Stenting a coronary lesion should not present a drop in pressure when measuring the treated segment with fractional flow reserve (FFR). FFR based trans-stent gradient should involve a segment of the sub-expanded vessel or instent obstruction as plaque prolapse or thrombus. The link between post-stenting physiology and long-term outcomes have been looked at in several…
Spontaneous Coronary Artery Dissection: Are There Differences Between Men and Women?
Spontaneous coronary artery dissection is one of the causes of acute coronary syndrome, with a prevalence between 1 and 4%, that might reach up to 35% in women <50 years old, according to recent studies. As dissections are more frequent in women, research focuses on this population. Small retrospective studies have shown different triggers and predisposing…
TCT 2022 | FAME-3 Trial: post PCI FFR And IVUS in Patients with Three-Vessel Disease
We are well aware of the benefits of Fractional Flow Reserve (FFR) to assess coronary artery stenosis. FFR after PCI (post-PCI FFR) has been shown to have prognostic value; however, few studies have included patients with complex three-vessel disease. The impact of intravascular ultrasound (IVUS) or optical computer tomography (OCT) in this field has been…
Gender Differences and 10-Year Prognosis in STEMI
Coronary artery disease in women usually develops 10 years later than in men, and some evidence suggests women have higher mortality, especially when it comes to ST elevation MI (STEMI). Registries have shown higher mortality both in hospital and at one year follow up. In part, this difference is observed because of the gap in…
Coronary Bifurcation Lesions: MRS or PCI? 10-Year Mortality of the SYNTAX Study
Percutaneous treatment of coronary lesions affecting bifurcations has increased in recent decades. Coronary angioplasty (percutaneous coronary intervention, PCI) in these cases is associated with an increased rate of adverse events in patients with multivessel disease and left main coronary artery lesions. The SYNTAX score, which is a predictor of total mortality, is used to evaluate…
Prognostic Value of Structural and Functional Microvascular Dysfunction in Patients with Nonobstructive Coronary Artery Disease
Coronary microvascular dysfunction (CMD) is a paramount factor involved in the development of anginal syndromes. Among patients with angina and nonobstructive coronary artery disease with CMD, two patterns have been identified using minimal microvascular resistance: structural CMD, and functional CMD. Structural CMD is characterized by decreased coronary flow reserve (CFR) in the presence of increased…
Takotsubo Syndrome: Does Gender Impact Prognosis?
Takotsubo Syndrome (STT) is characterized by acute cardiac failure which can be reversed in many occasions, but is associated with morbidity and mortality at short and long term. It is most frequent among women, especially after menopause. However, gender differences have not been looked into when analyzing the evolution of this cardiomyopathy. This was an…
Using Biolimus-Coated Balloons for Treating Small-Vessel Disease Yields Promising Results
Drug-eluting balloons have demonstrated safety and effectiveness in the treatment of small-vessel coronary artery disease and in-stent restenosis. However, randomized studies were performed using paclitaxel. Several studies have shown that using biolimus, a semisynthetic analog of sirolimus, optimizes drug delivery in both stents and balloons. The aim of this randomized, multicenter study was to evaluate…
Improved Ventricular Function Post Revascularization: Fewer Events across Subgroups?
According to the STITCH and STITCHES trials, in patients with coronary artery disease and deteriorated left ventricular ejection fraction (EF), revascularization of a viable heart might reverse left ventricular systolic dysfunction. In these patients, improved EF after coronary revascularization appears to increase long term survival, particularly after cardiac artery bypass grafting (CABG), compared against medical…
5-year TVF and MACCE in patients with deferred of revascularization after FFR: Is FFR enough?
Fractional flow reserve (FFR) has been shown effective and safe by different studies, yet not at 5 years. The aim of this multicenter registry was to assess the impact of thrombotic risk (as per CREDO-Kyoto score) as a predictor of cardiovascular events at 5 years in patients with deferred revascularization after FFR measurement. The score…