Peripheral vascular disease (PVD) has been under-studied and under-recognized in comparison with ischemic heart disease and stroke, despite its well-known impact on quality of life and its associated morbidity and mortality. According to a systematic review, it was estimated that in 2015 about 238 million people globally had PVD. This number is on the rise.…
EuroPCR 2022 | Should Revascularization Be Performed Before TAVR in Patients with Stable Coronary Disease?
Currently, the American and European guidelines recommend coronary angioplasty in patients with severe aortic stenosis with lesions >70% (Class IIa) who will undergo transcatheter aortic valve replacement (TAVR). However, the benefit of performing a revascularization in these patients is still uncertain. This prospective multicenter study included 2025 patients divided into two groups: complete revascularization (N = 1310)…
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…
In Multivessel Disease, When Should Renal Impairment Be Considered?
Cardiovascular disease is one of the main causes of morbidity and mortality in patients with advanced chronic kidney disease (CKD), and vice-versa. Both diseases share risk factors, including, but not limited to, diabetes, high blood pressure, smoking, dyslipidemia, and old age. As kidney disease develops, its severity grade has been linked to more thrombotic events…
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…
April 7th | Medtronic-SOLACI Masterclass with Gregg Stone: Revascularization in Patients with Multivessel Lesions
Join us in the third Medtronic-SOLACI masterclass with Dr. Gregg Stone (USA) and renowned Latin-American panelists. In this last session of this cycle of 3 masterclasses organized alongside Medtronic, Dr. Stone will discuss revascularization in patients with multivessel lesions. Date: April 7th, 2022, at 07:30 p.m. (Argentina/Brazil time, UTC -3). As usual, this event is…
ISCHEMIA: Prognosis is Determined by Anatomy, not Functionality
The ISCHEMIA study keeps providing scientific news. This work in patients with stable coronary artery disease had already shown (to our surprise) that ischemic burden does not predict 4-year mortality. Now, this new analysis suggests that anatomic severity can predict events. However (surprisingly, once more), altering this severity through angioplasty does not change the prognosis…
Revascularization Is Needed Before TAVR
Disease prevalence in patients with severe aortic stenosis is highly variable: from 80% in inoperable patients to only 15% according to the most recent research including low-risk patients. Given the high mortality observed in patients with heart disease, guidelines suggest considering coronary bypass revascularization in those in need of a valve replacement. This experience with…
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…
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