New information has been published fast, and what we thought we knew about hypertension has also changed fast. One of the biggest differences between American and European hypertension guidelines is whether patients with systolic blood pressure (BP) 130/139 mmHg and diastolic BP 80/89 mmHg are considered hypertensive or not. The only place where enough patients with these...
As a prologue to Peru 2018 Sessions, Nurses and Technicians Sessions will be held on October 24, 2018. The event will take place at the Main Arena of the National Cardiovascular Institute (INCOR), in Lima. These sessions will be about several topics, among others, radioprotection in the cath lab, valve disease procedures, TAVR, mitral valve,...
Angina pectoris without stenosis in the epicardial coronary arteries is a common problem with several possible underlying causes. The main purpose of this work was to test the hypothesis that stratified medical therapy guided by an interventional diagnostic procedure might improve outcomes. Patients without coronary lesions and with angina were immediately randomized 1:1 to an...
Despite optimal medical treatment and modification of risk factors, patients may spend long periods without symptoms and then experience acute coronary syndrome without any prior indication that may allow us to predict the time of occurrence. This is why the possibility of detecting patients with vulnerable plaques and who are at higher risk is very...
Prosthesis-patient mismatch (i.e. a difference between the size of the implanted prosthetic valve and the patient body size) in patients who undergo surgery is associated with worse outcomes. This may also apply to percutaneous prostheses, although that has not been well-studied yet. This work, presented at TCT 2018 and published simultaneously in JACC, analyzes this problem...
This prospective, randomized, multicenter study included 447 patients with severe aortic stenosis and intermediate or high surgical risk randomized in a 2×2 factorial design to general vs. conscious sedation with local anesthesia and also to receiving the Sapien 3 valve (balloon-expandable) vs. CoreValve Evolut R (self-expandable). Primary end point was a composite of all-cause mortality,...
The SYNTAX trial had a 5-year follow-up, but the SYNTAXES (“ES” for extended survival) was specifically designed to find out comparative mortality of both treatments (PCI or surgery) at 10 years in patients with three vessel and/or left main lesions. This study retrospectively compared survival data at long term of 897 patients randomized to surgery...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as an important treatment alternative for intermediate- and high-risk patients. In that sense, the presence of atrial fibrillation (AF) before TAVR is high and it has been associated with worse outcomes and higher mortality. However, there is not much evidence available regarding new-onset atrial...
Symptomatic patients with <1 cm² aortic valve area will benefit from an intervention regardless parameters such as flow and gradient, even if these are normal (or at least not severe). A valve replacement will be indicated without question (either surgical or percutaneous) in patients with >40 mHg mean gradient or low gradient justified by low...
These new hypertension guidelines (which were as long-awaited as the American ones, back then) finally emerged in Barcelona, at the European Society of Hypertension (ESH) Congress. The document was issued jointly with the European Society of Cardiology (ESC). These guidelines provide recommendations for physicians to diagnose hypertension, evaluate risk, and determine when and how to...