In general, thrombus aspiration in acute myocardial infarction (AMI) has not been shown beneficial by large studies. It could even be prejudicial, since it has been associated with stroke. However, there are certain scenarios where the presence of a significant number of these prevents us from reaching adequate TIMI flow 3, or is associated with…
Ticagrelor Shows Benefits in Coronary Microvascular Function after NSTEMI
Coronary microvascular disfunction (CMD) is an important long-term prognosis predictor. CMD treatment can be an effective therapeutic strategy for patients with acute coronary syndrome (ACS). Nevertheless, more studies are needed to assess different strategies. In the PLATO (Study of Platelet Inhibition and Patient Outcomes) study, ticagrelor vs. clopidogrel reduced ischemic events and overall mortality in…
OCT in STEMI Patients: Is It Safe to Prevent Stenting?
Percutaneous coronary intervention in patients with acute myocardial infarction (AMI) where the physiopathological mechanism is plaque erosion or non-atherosclerotic mechanisms (such as spontaneous coronary artery dissection) is not beneficial according to recent studies. The EROSION study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography–Based Management in Plaque Erosion) has shown medical treatment with no…
ACC 2022 | PACMAN AMI
Atherosclerosis plaque causing AMI is often large in volume, high in lipids and have a thin fibrous cap. Statins often reduce atherosclerosis progress, but the impact of PCSK 9 inhibitors (alirocumab) after acute coronary syndrome is scarcely known. The aim of this study was to determine the effect of alirocumab using intracoronary imaging (IVUS, OCT,…
Survey to Evaluate Myocardial Infarction Reperfusion in LatAm
The Latin American Society of Interventional Cardiology together with the Interamerican Society of Cardiology (SIAC) and the Stent-Save a Life! Initiative have developed a short survey (which can be answered in less than 5 minutes) to learn how ST-segment elevation acute coronary syndromes are treated in Latin America. The final objective of this survey is…
Is Coronary Revascularization Useful in Renal Transplant Candidates?
Coronary artery disease is the main cause of death in patients with functioning renal transplant, reaching 30%, with the highest rate at peri transplant stage. At the same time, the incidence of acute myocardial infraction (AMI) after renal transplant ranges from 5% to 11%. This is why asymptomatic candidates are routinely screened for CAD before…
Zwolle Score: Can a Risk Score Decide Where STEACS Patients Should Stay?
The mortality of ST-segment elevation acute coronary syndromes (STEACS) has decreased thanks to improved reperfusion times (fibrinolysis or primary angioplasty), so that, in daily practice, there is a greater number of patients with stable acute myocardial infarction (AMI). This clinical stability and a low rate of complications raise the question of whether performing triage is…
ST Elevation Acute Myocardial Infarction Management in Latin America: A Survey
We are glad to invite the entire Latin American community to make part of this survey aimed at collecting data on the quality of ST elevation MI management in Latin America. It will take just 5 minutes of your time, is totally anonymous, and will contribute to the better understanding of the different treatment realities…
FLOWER-MI Sub-Studies Coming Out Generate More Questions about FFR
The FLOWER-MI (presented simultaneously at ACC 2021 and NEJM) hit FFR hard. Its outcomes showed that STEMI patients presenting other non-culprit lesions did not benefit from FFR guided revascularization vs PCI. As it happens with most large studies with unexpected results in the general population, the sub-studies that follow select better samples and, as a…
ESC 2021 | COVERT-MI: Colchicine Attempts to Reduce Infarct Size
Colchicine does not offer protection against myocardial injury in ST-segment elevation myocardial infarction when administered during reperfusion and in the following five days, according to the randomized study COVERT-MI. It could even generate signs of damage with 3x the amount of thrombi in the ventricle. The results presented at the European Society of Cardiology 2021…