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General Internal Medicine

Interventional Cardiology   

Questions discussed in this category

What are alternate approaches to medical therapy and/or interventions to consider in patients with refractory, severe coronary vasospasm despite short-acting nitrates, calcium channel blockers, L-arginine, and clonidine?
6 Answers available
What type of DES should you opt for if a patient has or is concerned about possible nickel allergy?
2 Answers available
Is there any difference between colchicine 0.5mg vs 0.6 mg for high risk coronary artery disease?
European trials used 0.5mg dosing, whereas we have 0.6mg widely available in the US (but significantly less expensive than the 0.5mg dosing).
1 Answer available
When do you consider revascularizing Chronic total occlusions after failing medical management?
1 Answer available
How do you view the balance between opting for percutaneous coronary intervention and prioritizing optimal medical therapy as the initial treatment choice for patients with stable angina?
ORBITA-2 Trial
3 Answers available
In patients with post-MI LV thrombus which resolves after 3-6 months of anticoagulation, would you consider surveillance imaging for thrombus recurrence if there is persistent apical akinesis?
2 Answers available
Do you recommend avoiding radial artery access for cardiac catheterization to preserve potential future dialysis access sites in patients with advanced CKD?
7 Answers available
What techniques do you use in the lab to reduce the amount of contrast that needs to be used in patients with CKD?
2 Answers available
What factors influence your choice between low-dose DOAC therapy and dual antiplatelet therapy for the first 3 months after percutaneous left atrial appendage occlusion?
Freixa, et al., PMID 39110427
1 Answer available
Would you recommend delaying left heart catheterization until development of ESKD in a patient with CKD Stage 5 and stable coronary artery disease given concern for contrast-induced nephropathy?
5 Answers available
What is your approach to counseling a patient with stable but severe multivessel coronary disease if the patient does not wish to undergo bypass surgery? 
And when would you consider referral for staged/complex PCI instead? 
1 Answer available
Given that high coronary calcium scores portend significantly increased cardiac mortality rates over 5-6 years, is there any data to support performing coronary angiography when the score is very high, e.g. over 1000, even in asymptomatic patients with no objective evidence of ischemia?
1 Answer available
Would you consider switching choice of P2Y12 inhibitor for patients with ISR (non-ACS presentation), with acceptable bleeding risk?
1 Answer available
What is a reasonable length of time for systemic anticoagulation in patients presenting with MI in the setting of coronary artery aneurysm with large thrombus formation?
5 Answers available
Should intervention be considered for an intermediate flow-limiting coronary lesion that does not correlate with perfusion defects on stress testing in a patient with atypical anginal symptoms?
7 Answers available
What is your approach to considering geriatric patients for complex PCI given their overall frailty and increased risk of complications such as bleeding and stroke?
2 Answers available
Should we routinely include geriatric functional assessments to determine candidacy for TAVR?
(ie., assessing gait speed, cognition, physical function, fall history, orthostatic vital signs, etc.)
1 Answer available
For patients maintained on antiplatelet monotherapy post-DAPT following PCI, what is your recommendation for holding antiplatelet therapy prior to non-cardiac surgery?
Do you ever recommend "bridging" with low-dose aspirin?
1 Answer available
What is your approach to abbreviated DAPT in post-PCI patients (ACS and non-ACS) with high bleeding risk?
1 Answer available
Should we have a lower threshold to consider revascularization of coronary lesions in athletes, compared to non-athletes?
1 Answer available
Which factors favor extended dual antiplatelet therapy beyond one year in ACS patients with low bleeding risk?
1 Answer available


Papers discussed in this category

Journal of the American College of Cardiology, 2023 Nov 21
Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non-ST-Segment Elevation Acute Coronary Syndromes.
The New England journal of medicine, 2023 Aug 26
Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction.
JACC. Cardiovascular interventions, 2014-07
Futility, benefit, and transcatheter aortic valve replacement.
Circulation, 2021 Oct 28
2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
JAMA, 2020 Dec 15
Association Between Adherence to Fractional Flow Reserve Treatment Thresholds and Major Adverse Cardiac Events in Patients With Coronary Artery Disease.
J Am Coll Cardiol, 2020 Jun 09
Survival of Patients With Angina Pectoris Undergoing Percutaneous Coronary Intervention With Intracoronary Pressure Wire Guidance.
J Am Heart Assoc, 2019 Oct 02
Extended Duration of Dual-Antiplatelet Therapy After Percutaneous Coronary Intervention: How Long Is Too Long?
Circulation, 2022 Nov 07
Aspirin Versus Clopidogrel for Long-Term Maintenance Monotherapy After Percutaneous Coronary Intervention: The HOST-EXAM Extended Study.
Lancet (London, England), 2015 Jul 15
Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial.
The New England journal of medicine, 2020 Mar 30
Initial Invasive or Conservative Strategy for Stable Coronary Disease.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2020 Sep 09
Usefulness of oral anticoagulation in patients with coronary aneurysms: Insights from the CAAR registry.
Circulation research, 2019 Feb
Synergy of Dual Pathway Inhibition in Chronic Cardiovascular Disease.
Current cardiology reviews, 2021
Access-site Complications of the Transradial Approach: Rare But Still There.
Interactive cardiovascular and thoracic surgery, 2013 Nov 19
Should the radial artery be used as a bypass graft following radial access coronary angiography.
The American journal of cardiology, 2021 Aug 11
Meta-Analysis of Transradial Versus Transfemoral Access for Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease.
JAMA cardiology, 2024 Aug 07
Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial.
Circulation. Cardiovascular interventions, 2012-04
Outcomes after coronary stent implantation in patients with metal allergy.
Circulation, 2021 Dec 09
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

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