Key Points Dual-antiplatelet therapy (DAPT) with aspirin and a P2Y 12 receptor inhibitor is the cornerstone of therapy after percutaneous coronary intervention (PCI) with stents. The thienopyridines—ticlopidine, clopidogrel, and prasugrel—are P2Y 12 inhibitors that are prodrugs and therefore require conversion…
Key Points Women who present for percutaneous coronary intervention (PCI) are generally older and have more comorbidities compared with men. Women and men have comparable short- and long-term outcomes with bare-metal stents (BMSs) and drug-eluting stents (DESs), including similar mortality…
Key Points Perioperative myocardial infarction typically occurs in the first 48 to 72 hours following noncardiac surgery (NCS) and, even if clinically silent, is associated with substantial early and late mortality. The initiation of β-blocker and/or aspirin therapy prior to…
Key Points Interventional cardiologists who use fluoroscopy should be familiar with radiation risks and should know how to manage radiation appropriately. Incidents of patient skin injury following fluoroscopy-guided interventional procedures have been reported. Many reported skin effects resulting from fluoroscopic…
Key Points Although the advent of new-generation contrast agents has resulted in a decreased incidence of contrast-induced acute kidney injury (CI-AKI), it remains a concern especially in patients undergoing cardiac catheterization. Chronic kidney disease (CKD) as one of the most…
Key Points Angiography alone is often insufficient to assess intermediate and, at times, severe stenoses. Although adjunctive stress testing has limitations, fractional flow reserve (FFR) provides an accurate detector of lesion specific myocardial ischemia. Deferring revascularization of a coronary stenosis…
Key Points Functional tests such as stress electrocardiography (ECG), stress echocardiography, and stress nuclear perfusion imaging have limited accuracy for the detection of anatomic coronary artery disease but provide important prognostic information. Normal functional testing, including exercise echocardiography and myocardial…
Key Points Although all diabetic individuals should be considered at high cardiovascular (CV) risk, those with at least one additional CV risk factor or with target-organ damage should be considered at very high CV risk. Subjects with diabetes have twofold…
Key Points When coronary revascularization is considered, prognostic and symptomatic indications must be distinguished. In general, percutaneous coronary intervention (PCI) for single-vessel disease is justified only if an improvement of symptoms can be anticipated or ischemia that comprises more than…
Key Points Changes in the demographics of patients who present in need of revascularization, advances in percutaneous and surgical revascularization techniques, and results from contemporary studies of percutaneous versus surgical revascularization have made it essential that patients be assessed as…