In the field of percutaneous coronary intervention (PCI) and myocardial revascularization surgery (MRS), previous analyses have shown a link between in-hospital and 30-day complications, in terms of complicated progress and/or mortality. Most of this information comes from non-randomized or old studies, which translates into contradictory data. Researchers analyzed the EXCEL study, which included patients with…
ACC 2023 | Subanalysis of the REVIVED-BICS Study2
This study demonstrated that coronary angioplasty does not entail any benefit in chronic stable angina over optimal medical therapy in those with impaired ventricular function (EF >35%) with extensive coronary artery disease and viable myocardium. Dr. Divaka Perera performed a subanalysis of said study. At the time of the study, the amount of viability and…
Combined Calcified Lesion Preparation Strategy
Stent sub-expansion in coronary territory has been identified as one of the major predictors of stent failure at followup, which is why improving stent expansion will improve clinical and imaging outcomes. In percutaneous coronary interventions (PCI) of severely calcified lesions, calcified lesions present a major challenge since they impede stent delivery, causing stent under-expansion or…
Is Clopidogrel Monotherapy Safe After a Month of Dual Antiplatelet Therapy in Diabetic Patients?
Currently, many randomized studies have suggested that short-term dual antiplatelet therapy (DAPT) followed by monotherapy reduces bleeding without increasing major cardiovascular events after percutaneous coronary intervention (PCI). A meta-analysis of six randomized studies has shown this benefit using ticagrelor monotherapy after short DAPT. However, there is no data on the results of clopidogrel monotherapy. Researchers…
Ticagrelor or Prasugrel Post-PCI in Daily Practice Patients
The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such…
Post PCI FFR
Much research has been done on the usefulness of functional testing such as fractional Flow reserve (FFR) after percutaneous coronary intervention (PCI), resulting in the correlation of pathological FFR values with major adverse events at 6 months, as shown by Pijls, et al. The impact of post PCI FFR on prognosis has not been studied…
IVUS Use in Peripheral Vascular Disease: Should this Tool Be Used More Frequently in Peripheral Interventions?
Use of intravascular ultrasound (IVUS) has increased rapidly, and several randomized and observational studies have shown improved results in patients who underwent coronary angioplasty using this tool. However, evidence on IVUS on peripheral interventions is more limited. Observational studies have found similar benefits when IVUS was part of the revascularization strategy. In a meta-analysis of…
Sex Differences According to Thrombus Burden in STEMI Patients
Many studies have shown there is higher mortality and complications among women after acute myocardial infarction (AMI) vs. men, especially after 30 days. Even though the mechanism driving higher mortality remains uncertain, recent studies have seen differences in thrombus formation with increased platelet count among women. In STEMI patients, intracoronary thrombus burden is a predictor…
Stent Thrombosis: Clinical Characteristics and Event Predictors in a Contemporary Cohort
Stent thrombosis (ST) is a serious complication of coronary PCI. However, its incidence across registries is low. It has been classified according to onset into acute (less than 24 hrs.), subacute (between 24 and 30 days), late (between 30 and 365 days) and very late (later than 365 days). The estimated incidence of ST is…
Is TCA Useful for Severe Impairment of Left Ventricular Ejection Fraction?
Heart disease is the most frequent cause of heart failure and, in some observational studies, transluminal coronary angioplasty (TCA) could help improve ventricular function. The only major randomized study to compare myocardial revascularization surgery (MRS) vs. medical treatment in patients with ventricular function impairment was the STICH study, which showed no difference at 5 years,…