This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography…
Is Troponin Elevation After TAVR Related to Mortality?
Troponins have long had diagnostic value not only for infarction. Their ability to predict mortality is well established for all cardiac conditions. Moreover, it has been demonstrated in all critically ill patients, including patients with COVID-19, regardless of the triggering condition. While their significance in COVID cases is backed by the literature, there was not…
ESC 2021 | Acute and Chronic Myocardial Injury in COVID-19 Patients and Impact in Mortality
In patients hospitalized for COVID-19, both acute and chronic myocardial injury impact survival at 6 months. In addition, the risk does not disappear after the acute phase of the disease, instead it persists in the following months among those who survive. This study was presented at the scientific sessions of ESC 2021 and was simultaneously…
ACC 2021 | SAFE-PAD: Paclitaxel-Eluting Devices in Peripheral Disease
This work was conducted alongside the US Food and Drug Administration (FDA) to investigate the association between all-cause mortality and paclitaxel-eluting devices in peripheral vascular disease. According to data from SAFE-PAD, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in JAMA, there is no increase in mortality compared with conventional…
The Transradial Approach Continues to Be the Best for Primary PCI
The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI. This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral. The transradial…
Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks
This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials. The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization…
Is Medical Treatment Better at Lowering Bleeding-Caused Mortality than Angioplasty?
Post-discharge bleeding in patients admitted for acute coronary syndrome (ACS) is linked to higher all-cause mortality. However, this is the case for both patients who underwent angioplasty and those who were managed with medical treatment. These are interesting data, given that medical treatment is frequently preferred due to lower bleeding risk. Speculation is based on…
High Mortality Rates for Redo Surgery After TAVR
Courtesy of Dr. Carlos Fava. Since the beginnings of transcatheter aortic valve replacement (TAVR) back in 2002, this strategy has gained considerable ground, encompassing not only inoperable or high-risk patients but also those at medium and low risk. Additionally, it came to include patients with failed bioprostheses. The most common reason for surgery was paravalvular leak,…
AHA 2019 | Sapien vs Evolut: A Head-to-Head Study Seems Mandatory
Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality. The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both…
Incidence and Prognosis of Heart Valve Embolization
The incidence of peri-procedural transcatheter heart valve embolization and migration (TVEM) is as low as 1%. However, it is associated with increased morbidity and mortality. Peri-procedural TVEM is one of the most feared complication given its potential to transform the procedure into a catastrophe, but little do we know about its incidence (except for a…
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