myocardial infarction

Rivaroxaban reduces in-stent thrombosis in patients with acute coronary syndromes

Original title: Reduction of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Rivaroxaban in ATLAS-ACS 2 TIMI 51. Reference: C. Michael Gibson et al. J Am Coll Cardiol 2013;62:286–90. There are few contemporary studies that investigated oral anticoagulation utility in patients with acute coronary syndromes and coronary angioplasty. Rivaroxaban is an oral anticoagulant that directly and...

Primary angioplasty in octogenarians and nonagenarians is increasing in frequency.

Original title: Outcomes After Primary Percutaneous Coronary Intervention in Octogenarians and Nonagenarians With ST-Segment Elevation Myocardial Infarction: From the Western Denmark Heart Registry. Reference: Lisbeth Antonsen et al. Catheterization and Cardiovascular Interventions 81:912–919 (2013) With increasing life expectancy worldwide, older patients will become increasingly referred to us for angioplasty in the context of a heart attack with ST...

The Importance of TIMI 3 flow in primary angioplasty

Original title: Predicitors of suboptimal TIMI flow alter primary angioplasty for acute myocardial infarction: results from the HORIZON-AMI trial. Reference: Adriano Caixeta et al.  Eurointervention 2013;9:220-227 Primary angioplasty showed greater efficacy than thrombolytics but one out of every four patients cannot achieve TIMI 3 flow. The Horizons-AMI trial randomized 3,602 patients to receive bivalirudin or heparin plus inhibitors...

DES versus Bare in primary angioplasty at five years. Initial advantage is reducing

Original: title Long-Term Outcome After Drug-Eluting VersusBare-Metal Stent Implantation in Patients WithST-Segment Elevation Myocardial Infarction. 5 Years Follow-Up From the Randomized DEDICATION (Drug Elution and DistalProtection in Acute Myocardial Infarction) Trial. Reference: Lene Holmvang et al. J Am CollCardiolIntv 2013, article in press.   Primary angioplasty reduced mortality and reinfarction compared with thrombolytics in patients experiencing an ST...

Rational use of bivalirudin, less bleeding and less costs using risk score

Original title: Pre-Procedural Estimate of Individualized Bleeding Risk Impacts Physicians’ Utilization of Bivalirudin During Percutaneous Coronary Intervention. Reference: Seshu C. Rao et al. J Am Coll Cardiol 2013;61:1847–52 While safety of coronary angioplasty has improved over time, post-procedure bleeding  is still frequent with a large variability between centers. Bleeding is associated with increased mortality, myocardial infarction, stroke, increased...

Transradial Angioplasty: do we need more proof to adopt it for good?

Original title: Influence of Arterial Access Site Selection on Outcomes in Primary Percutaneous Coronary Intervention. Are the Results of Randomized Trials Achievable in Clinical Practice? Reference: Mamas A. Mamas et al. J Am Coll Cardiol Intv 2013. Article in press. Antithrombotic therapy has improved the prognosis of patients with acute ST-segment elevation myocardial infarction by reducing ischemic events....

High doses of Rosuvastatin in acute coronary syndromes

Original title: Rosuvastatin calcium in acute coronary sydromes Reference: Aggarwal, R. et al, Expert Opinion on Pharmacotherapy , Volume 14, Number 9, June 2013 , pp. 1215-1227(13). Lowering cholesterol of low density lipoproteins (LDL-C) by reducing inhibitors of 3-hydroxy-3-metilgutaril coenzyme A (HMGCoA) statins has proven advantageous for the survival of patients with acute coronary syndrome (ACS). These patients...

Direct Stent, no clinical utility in patients undergoing elective

 Original title: The Independent Value of a Direct Stenting Strategy on Early and Late Clinical Outcomes in Patients Undergoing Elective Percutaneous Coronary Intervention. Reference: Gabriel L. Sardi et al. Catheterization and Cardiovascular Interventions 81:949–956 (2013).   The use of direct stenting (DS) without pre-stenting dilation has proven to be a safe strategy, especially with the...

Double DES in bifurcations, double thrombosis risk

Original title: Late Thrombosis After Double Versus Single Drug-Eluting Stent in the Treatment of Coronary Bifurcations A Meta-analysis of Randomized and Observational Studies. Reference: Marco Zimarino et al. J Am Coll Cardiol Intv 2013. Article in press. In the era of drug-eluting stents, (DES), several randomized and observational studies have been conducted trying to find the best strategy...

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