The purpose of this phase 2 study was to test the safety and efficacy of new drug bendavia to prevent mitochondrial dysfunction. It was a randomized, double-blind, placebo-controlled study enrolled 58 patients in the bendavia branch and 60 in the control branch. All patients were undergoing anterior ST segment elevation myocardial infarction with TIMI 0/1...
This study included 329 consecutive patients derived to coronary angiography based on myocardial perfusion tests or PET scan (positron emission tomography). The extension and severity of heart disease was assessed by angiography, and coronary flow reserve (CFR) was measured non-invasively by PET. After adjusting risk factors, ejection fraction, revascularization, etc, both the severity of angiographic...
Current guidelines suggest treating only the culprit artery of myocardial infarction with ST-segment elevation. This prospective and randomized work included 296 patients in 7 centers suffering ST-segment elevation acute myocardial infarction referred for primary angioplasty randomized to treat only the culprit artery (n = 146) versus complete revascularization (n = 150). In the culprit artery...
The platelet P2Y12 receptor antagonist ticagrelor is shown to reduce the incidence of cardiovascular events when administered in hospital admission to patients suffering an ST-segment elevation acute myocardial infarction. Pre-hospital management that could improve coronary reperfusion and events like death or stent thrombosis was not studied. 1862 patients were included suffering ST-segment elevation acute myocardial...
The individual variability to platelet response of clopidogrel is related to several mechanisms with high intrinsic platelet reactivity, variability in drug metabolism, drug interactions, etc. The hepatic cytochrome P450 system plays a key role in the metabolism of clopidogrel, and the CYP2C19 allele loss of function is associated with high platelet reactivity with clopidogrel use...
The PARIS registry was a prospective observational study in 5018 patients undergoing coronary angioplasty with stent implantation in 15 centers. Three categories were prespecified in the discontinuation of dual antiplatelet therapy: 1) discontinuation for medical guidance, 2) transient discontinuation for less than 15 days for surgery and 3) permanent abandonment of it by non-adherence or...
P2Y12 receptor inhibitors are effective in patients experiencing NSTE-ACS, however, the administration timing is not clear. This study evaluated the administration of prasugrel at the time of diagnosis of ACS or after performing coronary angiography when angioplasty was already decided. 4033 patients were included experiencing an NSTE-ACS troponin positive who had planned angiography between 2...
This work aimed to evaluate the use of optical coherence tomography (OCT) to guide the drug-eluting stent implantation during primary angioplasty. 201 patients experiencing STEMI to use or not OCT during primary angioplasty were randomized. The clinical and angiographic characteristics were well balanced, and no differences in MACE, cardiac death, TLR, or stent thrombosis at...
The STREAM study (Strategic Reperfusion Early After Myocardial Infarction) that included 1891 patients gave support to the fibrinolytic infusion strategy in the ambulance in patients treated within 3 hours of stroke and who cannot receive primary angioplasty within the hour versus primary angioplasty. The primary end point was a composite of death from any cause,...
Dr. David Antoniucci presented the immediate results of randomized trial SMART SMART (n=80, 1:1) comparing manual thrombectomy (MAT) vs. rheolytic aspiration (RT) in the context of ST elevation acute myocardial infarction (≤6 hours). In this study, primary outcome was residual thrombus burden after aspiration assessed with optical coherence tomography (OCT). Thrombus burden was defined as...