RIGHT Trial: Anticoagulation shows no benefit after primary PCI in STEMI
Key Points: The RIGHT trial assessed the benefit of post-procedural anticoagulation (PPA) after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. The trial found that overall,…
OPT-BIRISK: Extended P2Y12 Monotherapy is Superior to Extended DAPT for High Risk ACS Patients
Key Points This trial randomizing patients at high bleeding and/or ischemic risk who had successfully completed 9-12 months of dual anti-platelet therapy (DAPT) following initial percutaneous coronary intervention (PCI) for…
OCTIVUS: OCT- Guided PCI is non-inferior to IVUS-Guided PCI for Clinical Outcomes
Key Points This pragmatic trial randomizing patients to optical coherence tomography (OCT)-guided or intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) found that OCT was non-inferior to IVUS for a composite…
Metanalysis: OCT or IVUS is associated with improved outcomes compared to angiography alone
Key Points This metanalysis integrating data from ILUMIEN IV and OCTOBER Trials with 18 prior randomized trials found that intravascular imaging (IVI) with intravascular ultrasound (IVUS) or optical coherence tomography…
Addressing the Triple Threat: Proactive Screening Resulted in Improved Early Detection of Coronary Artery Disease, Atrial Fibrillation, and Heart Failure in the RED-CVD Trial
Key Points: Tertiary screening for chronic cardiovascular disease as a means to reduce morbidity, mortality, and economic burden on the healthcare system has been proposed. RED-CVD trial was the first…
OCTOBER Trial: OCT Reduces MACE in complex bifurcation lesions
Key Points This trial randomizing patients with stable angina, unstable angina (UA), or non–ST-segment elevation myocardial infarction (NSTEMI) and a true bifurcation lesion to optical coherence tomography (OCT)-guided or angiography-guided…
ONCO-DVT– 1 Year of Anticoagulation With Edoxaban Is Superior To 3-Months In Cancer Patients With Distal DVT
Key Points: The optimal duration of therapy for distal deep vein thrombosis (DVT) among patients with an active malignancy is unknown. ONCO-DVT was the first randomized controlled trial comparing 12-months…
ILUMIEN IV: OCT-guided complex PCI led to increased minimal stent area, improved safety, and lower in-stent thrombosis rates but no difference in target vessel failure at 2 years
Key Points This trial randomizing patients with diabetes and/or complex lesions to optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) or angiography-guided PCI found that post-PCI minimum stent area (MSA)…
MULTISTARS AMI Trial: Immediate Complete Multivessel PCI non-inferior to staged approach in patients with STEMI and MVD
Key Points: It is well known that patients with STEMI often have multivessel disease (MVD) and those with MVD have worse outcomes compared to patients without it. Current US and…
FRAIL-AF: Switching to NOACs in Frail Elderly with AF Linked to Increased Bleeding
Key Points: The FRAIL-AF trial is an open-label, randomized controlled trial that randomized frail adults (75 years or older) who were on VKA for atrial fibrillation to either continuing VKA…
ARREST: Transfer to a cardiac arrest center instead of the nearest ED does not improve mortality in OHCA patients
Key Points: Sudden cardiac death causes a fifth of all deaths in industrialized countries, but survival to hospital discharge remains low. Transfer to a specialized, cath-lab capable cardiac arrest center…
ATTRibute-CM: Acoramidis Linked to Improved clinical outcomes in transthyretin amyloid cardiomyopathy
Key Points: Transthyretin amyloid cardiomyopathy develops because of mis-folded proteins infiltrating the myocardium, leading to clinical heart failure. Currently, tafamidis is the only commercially approved medication and is the most…
The ADVENT of Pulsed Field Ablation for Atrial Fibrillation: just as effective and safe as traditional thermal ablation, but faster
Key Points: ADVENT was the first randomized controlled trial comparing pulsed field ablation (PFA) to conventional strategies for ablation (including either radiofrequency or cryothermal ablation). The success rate was 73.3%…
STOPDAPT-3: Prasugrel monotherapy after PCI with DES not superior to DAPT for major bleeding but non-inferior for CV events
Key Points: This trial randomized 6,000 patients with high bleeding risk or acute coronary syndrome undergoing planned PCI to a strategy of 3.75mg of prasugrel or DAPT with aspirin 81-100…
FIRE: Complete revascularization better than culprit-only strategy for elderly with MI and MVD
Key Points The FIRE trial aimed to address the lack of evidence regarding complete revascularization in older MI patients and examined the superiority of complete revascularization based on coronary physiology.…
Meta-analysis demonstrates that IV Iron is associated with reduced HF hospitalizations in HF patients with iron deficiency
Key Points: Iron-deficiency is common in heart failure (HF) and associated with increased mortality and hospitalization. Previous trials of intravenous (IV) iron in the form of ferric carboxymaltose (FCM) in…
ECLS-SHOCK: ECMO does not reduce mortality in acute MI-related cardiogenic shock compared to control
Key Points: The use of ECLS has increased substantially over the past decade despite stagnant, high mortality in cardiogenic shock. This multicenter randomized trial compared ECLS with control in patients…
QUEST: Chinese Herbal Medicine (Qiliqiangxin) reduces heart failure hospitalizations and cardiovascular mortality in HFrEF
Key Points: Qiliqiangxin is a traditional Chinese herbal medicine extract which has been approved since 2004 for the treatment of HF in China. This multicenter, double-blind, placebo-controlled trial compared qiliqiangxin…
HEART-FID Trial: Ferric Carboxymaltose resulted in modest improvement in hierarchical outcomes but did not reach statistical significance
Key Points: Prior data suggest that heart failure with reduced ejection fraction (HFrEF) patients with iron deficiency receiving IV iron supplementation had improvement in exercise capacity and HF hospitalizations, but…
Wait no more – HFrEF patients with high RV pacing burden from pacemakers or defibrillators should be promptly upgraded to CRT devices: insights from the BUDAPEST-CRT Upgrade Study
Key Points: A high burden of right ventricular pacing among patients with heart failure patients with reduced ejection fraction is known to cause left ventricular dyssynchrony and progressive dysfunction, yet…