Tag Archives: bleeding

La revascularización incompleta se asocia a mortalidad en el TAVI

Thrombotic and Bleeding Risk after TAVR: Quick Tips to Stay Up to Date

Thrombotic and Bleeding Risk after TAVR: Quick Tips to Stay Up to Date

Transcatheter aortic valve replacement (TAVR) is an increasingly frequent option for patients with severe aortic stenosis across the entire risk spectrum.  However, TAVR involves bleeding and thrombosis risk and therefore calls for an optimal adjuvant treatment.  Any scheme is complex if we take into account most patients undergoing TAVR are generally elderly and have multiple

Can Ticagrelor Prevent Strokes in High-Risk Patients?

In addition to aspirin, Ticagrelor offers better prognosis in patients that already had a stroke and have a high-risk cardiovascular profile. These benefits should be correctly balanced seeing as they are not free of risk.  Antiplatelet therapy makes part of the standard treatment of cardiac or cerebrovascular patients. Ticagrelor has shown superior to clopidogrel in

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

¿Desescalar la doble antiagregación es el nuevo paradigma?

Dual Antiaggregation De-Escalation: A New Paradigm?

De-escalating dual antiaggregation could be the most effective strategy after acute coronary syndrome seeing as it prevents bleeding and cut down costs with no increase of ischemic events.  Balancing the effects of dual antiaggregation therapy (DAPT) in the era of potent P2Y12 inhibitors has become the cornerstone of acute coronary syndrome (ACS) management.  This meta-analysis

Síntomas persistentes post COVID-19: mucho más frecuentes de lo que creíamos

Heparin Anticoagulation in Critically Ill COVID-19 Patients: Results that Differ from the Rest

In critically ill COVID-19 patients, an initial strategy of anticoagulation with heparin did not result in any benefit compared with standard prophylactic treatment. Thrombosis and inflammation are the main issues when discussing COVID-19 related morbidity. This led to testing whether an anticoagulation scheme could improve prognosis in critically ill COVID-19 patients. Given the dynamics of

Síntomas persistentes post COVID-19: mucho más frecuentes de lo que creíamos

Surviving Covid-19 with Good Old Heparin?

Patients hospitalized for COVID-19 are at high risk for thrombosis, particularly venous thromboembolism. This information is not new: in a meta-analysis of 66 studies, the overall prevalence of venous thromboembolism among patients with COVID-19 admitted to intensive care units was between 14.1% and 22.7%. Hypercoagulability is an early-described feature of this new virus, and so is

Recomendaciones de la ACC con el nuevo coronavirus

Anticoagulation with Heparin in Non-Critical COVID-19

In non-severe COVID-19 patients, an initial therapeutic strategy with heparin increases the chance of survival after discharge and reduces the need for respiratory and cardiovascular support compared against usual thromboprophylaxis doses.  These data have been welcomed by a medical community eager to receive good news in terms of effective strategies to combat an already existing

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

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

Desafíos pendientes con el acceso radial

MATRIX: Impact of Crossover from Radial Access to Femoral Access

The new MATRIX trial, recently published in JACC Interv., shows that an access-site crossover from radial to femoral access in patients with acute coronary syndrome cancels out the benefit provided by radial access as regards bleeding.  However, there are no signs of comparative damage between successfully conducted radial or femoral access as a first attempt. 

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