Acute coronary syndromes refer to any constellation of clinical symptoms compatible with acute myocardial ischemia which may be life-threatening.
It encompasses unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI).
Unstable angina is the ischemic discomfort that presents without persistent ST-segment elevation on ECG and without the presence of cardiac markers in the blood.
Non-ST-segment elevation myocardial infarction is diagnosed if cardiac markers are positive with ST-segment depression or with nonspecific or normal ECGs.
The patient typically presents with ischemic-type chest pain that is severe and prolonged and may occur at rest or may be caused by less exertion than previous episodes.
An edoxaban-based dual antithrombotic therapy (DAT) was noninferior to a VKA*-based triple AT (TAT) in terms of bleeding events at 12 months in patients with atrial fibrillation (AF) following a successful PCI**, without compromising the antithrombotic’s efficacy in preventing ischaemic events, the ENTRUST-AF PCI*** study shows.
The addition of alirocumab to intensive statin therapy appears to cut the risk of death following acute coronary syndrome, especially if treatment is sustained for at least 3 years, if baseline low-density lipoprotein cholesterol (LDL-C) is ≥100 mg/dL or if achieved LDL-C is low, according to data from the ODYSSEY OUTCOMES.
Undergoing primary percutaneous coronary intervention (PCI) through the transradial route did not confer survival benefit at 30 days in patients with acute myocardial infarction compared with the transfemoral approach, contrary to common belief.
Use of the NOAC* apixaban led to less bleeding and hospitalizations compared with vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) who had a recent acute coronary syndrome (ACS) or had undergone percutaneous coronary intervention (PCI) and were on treatment with a P2Y12 inhibitor, reveals the AUGUSTUS study. Furthermore, dropping aspirin from the regimen shields these patients against bleeding risk without significant increase in ischaemic events.
Coronary artery bypass grafting (CABG) offers similar long-term outcomes in terms of all-cause mortality and cardiovascular events as percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD) who had end-stage renal disease (ESRD) requiring dialysis, but the mode of dialysis appears to be associated with differential risk of death in this group of patients, according to a study presented at the ACC Asia 2018 Congress in Shanghai, China.
Lowering of resting heart rate (RHR) with bisoprolol was associated with improved composite cardiac clinical outcome (CCCO) in Asian patients who had coronary artery disease (CAD) with comorbid hypertension, according to a subgroup analysis of the BISO-CAD study presented at ACC Asia 2018 in Shanghai, China.
New-generation drug-eluting stents (DES) are superior to early-generation stents in reducing cardiovascular (CV) events and mortality out to 10 years, but there are no significant differences between new-generation stents based on biodegradable polymer and those with permanent polymer, according to the ISAR-TEST* 4 study presented at AHA 2018.
Coronary revascularization with bypass surgery proves to be superior to drug eluting stents in the long term in preventing all-cause mortality in patients with diabetes mellitus (DM) and multivessel coronary disease (MVD), even 8 years after the procedure, the FREEDOM* Follow-On Study reveals.
The duration of dual antiplatelet therapy (DAPT) should be individualized based on ischaemic and bleeding risk of a particular patient, rather than focusing on a dualistic short- vs long-duration therapy thinking, advocates a leading expert during AFCC 2018.
Sleep apnoea is highly prevalent but largely undetected in the general population of middle-aged adults, with a symptom-based strategy proving to be useless for specific diagnosis, according to a recent study. Moreover, mild sleep apnoea represents a higher-risk phenotype with manifestly increased metabolic, inflammatory and cardiovascular risk factor burden, with potential public health implications.
The sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin significantly reduces the risk of death and hospitalization in patients with heart failure (HF) with reduced ejection fraction (rEF) regardless of whether they have type 2 diabetes mellitus (T2DM), the DAPA-HF trial has shown.