Courtesy of Dr. Santiago F. Coroleu. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel after percutaneous coronary intervention (PCI) reduces the risk for coronary thrombotic events (CTEs) at the expense of increasing risk for major bleeding (MB). However, the lack of information to accurately predict the occurrence of each event in out-of-hospital patients under…
Closure Devices vs. Manual Compression
Courtesy of Dr. Guillermo Migliaro. Post PCI major bleeding has been associated with short term mortality in acute coronary syndromes (ACS). Even though studies have shown the transradial approach is safer than the femoral, especially in high risk subgroups ─ mainly STEMI patients ─ the femoral access site continues to be widely used. …
No Extra Benefit for Combined Use of Bivalirudin and Transradial Approach
The aim of this meta-analyzis was to study the relation between bivalirudin and access site in patients undergoing acute coronary syndrome (ACS). Both bivalirudin and the transradial access site are strategies aiming at reducing bleeding complication in patients with ACS undergoing invasive approaches. The interaction of both strategies and the potential benefits of their combined use…
All-Spectrum Transradial Approach: Safer than Femoral
Original Title: Radial vs femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. Reference: Ferrante G et al. J Am Coll Cardiol Intv. 2016; Epub ahead of print. Regardless the type of coronary syndrome, the transradial approach results in lower mortality and complications…
TR-PCI: Upper Extremity Function Post Transradial PCI
Original Title: Upper extremity function post-transradial (TR)-PCI: interim results. Presenter: Eva Zwaan. The use of transradial access has increased in the clinical practice thanks to the reduction of vascular and bleeding complications in addition to the shorter time of hospitalization. The aim of this study was to assess prevalence, magnitude and mechanisms responsible…
MATRIX: Transradial vs. Femoral Access in Non-ST Elevation AMI
Original Title: Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation. Presenter: Bernardo Cortese. The MATRIX study showed that the transradial access is associated with a reduction of combined events, death, infarction, stroke and bleeding, compared to femoral access, in ACS patients. The goal of this sub-analyzis was…
New Meta-Analysis Shows Similar Mortality between Bivalirudin and Heparin
This meta-analyzis of contemporary studies comparing the safety and efficacy of bivalirudin vs. heparin showed no differences in mortality between the two drugs and, consistently with other studies, bivalirudin was associated with an increased risk of acute stent thrombosis. During ACC 2015, the MATRIX study did succeed in showing global differences between the two drugs…
High bleeding risk: is BMS still justifiable?
Original Title: Is Bare-Metal Stent Implantation Still Justifiable in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention? A Pre-Specified Analysis From the ZEUS Trial. Reference: Sara Ariotti et al. J Am Coll Cardiol Intv. 2016;9(5):426-436. This work studied ischemic and bleeding events in high bleeding risk patients randomized to the zotarolimus eluting stent (ZEZ) Endeavor…
Bivalirudin could be beneficial in peripheral PCI
Original Title: Bivalirudin Is Associated with Improved In-Hospital Outcomes Compared with Heparin in Percutaneous Vascular Intervention. Observational, Propensity –Matched Analysis From the Premier Hospital Database. Reference: Carey Kimmeslstiel, et al. Circ Cardiovasc Interv. 2016 Jan;9(1). Courtesy of Dr. Carlos Fava Lower limb vascular interventions are increasing in number and bleeding is one of its most…
Triple Antithrombotic Scheme in AMI Patients undergoing PCI
Original Title: Outcomes of Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Receiving an Oral Anticoagulant and Dual Antiplatelet Therapy, a Comparison of Clopidogrel vs. Prasugrel from the TRANSLATE-ACS Study. Reference: Jackson L.R. et al. JACC Cardiovasc Interv. 2015 Dec 21;8(14):1880-9. Courtesy of Dr Agustín Vecchia. In these last years, new and more powerful antiaggregants have…