Given the individual variability of response to antiplatelet therapies, measuring platelet function and designing tailored therapies could be beneficial. The ARTIC study tested the superiority of bedside platelet function monitoring with drug adjustment vs. the conventional post DES therapy without monitoring and drug adjustment. It included 2466 patients with stable coronary disease or Non-ST Elevation...
Coronary artery bypass grafting (CABG) without a cardiopulmonary bypass, (CBP), has increasingly become an alternative to the conventional standard (with pump). However, it is still controversial whether there is a decrease in morbidity and mortality between these two techniques. The aim of this study was to compare these two techniques in a high risk population. ...
The PARTNER Cohort A randomized 699 elderly patients, (mean age 84.1), with severe aortic stenosis for TAVI or conventional surgery in 26 centers. The group of patients who received TAVI was divided into two groups: trans-femoral procedure, (244 patients), or trans-apical procedure, (104 patients). After one year mortality was similar but stroke and transient ischemic...
Increasingly, the frequent performances of elective angioplasties are in hospitals that do not have a cardiac surgery team. The occurrence for the need of emergency surgery varies from 0.1 to 0.4% in the contemporary age. There is an ongoing debate on health policy about whether to perform elective coronary angioplasty at hospitals without cardiac surgery...
The relative benefits and risks of off-pump coronary artery bypass grafting (CABG) as compared with the use of CBP are not clearly defined. The CORONARY trial in 79 centers randomized 4,752 patients in whom CABG was planned with or without CBP. There was no significant difference in the primary end point which was a composite...
Background: There is much debate about a possible benefit of coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) compared with on-pump surgery. However, a randomized study could not confirm this benefit. The objective of these studies was to compare the MACCE, (death, MI, stroke, revascularization repeated and a new dialysis), of surgical revascularization with...
In the PARTNER 1 study, patients with inoperable severe aortic stenosis treated with an aortic valve prosthesis balloon-expandable Edwards-SAPIEN showed a mortality reduction compared with standard treatment. However, the Edwards SAPIEN device is associated with peri-procedural complications. The new generation of Edwards SAPIEN XT prosthesis incorporates significant improvements in the profile of the delivery system,...
The aim of this study was to determine whether patients without ST-segment elevation acute coronary syndromes who were not taking statins previously, can receive high doses of rosuvastatin before coronary angiography or angioplasty and if this action could exert protection in renal function and reduce the incidence of contrast-induced nephropathy (CIN). This prospective study randomized...
The THRIVE study, (also known as HPS2-THRIVE), was a multicenter clinical trial designed to test the hypothesis that the increase in HDL, (using ER niacin/laropiprant), could prevent vascular events in a high risk population already receiving statin standard therapy. Between April 2007 and July 2010 a total of 25,673 randomized patients in China, the UK...
Alan Wilson and Szeto Zajarias show that vascular complications of the trans-femoral path remain an important factor because of the high profile of the catheters used in TAVI and the appearance of smaller devices, as well as the experience of surgeons, will progressively reduce complication rates. Josep Rodes-Cabau commented about the negative impact a stroke...