURAGE study (Clinical Outcomes Utilizing...

Longer follow-up registry of angioplasty in left main coronary artery. Significant differences according to the diseased segment.

Original title: The DELTA Registry (Drug-Eluting Stent for Left Main Coronary Artery Disease): A Multicenter registry Evaluating Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for left Main Treatment Reference: Naganuma T, et al. J Am Coll Cardiol Intv 2013;6:1242–9 Angioplasty of the unprotected left coronary trunk has increased significantly in recent years showing good results. Currently the...

Stent reestenosis, the only subgroup that benefits from longer double antiaggregation

Original title: Short vs. Long Term Duration of Dual Antiplatelet Therapy in Patients treated for InstentRestenosis. A PRODIGY Trial substudy. Reference: Gianluca Campo el al. J Am CollCardiol, article in press.   In the study PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent- Induced Intimal Hyperplasia) we found that the 24 months ratio of dual antiaggregation was not...

Top