In patients with coronary artery disease, percutaneous coronary interventions (PCI) are the mainstay of treatment for those presenting with acute coronary syndrome (ACS); PCI has also been widely adopted in patients with chronic coronary syndromes. Adjuvant pharmacotherapy, especially antithrombotic therapy, is the key to reducing local thrombotic complications and systemic ischemic events among patients undergoing percutaneous coronary interventions, but is inevitably associated with the occurrence of bleeding events. Prasugrel and ticagrelor are preferred over clopidogrel in patients with ACS in the absence of contraindications. Despite this, clopidogrel remains the most widely used. In this article, the bleeding events that occurred during 6-12 months of dual antiplatelet therapy (aspirin + P2Y12 inhibitor - clopidogrel) in patients who underwent myocardial revascularization by PCI, the factors that favored their occurrence and the use of the prediction score were studied.
The aim of the study was to identify the optimal time window for performing effective percutaneous coronary reperfusion in patients with non-ST-segment elevation acute myocardial infarction (NSTEMI) who are part of the low ischemic risk group. 252 patients with NSTEMI and low ischemic risk who underwent coronary angioplasty up to 30 days after the onset of the infarction were evaluated the second day post-procedurally and at a distance of 6 months. The general group was randomized depending on the echocardiographic evolution. 131 patients with unfavorable evolution and 121 with more complete restoration of left ventricular contractile function. The time windows from the onset of myocardial infarction symptoms in which percutaneous myocardial reperfusion was applied were studied. Following the study, the time interval of 73 hours -14 days proved to be optimal in which a more favorable clinical and echocardiographic evolution is ensured.
SARS-COV-2 infection primarily affects the respiratory system with emerging complications, but can also involve other systems and organs, as well as cause coagulopathy. Cases of deep vein thrombosis with pulmonary thromboembolic complications are commonly reported in critically ill patients with COVID-19, much less frequently encountered is thrombosis in the arterial bed. Particularly rare are cases of concomitant thrombosis in multiple sites. We present a case with multiple arterial thrombosis in a patient with COVID-19 and increased cardiovascular risk.
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