Tag Archives: acute coronary syndrome

High Risk Anatomy Challenges ISCHEMIA Outcomes

According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization at long term vs. the conservative treatment.  This goes against the study presented by Reynolds H et al at AHA 2020. Dr. Reynold’s was a sub-study of the ISCHEMIA trial which had observed that even


The Ten Commandments from the New Guidelines on Infarction Without ST-Segment Elevation

In 2020, the European Society of Cardiology guidelines for the management of patients with acute coronary syndromes without ST-segment elevation (Non-ST-Segment Elevation Myocardial Infarction, NSTEMI) were presented. This document went somewhat unnoticed in the context of the COVID-19 pandemic, so this seems a good time to review it and set out some practical “commandments” (something

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Is Loading NSTEMI with DAPT Convenient?

Pretreating non-ST elevation acute myocardial infarction (NSTEMI) patients with P2Y12 receptor inhibitors is not associated with improved clinical outcomes as it is to increased bleeding. NSTEMI patients are often treated with platelet antiaggregants in the daily clinical practice despite the lack of evidence for its benefits. This Swedish registry prospectively included 64857 patients undergoing NSTEMI

TCT 2020 | Ticagrelor Monotherapy After ST-Segment Elevation Infarction

Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment

Doctor con tabletas de aspirinas

How To De-Escalate Prasugrel After Acute Coronary Syndrome?

Patients who undergo coronary angioplasty after acute coronary syndrome could de-escalate dual antiplatelet therapy with prasugrel to maintain the protection against ischemic events while lowering their hemorrhagic risk. The HOST-REDUCE-POLYTECH-ACS study (recently published in The Lancet) included 2338 patients who underwent coronary angioplasty in a setting of acute coronary syndrome. Patients were randomized to a year-long

ESC 2020 | New European Guidelines on Non-ST-Segment Elevation Acute Coronary Syndromes: What’s New?

The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. This document includes news regarding a more agile infarction diagnosis, the use of non-invasive imaging, the simplification of anticoagulant therapy, infarction with normal coronary arteries,

infarto peri-procedimiento

Long Term Changes ACS Revascularization

Long term outcomes support complete revascularization in multivessel patients undergoing acute coronary syndrome (ACS). This large contemporary registry recently published in J Am Coll Cardiol Intv.  has shown complete revascularization is gaining ground in the daily practice and is associated to clinical benefits in patients undergoing ACS.  It included 9094 individuals with ACS and multivessel

doble antiagregacion plaquetaria sexo

Optimal Intervention Timing for NSTEMI with No Antiaggregant Pre-Treatment

Patients undergoing non-ST elevation MI (NSTEMI) who are not pre-treated with P2Y12 receptor inhibitors will benefit from a very early intervention strategy.  The optimal intervention timing for NSTEMI patients is still under debate, despite multiple studies, but the ideal timing had never been tested in patients with no platelet aggregation inhibitor pretreatment.  After the surge of

Historia natural de la infección asintomática por COVID-19

Temporary Emergency Guidelines for Infarction During the Pandemic

Several United States societies (the American Heart Association [AHA] among them) have answered the question of many physicians in the front lines: what is the ideal strategy for the treatment of ST segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic? This document intends to ensure that patients with STEMI continue to receive adequate, proven