1- High-Sensitivity Troponins Turned All Events into Infarctions; the 4th Universal Definition Clarifies Things Myocardial infarction or myocardial injury? The Fourth Universal Definition of Myocardial Infarction (an update of the 2012 version) is here to clarify that not all cases of elevated cardiac troponin values are acute myocardial infarctions. Read more 2- A Simple...
ESC 2018 | ART: Disappointment with Bilateral Internal-Thoracic Artery Grafts After a 10-Year Follow-Up
Published 5-year results had been neutral for bilateral vs. single internal-thoracic artery grafts, but, at the time, surgeons argued that the time period analyzed was not enough and that a difference would be observed after 10 years of follow-up, once the trial finished. Such follow-up was presented at the European Society of Cardiology (ESC) Congress 2018...
ESC 2018 | CULPRIT-SHOCK: 1-Year Results Continue to Support Treatment of the Culprit Artery Only
Increases in the rates of revascularization and heart failure do not justify the early mortality advantage shown by treatment of the culprit artery only in patients with acute myocardial infarction and cardiogenic shock. The 1-year follow-up of the CULPRIT-SHOCK trial reinforces the idea of only treating the culprit artery, with an option for revascularization of...
Tips to Prevent Radial Occlusion after Catheterization
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...
Next-Day Discharge after TAVR: Is It Viable?
Next-day discharge after transfemoral transcatheter aortic valve replacement (TAVR) might be viable, with no major complications at 30 days or one year, compared against patients with longer hospital stay. We only have to consider a few factors that will help us choose the most adequate patients for this modality without compromising safety. One of the main advantages...
Clopidogrel or Ticagrelor in Patients with Acute Coronary Syndrome Treated with New-Generation DES: CHANGE DAPT
Courtesy of Dr. Pablo Baglioni. This is a prospective observational study with a 1-year follow-up analyzing 2062 patients with acute coronary syndrome (ACS) who have been treated with coronary angioplasty using new-generation drug-eluting stents (DES). Patients were included between December 21, 2012 and August 25, 2015. On May, 2014, due to changes in international guidelines, clopidogrel...
Early Coronary Angiography in High-Risk Non-ST-Elevation ACS
Coronary angiography is essential for patients admitted with non-ST-elevation acute coronary syndrome, since it allows physicians to confirm the diagnosis, stratify the risk, and define the revascularization and antithrombotic management strategies. There is no doubt that these patients should be studied invasively, but the timing for that is still uncertain. Coronary catheterization within...
Is Same-Day Discharge After Angioplasty Safe?
Overnight observation after coronary angioplasty has been the standard of care in the United States. The foundations for this practice go back to the early days of balloon angioplasty, when acute occlusion and access-site complications were frequent. There are several registries and randomized studies showing the clear safety of same-day discharge after coronary angioplasty. This practice...
VALIDATE-SWEDEHEART: bivalirudin seems to be losing ground
Another important work that does not see the benefits of bivalirudin over heparin as monotherapy as regards both efficacy (death and MI) and safety end points (bleeding) in patients undergoing acute myocardial infarction with and without ST elevation. The study VALIDATE-SWEDEHEART, presented at ESC, simultaneously published in the New England Journal of Medicine, randomized 6000 patients...
See All ProEducar “José Gabay” Course (Eighth Edition) Presentations
We are deeply thankful to all interventional physicians who, motivated by their great scientific and educational vocation, presented their works at the “José Gabay” Course and actively collaborated in training and providing updated concepts for the next generations of interventional cardiologists. Read and/or download the presentations below: Module I: Fundamentals and Basic Elements. Álvarez, José....