Seguimiento a 10 años de estrategia invasiva vs conservadora en infartos sin supradesnivel del ST

Follow-up at 10 years for invasive vs. conservative strategy for non-ST-segment elevation infarction

The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), with elevated markers such as cardiac troponin T. The absence of long-term benefit of an early invasive strategy at 1 and 5 years had already been reported.<a href="https://solaci.org/en/2017/05/09/follow-up-at-10-years-for-invasive-vs-conservative-strategy-for-non-st-segment-elevation-infarction/" title="Read more" >...</a>

mejor estrategia infarto agudo de miocardio y múltiples vasos

Best Strategy for Acute MI and Multivessel Disease

The goal of this study was to assess all available revascularization strategies for patients undergoing ST elevation acute myocardial infarction and multivessel disease.   Among the strategies to treat this group of patients, there were: culprit vessel intervention only, culprit vessel intervention and, in case of success, multivessel intervention, culprit vessel intervention with staged revascularization,<a href="https://solaci.org/en/2017/01/14/best-strategy-for-acute-mi-and-multivessel-disease/" title="Read more" >...</a>

Myocardial Revascularization Surgery: One or Two Internal-Thoracic-Artery Grafts?

The use of both internal thoracic (mammary) arteries for myocardial revascularization surgery might improve long-term outcomes, compared with the use of a single internal thoracic artery.   Patients scheduled for myocardial revascularization surgery (only multivessel procedures; combined valve procedures were excluded) were randomized to receive a single internal-thoracic-artery graft (internal thoracic artery for the anterior<a href="https://solaci.org/en/2016/12/21/myocardial-revascularization-surgery-one-or-two-internal-thoracic-artery-grafts/" title="Read more" >...</a>

Metoprolol before primary PCI doesn’t reduce infarction size

Original Title: Early Intravenous Beta-Blockers in Patients with ST-Segment Elevation Myocardial Infarction before Primary Percutaneous Coronary Intervention. Reference: Roolvink V et al. J Am Coll Cardiol. 2016 Jun 14;67(23):2705-15.   The impact of endovenous beta-blockers before primary PCI has not been established yet. This is the first double blind multicenter trial, controlled with placebo, to<a href="https://solaci.org/en/2016/06/23/metoprolol-before-primary-pci-doesnt-reduce-infarction-size/" title="Read more" >...</a>

Morphine Increases Platelet Reactivity in Infarctions

The use of morphine in patients undergoing ST elevation acute coronary syndromes is associated to higher platelet reactivity and lower thrombolysiscapacity, according to this small study. The negative effects seem to resolve 2 days after administration. This transient effect is believed to be the result of the inhibition of the normal muscular activity of the<a href="https://solaci.org/en/2016/04/08/morphine-increases-platelet-reactivity-in-infarctions/" title="Read more" >...</a>

Survivors of Myocardial Infarction with Cardiogenic Shock: Long Term Outcomes.

Título original: Post-Hospital Outcomes of Patients With Acute Myocardial Infarction With Cardiogenic Shock Findings From the NCDR. Referencia: Rashmee U. Shah et al. J Am Coll Cardiol. 2016;67(7):739-747.   Even though mortality after cardiogenic shock MI is quite high, many survive and are discharged. So far, there is little we know about their prognosis after discharge.<a href="https://solaci.org/en/2016/03/23/survivors-of-myocardial-infarction-with-cardiogenic-shock-long-term-outcomes/" title="Read more" >...</a>

FFR in non-ST elevation myocardial infarction

Original Title: Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-St segment elevation myocardial infarction: the British Heart Foundation FAMOUS–NSTEMI randomized trial. Reference: Jamie Layland et al. European Heart Journal (2015) 36, 100–111 Courtesy of Dr. José Amadeo Guillermo Álvarez. Several studies have established the value of fractional flow reserve (FFR) in<a href="https://solaci.org/en/2016/02/19/ffr-in-non-st-elevation-myocardial-infarction/" title="Read more" >...</a>

NONSTEMI: Superiority of early angioplasty in non-ST elevation myocardial infarction

The European guidelines recommend revascularization within 24 hours in high-risk patients with No ST segment elevation myocardial infarction. It is unclear whether these patients would benefit from an immediate strategy. This randomized, open, and controlled study included 250 patients with suspected Non ST segment elevation myocardial infarction. Patients were randomized to early coronary angiography or<a href="https://solaci.org/en/2015/06/24/nonstemi-superiority-of-early-angioplasty-in-non-st-elevation-myocardial-infarction/" title="Read more" >...</a>

After 80: The octogenarian patients with acute coronary syndrome benefit from an aggressive strategy

This work published simultaneously in The New England Journal of Medicine showed that patients over eighty years may benefit from an aggressive and invasive treatment strategy that could be unnecessarily denied given age. The study was conducted in 16 centers in Norway and included 458 octogenarians patients admitted with acute coronary syndromes without ST-segment elevation<a href="https://solaci.org/en/2015/06/24/after-80-the-octogenarian-patients-with-acute-coronary-syndrome-benefit-from-an-aggressive-strategy/" title="Read more" >...</a>

NONI: Inhaled nitric oxide to reduce reperfusion injury in myocardial infarction

Infarct size is an independent predictor of survival and ventricular function. Several alternatives have been tried to reduce the size of the infarcted area and its consequences. Small pilot studies suggest that inhaled nitric oxide may improve reperfusion in acute myocardial infarction with ST-segment elevation. Patients were randomized to conventional treatment versus inhalation of 80<a href="https://solaci.org/en/2015/06/24/noni-inhaled-nitric-oxide-to-reduce-reperfusion-injury-in-myocardial-infarction/" title="Read more" >...</a>