Tag Archives: acute coronary syndrome

AHA 2021 | RAPID CABG: seguridad de ir al quirófano precozmente en un síndrome coronario agudo

AHA 2021 | RAPID CABG: Safety of Early Surgical Intervention in Acute Coronary Syndrome

AHA 2021 | RAPID CABG: Safety of Early Surgical Intervention in Acute Coronary Syndrome

Suspending ticagrelor a couple of days before surgery was non-inferior to waiting 5-6 days in terms of bleeding in patients with acute coronary syndrome (ACS) requiring myocardial revascularization surgery. Patients who waited longer had more ischemic events and longer hospitalizations. Current American guidelines recommend waiting at least 5 days before operating on patients with ACS who

isar-react-esc-2021

ESC 2021 | ISAR-REACT 5: Prasugrel Superior to Ticagrelor in ACS across Kidney Function Spectrum

When we have to choose between two potent P2Y12 receptor inhibitors for a patient undergoing ACS with a planned invasive strategy, kidney function should not interfere in this decision.  The main findings of this study were that prasugrel has lower risk of all cause death, MI or stroke, and also had a similar risk of

Doctor con tabletas de aspirinas

The Role of Aspirin after the TWILIGHT-ACS

This analysis corroborates the potential benefit of ticagrelor monotherapy following a short period of dual antiaggregation (DAPT) in patients with acute coronary syndrome (ACS). This benefit consists of a significant bleeding reduction (3.6% vs. 7.6%, P < 0.001), without compromising ischemic events (4.3% vs. 4.4%, P = 0.84). The latter, however, could be seen as

ticagrelor_enfermedad_vascular_periférica

Ticagrelor or Prasugrel for Acute Patients Who Undergo Angioplasty

We are still asking the same question: ticagrelor or prasugrel? With narrow margins between these drugs in terms of efficacy and bleeding, it is difficult to decide which to prescribe. While it has certain methodological limitations, this research published in JAMA seems to clarify the picture at least for patients with acute coronary syndromes who

ACC 2021 | RAPID-TnT: Utilidad de la troponina T ultrasensible y ultra rápida

ACC 2021 | RAPID-TnT: Usefulness of High-Sensitivity Ultra-Fast Troponin T

Patients under evaluation for acute coronary syndrome (ACS) without clear ischemia signs in an electrocardiogram find no benefit in a 0/1-hour high-sensitivity troponin T (ultra-fast) protocol compared with the conventional 0/3-hour protocol. These data come from the RAPID-TnT trial presented during the scientific sessions at the American College of Cardiology (ACC) 2021 Congress, simultaneously published in

ticagrelor_enfermedad_vascular_periférica

Back to Basics: Ticagrelor Questioned and Clopidogrel in the Limelight

Yet another observational study has come to question the antiaggregation power of ticagrelor when it comes to death or MI reduction, pointing at its higher risk of bleeding vs. clopidogrel.  This new analysis recently published in JAHA includes a large number of patients undergoing acute coronary syndrome (ACS) in the clinical practice.  Ticagrelor has been

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

STEMI

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

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