Tag Archives: chronic stable angina

Ischemia

ISCHEMIA: New Analysis Might Change Study Outcome Interpretation

ISCHEMIA: New Analysis Might Change Study Outcome Interpretation

A new ISCHEMIA analysis has shown its outcomes are highly dependent on MI definition. The original conclusion had shown a significant difference between invasive and conservative strategies using the most sensible definition of MI: troponin elevation.  When looking at events using MI definition as troponin elevation, we will see the conservative treatment reduces primary end

High Risk Anatomy Challenges ISCHEMIA Outcomes

According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization at long term vs. the conservative treatment.  This goes against the study presented by Reynolds H et al at AHA 2020. Dr. Reynold’s was a sub-study of the ISCHEMIA trial which had observed that even

Efecto a largo plazo de los balones liberadores con bajas dosis de paclitaxel

Global FFR as Prognosis in CAD Patients without Ischemia

Global fractional flow reserve (FFR) results from adding up FFR values of the three major coronary arteries. This figure represents the physiological atherosclerosis burden and can predict events at long term in patients without stenosis leading to ischemia. This recent study published in JAHA looked at major cardiovascular events (death, infarction and revascularization) at 5

ESC 2020 | Trimetazidina post angioplastia: sin efectos adversos pero sin grandes beneficios

ESC 2020 | Post PCI Trimetazidine: No Adverse Events or Great Benefits

Trimetazidine in addition to optimal medical therapy in patients undergoing coronary PCI does not change events rate at long term.  The ATPCI study was presented at ESC 2020 and simultaneously published in the Lancet. This study randomized coronary PCI patients with stable or acute NSTEMI coronary syndromes to trimetazidine vs. placebo.   What is the rationale

Revascularización vs tratamiento médico inicial en pacientes crónicos

EuroPCR 2020 | Revascularization vs. Initial Medical Treatment in Chronic Patients

There is no survival advantage with invasive coronary revascularization over initial medical treatment in patients with chronic coronary artery disease.  However, revascularization did reduce the incidence of unstable angina and its symptoms, according to this new meta-analysis published in Circulation and presented virtually at EuroPCR 2020. There was no significant difference in spontaneous infarctions overall, but

Virtual ACC 2020 | ISCHEMIA-CKD: Invasive Strategy vs. Medical Treatment in Higher Risk Patients

This pre-specified protocol originally included 777 patients with chronic kidney failure. These patients are a special population of higher risk where we might be able to see the advantage of a more aggressive initial strategy. Death or MI rate (combined primary end point) resulted 36.4% for the invasive strategy vs. 36.7% for the initially conservative

ACC 2020 Virtual | ISCHEMIA: la calidad de vida no es un punto blando

Virtual ACC 2020 | ISCHEMIA: Quality of Life, Not a Soft Endpoint

In the general study, an invasive strategy followed by revascularization (when necessary) vs. an initially conservative strategy with OMT resulted similar in patients with stable CAD with moderate to severe ischemia. A secondary end point of this analysis were angina symptoms and quality of life. Angina symptoms, functional activity and quality of life were assessed

ACC 2020 Virtual | El controvertido estudio ISCHEMIA llega finalmente a NEJM

Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM

In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed out of a science-fiction tale. The world has changed

FFR in the Time of ISCHEMIA

The results of this great multicenter “real-life” registry are similar to those of randomized clinical trials that studied fractional flow reserve (FFR). Lesion deferral based on FFR is a very safe strategy, even for lesions located in the proximal anterior descending artery. Randomized controlled studies FAME and DEFER convincingly showed the safety of lesion revascularization

ESC 2019 | CLARIFY: Los síntomas predicen riesgo solamente en pacientes con infarto previo

ESC 2019 | CLARIFY: Symptoms Predict Risk Only in Patients with Prior MI

The 5-year follow up of patients with chronic stable angina (or as the guidelines currently call it “chronic coronary syndrome”) indicate the risk of cardiovascular death or non-fatal MI is quite low, but risk factor control is still fairly poor. This information comes from the CLARIFY study, presented at ESC 2019 and published simultaneously in

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