For years, treating dyslipidemia mainly focused on reducing LDL cholesterol (LDL-C) with statins, which had shown benefits in reducing atherosclerotic cardiovascular disease (ASCVD). Lipoprotein(a) [Lp(a)] is a form of apoB-containing lipoprotein bound to a hydrophilic, highly glycosylated protein called apolipoprotein(a) [apo(a)]. Circulating levels of Lp(a) are genetically determined, and are hardly affected by eating habits…
Prognostic Impact of SYNTAX and SYNTAX II Scores in Patients with Acute Myocardial Infarction
Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX…
AMI and Multivessel Disease: Can We Perform a Single Procedure?
Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery.…
What to Do in Cases of AMI with Multivessel Disease
The presence of lesions in multiple vessels is common in ST-segment elevation myocardial infarction (STEMI). It has been shown that, when they are treated in a second procedure, patients have a better outcome. To date, there is limited information available on percutaneous transluminal coronary angioplasty (PTCA) in vessels with severe non-culprit lesions during primary angioplasty.…
AMI following Coronary Artery Dissection: Higher Mortality?
Though rare, spontaneous coronary artery dissection (SCAD) might lead to MI, most commonly affecting young middle aged women. In these cases, the angiographic image will present a characteristic double lumen, and an intramural hematoma in the coronary artery wall. Normally, it will be treated medically. However, a small number of cases presenting STEMI will require…
No Reflow after Primary PCI in STEMI: An Angiographic Analysis of the TOTAL Study
In the early days of percutaneous coronary intervention (PCI) in patients with ST elevation acute myocardial infarction (STEMI), no reflow phenomenon was known as an indicator of the worst possible outcomes in terms of left ventricular remodeling, infarct size, ejection fraction and mortality, at long term. The TOTAL study (Routine Aspiration Thrombectomy with PCI Versus…
Abbreviated Therapy in Patients with Acute Coronary Syndrome: How Safe Is Conservative DAPT Treatment?
Abbreviated dual antiplatelet therapy in patients at high risk for bleeding and acute myocardial infarction. Patients with acute coronary syndrome (ACS) who undergo stent placement (percutaneous coronary intervention, PCI) conventionally require at least 12 months of dual antiplatelet therapy (DAPT) to reduce ischemic events. Patients with ACS who are also at high risk for bleeding…
Non-ST Elevation MI: How Long Do We Have for A Coronary Angiography?
This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography…
Post AMI Ventricular Septal Defect: Contemporary Results of Endovascular vs Surgical Repair
In the era of endovascular intervention, with shorter revascularization times, we see lower rates of mechanical complications due to acute myocardial infarction (AMI). Increased rates were recorded during the COVID-19 pandemic, but driven by delays in consultation. Though occasional (with an estimated incidence of 0.2%), post AMI ventricular septal defect (VSD), or interventricular communication, involves…
Pregnancy and Risk of Spontaneous Coronary Artery Dissection: How to Proceed
Courtesy of Dr. Pablo Baglioni. Between the years 2000 and 2015, the authors of this article searched for reports on spontaneous coronary artery dissection (SCAD) in pregnant or immediate post-partum women aiming at defining the clinical characteristics of this pathology and offering management recommendations. Information on 120 women was analyzed; 116 were between 22…
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