Tag Archives: acute myocardial infarction

Nueva y discrepante información sobre los vasos no culpables en el infarto

New Unexpected Data on Non-Culprit Vessels in MI

New Unexpected Data on Non-Culprit Vessels in MI

Patients with acute myocardial infarction presenting lesions in multiple vessels is not associated with reduced infarct size in non-culprit lesions, even when functionally significant.  Animal models suggest brief periods of ischemia in non-infarct territories (non-culprit) might protect culprit territory thanks to remote ischemic preconditioning.  This pre-conditioning, according to this perspective, would reduce reperfusion injury and

Beta Bloqueantes

Post MI Betablockers for Good?

Patients receiving optimal medical treatment after MI do not seem to benefit from betablockers in the long term, provided they do not present cardiac failure or systolic function deterioration.  This study looked into the cardio protection effect of betablockers (BB) after long term follow up in stable patients with no cardiac failure and a history

ticagrelor_enfermedad_vascular_periférica

Ticagrelor: Yet Another Pleiotropic Effect?

Studies in animals have shown ticagrelor offers better myocardial protection against reperfusion injury after ST elevation MI than clopidogrel.  This had to be tested in the clinical arena, which is the aim of this study (published in JACC Intv): to assess left ventricular remodeling after reperfusion.  The study included patients undergoing their first ST elevation

Beta Bloqueantes

Pleiotropic Effect of Metoprolol: Different From other B-blockers

The clinical practice guidelines recommend the early use of endovenous B-blockers in patients undergoing acute myocardial MI, taking for granted that all B-blockers have a similar class effect.  This experimental study might show metoprolol has other benefits that could make it superior to the rest of the B-blocker family.  Using an animal model with 45-minute

El acceso radial se asocia a menor mortalidad y menor sangrado en los pacientes cursando un infarto con supradesnivel del segmento ST que reciben angioplastia primaria.

The Transradial Approach Continues to Be the Best for Primary PCI

The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI.  This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral.  The transradial

Esquema corto y monoterapia, una práctica llena de evidencia

Antiplatelet Therapy in Elderly Population: Are the New P2Y12 Inhibitors Safe?

Should elderly patients stick to clopidogrel? The first large study on prasugrel showed an unacceptable increase of bleeding in elderly patients, suggesting the use of 5 mg (although the sample size was small, which hindered the determination of dose efficacy). Later, ticagrelor showed better efficacy than clopidogrel without apparent safety concerns. However, specific evidence on elderly

ticagrelor vs. aspirina

Ticagrelor or Prasugrel in ST Elevation MI

In patients undergoing ST elevation acute myocardial infarction (STEMI) receiving primary PCI, no significative differences between prasugrel and ticagrelor were found. However, the latter was associated to a significantly higher number of repeat MI when considered separately.  Few studies have compared the efficacy and safety of the two most potent oral P2Y12 receptor inhibitors in

TCT 2020 | Administrar el comprimido de prasugrel molido previo a la angioplastia

TCT 2020 | Crushed Prasugrel Administration prior PCI

Prehospital administration of crushed tablets of prasugrel loading dose in the ambulance while patient is on his way to primary PCI does not improve reperfusion markers compared against uncrushed tablet administration according to the COMPARE CRUSH, presented at the virtual TCT 2020 and simultaneously published in Circulation. There were no differences in TIMI flow of

Doble puente mamario para reducir la chance de nuevas revascularizaciones

Visual Assessment for Non-Culprit Lesion Revascularization

There is evidence in favor of complete revascularization in the context of ST elevation MI with multivessel disease where primary PCI has been successful.  However, the small print in these studies should be read carefully. Should revascularization be completed during index intervention, index hospitalization or after discharge? Should complete revascularization be based on visual assessment,

Rincón del Fellow | Caso Clínico N°2: Misión Explosiva

The Fellow’s Corner | 2nd Clinical Case: An Explosive Mission

Read the case presentation and join the conversation through the comments in this post! Case Introduction: An Explosive Mission! 56-year-old male patient Severe smoker Hypertension Dyslipidemia Sedentary lifestyle and stress A sibling suffered from an acute myocardial infraction Cardiac markers: Standard angina, intensity of 8-9/10, 3-to-4-h long, and dyspnea (on and off for the past

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