Publications by authors named "Amar Al Mafragi"

Article Synopsis
  • The study aimed to compare the safety and effectiveness of two types of stents in patients at high bleeding risk who were undergoing abbreviated dual antiplatelet therapy after coronary stenting: the ultrathin-strut Supraflex Cruz stent and the thin-strut Ultimaster Tansei stent.
  • A total of 741 patients were enrolled in a randomized trial where they received one of the two stents, and the primary outcome measured was a combination of serious adverse events over one year.
  • Results showed that 15.4% of patients with the Supraflex Cruz stent experienced adverse outcomes compared to 17.1% with the Ultimaster Tansei stent, indicating a potential slight difference
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Up to 45% of patients who underwent percutaneous coronary intervention (PCI) may have a high bleeding risk (HBR), depending on the bleeding risk definition. This condition is often associated with an enhanced risk of thrombotic events with a negative impact on short- and long-term outcomes, making the choice of an appropriate antithrombotic regimen after PCI particularly challenging. Advances in stent technologies, in which the introduction of newer generations of thinner strut drug-eluting stents (DES), have significantly reduced the rate of thrombotic complications and may justify a shorter dual antiplatelet therapy (DAPT) duration.

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Background: The optimal duration of antiplatelet therapy (APT) after coronary stenting in patients at high bleeding risk (HBR) presenting with an acute coronary syndrome remains unclear.

Objectives: The objective of this study was to investigate the safety and efficacy of an abbreviated APT regimen after coronary stenting in an HBR population presenting with acute or recent myocardial infarction.

Methods: In the MASTER DAPT trial, 4,579 patients at HBR were randomized after 1 month of dual APT (DAPT) to abbreviated (DAPT stopped and 11 months single APT or 5 months in patients with oral anticoagulants) or nonabbreviated APT (DAPT for minimum 3 months) strategies.

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Inadequate diastolic closure of the aortic valve causes aortic regurgitation (AR). Diastolic regurgitation towards the left ventricle (LV) causes LV volume overload, resulting in eccentric LV remodelling. Transthoracic echocardiography (TTE) is the first line examination in the work-up of AR.

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Aortic stenosis (AS) causes left ventricular outflow obstruction. Severe AS has major haemodynamic implications in critically ill patients, in whom increased cardiac output and oxygen delivery are often required. Transthoracic echocardiography (TTE) plays a key role in the AS severity grading.

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