Low-dose colchicine seems to reduce the risk for new cardiovascular events in patients with a history of infarction. This drug is usually indicated for anti-inflammatory therapy in gout and pericarditis. Now, it could also reduce the rate of ischemic events as secondary prevention according to the COLCOT trial presented during the American Heart Association (AHA)…
Current Mechanical Complications of Infarction
Contemporary data of a recently published large registry show that mechanical complications after infarction are not frequent but maintain a very high mortality rate that does not seem to improve over time. Our information on mechanical complications was outdated and we did not have current data on their incidence and prognosis. Such is precisely the…
Hours of Sleep and Myocardial Infarction Risk
This is one of the first studies to prospectively assess this association, and its outcomes support the idea that poor sleep is a potential MI risk factor. Even though we need further data to be able to modify the current sleep duration standards as part of life-style change recommendations, it seems reasonable to start bearing…
TCT 2019 | COMPLETE: Sub-Study to Find Out Complete Optimal Revascularization Timing in STEMI
Courtesy of SBHCI. The COMPLETE study was carried out to assess the benefit of complete revascularization vs culprit vessel revascularization in the context of ST elevation acute myocardial infarction. This COMPLETE sub-study presented at TCT 2019 scientific sessions simultaneously published in JACC assessed the optimal timing of complete revascularization. The general study had already shown…
Revascularization in Spontaneous Coronary Artery Dissection Causing ST-Segment Elevation Myocardial Infarction
Spontaneous coronary artery dissection is an increasing cause of acute myocardial infarction, particularly in younger women. These infarctions are frequently treated conservatively given the risks entailed by revascularization, due to the possibility of causing an antegrade or retrograde expansion of the dissection. The uncertainty around treatment for these patients gave way to this study (recently…
STEMI in Coronary Dissections. When Should We Do It and What Are Its Outcomes?
Courtesy of Dr. Carlos Fava. Generally, coronary artery dissection (SCAD) is not very frequent in young women and presents better evolution with medical treatment. However, it is occasionally associated with ST segment elevation. In this scenario, PCI with stent implantation is quite challenging. The study looked at 4298 STEMI patients; 53 presented SCAD (1.23%). STEMI-SCAD…
Is Complete Revascularization the Right Choice in Acute Myocardial Infarction with Multivessel Disease?
Courtesy of Dr. Carlos Fava. Primary coronary angioplasty has been the treatment of choice for acute myocardial infarction (MI) for many years, but such strategy is associated with nonculprit lesions in a large group of patients. While it has been proven that nonculprit-lesion revascularization offers better outcomes, the groups that would benefit from it are…
ESC 2019 | COMPLETE: Definitive Evidence for Infarction with Multivessel Disease
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the…
ESC 2019 | CONDI-2ERIC-PPCI: Final Blow Against Ischemic Pre-Conditioning in Primary Angioplasty
Remote ischemic conditioning does not offer any clinical benefit to patients with ST-segment elevation acute myocardial infarction undergoing primary angioplasty, according to this study presented on Sunday at the European Society of Cardiology Congress 2019. Prior studies were limited and small, but this analysis seems to provide definitive evidence with regard to ischemic pre-conditioning. The…
ESC 2019 | ISAR-REACT 5 | Which Is Better in ACS, Prasugrel or Ticagrelor?
Courtesy of Dr. Carlos Fava. The benefit of dual antiplatelet therapy in acute coronary syndromes (ACS) has been proven long ago, and both prasugrel and ticagrelor have offered best results than clopidogrel. However, nowadays, it is unclear which of them is superior in the long term, taking into account the fact that one starts to…