Tag Archives: multiple vessels

El FFR ahorra síntomas a los pacientes y costos a los financiadores de salud

Is Complete Revascularization the Right Choice in Acute Myocardial Infarction with Multivessel Disease?

Is Complete Revascularization the Right Choice in Acute Myocardial Infarction with Multivessel Disease?

Courtesy of Dr. Carlos Fava. Primary coronary angioplasty has been the treatment of choice for acute myocardial infarction (MI) for many years, but such strategy is associated with nonculprit lesions in a large group of patients. While it has been proven that nonculprit-lesion revascularization offers better outcomes, the groups that would benefit from it are

ESC 2019 | SYNTAXES: Ten-Year Outcomes!

The SYNTAXES (SYNTAX Extended Survival) was presented at ESC 2019 with somewhat unexpected results in favor of PCI. This is why the SYNTAX continues to be one of the best studies interventional cardiologists can rely on. The original SYNTAX tested mortality (primary end point) with PCI vs. CABG in patients with multivessel and/or left main

ESC 2019 | Complete: La evidencia definitiva para infartos con múltiples vasos

ESC 2019 | COMPLETE: Definitive Evidence for Infarction with Multivessel Disease

For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the

Monto de isquemia basal en pacientes con múltiples vasos y evolución a largo plazo

Amount of Baseline Ischemia in Patients with Multivessel Disease and Long-Term Progress

According to this recent analysis of the MASS II trial, which will soon be published in JAMA, baseline ischemia is not associated with events at 10 years in patients with chronic stable angina. The ischemic burden induced through exercise does not predict events or long-term ventricular function. Such data add some suspense to the results

¿Qué pasa cuando nos encandilamos con el tronco y no vemos el resto de las lesiones?

What Happens When We Are Blinded by Left Main Disease and Ignore All Other Lesions?

According to this recent Excel analysis, mortality seems to rise when the SYNTAX II score is not taken into account when defining the revascularization strategy. The difference does not reach statistical significance and further studies are required, but the message is clear: the left main coronary artery is not the only thing that matters; other

Staged Complete Revascularization vs. Culprit Vessel PCI at Long-Term

Staged complete revascularization in patients with acute myocardial infarction and multivessel coronary disease is superior to culprit PCI only at five-year follow-up. The outcomes of this retrospective analysis show the benefit of staged PCI, though it might be attenuated in diabetic patients. Outcomes are consistent with previously published randomized studies. Nevertheless, we should remain cautious

Stent directo vs angioplastia convencional y sus interacciones con la trombo-aspiración

Revascularization in Patients with Multivessel Disease, Diabetes, and Kidney Disease

According to this new study, in patients with coronary disease, diabetes, and chronic kidney disease who underwent revascularization through angioplasty or surgery, events are similar. This is one of the first studies painting the real picture for the prognosis of patients revascularized in these conditions (diabetes plus chronic kidney disease).   At first sight, these

La cirugía parece superior a la angioplastia en pacientes jóvenes

Complete Revascularization Improves Long-Term Prognosis in Acute Coronary Syndromes

Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty.   This study, published online before

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

Stroke Rate after CABG vs PCI in over 10,000 Patients

Repeat revascularization rate has historically been the weak spot of PCI when compared against CABG: we are still unable to compete with a well done internal mammary artery graft connected to the anterior descending artery. However, repeat revascularization is the soft of end points commonly assessed in trials, and even though several studies have shown

EuroPCR 2018 | Compare-Acute: FFR o angioplastia primaria en el seguimiento a 2 años de la revascularización completa

EuroPCR 2018 | Compare-Acute: FFR or Primary Angioplasty at a 2-Year Follow-Up After Complete Revascularization

Recent studies in patients undergoing acute myocardial infarction showed that a complete revascularization strategy in an acute or subacute setting, whether it be guided through angiography (PRAMI, CvLPRIT) or fractional flow reserve (FFR) (PRIMULTI, COMPARE-ACUTE), improves the combined endpoint of major adverse cardiac events (MACE) when compared with treatment of the culprit artery only. Based

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