Guideline-recommended medical therapy efficacy according to use of digoxin

a study-level meta-analysis combining DECISION, DIGIT-HF and DIG

A study-level meta-analysis pooling DECISION, DIGIT-HF and DIG (n=9,013) shows digitalis glycosides reduce CV death or first worsening HF event (HR 0.85; 95% CI 0.80–0.90; p<0.001) and time to first worsening HF event (HR 0.75; p<0.001), with consistent benefit on top of contemporary RALES/EMPHASIS-HF/PARADIGM-HF/DAPA-HF backbones. Population-level evidence reopening the case for digitalis as an add-on in symptomatic HF(m)rEF despite four-pillar therapy.

Angiotensin Receptor Neprilysin Inhibitor in Heart Failure with Preserved Ejection Fraction and Secondary Mitral Regurgitation

the PRAISE-MR Randomized Trial

PRAISE-MR is the first medical-therapy trial demonstrating exercise-hemodynamic benefit in HFpEF with atrial functional mitral regurgitation (AFMR). In 84 patients randomized to sacubitril-valsartan or standard of care, the 6-month change in exercise mPAP/CO slope improved by 0.93 mmHg/L/min with sacubitril-valsartan (95% CI 0.07–1.80; p=0.035). Peak VO2, KCCQ score, NT-proBNP, LA volume and AFMR severity all improved. The findings position ARNI as a credible disease-modifying option for HFpEF + AFMR, alongside transcatheter mitral repair as evidence emerges.

Digoxin in Patients With Symptomatic Rheumatic Heart Disease

Dig-RHD is the first RCT of digoxin in rheumatic heart disease. 1,769 patients across 12 Indian tertiary centers (mean age 46, 72% female, 70% AF, 90% NYHA II–IV, mostly with mixed valve lesions) were randomized to digoxin 0.125–0.25 mg/day or placebo and followed a median 2.1 years. The primary composite of all-cause death or new-onset/worsening HF occurred in 31.4% (digoxin) vs 35.5% (placebo) — HR 0.82; 95% CI 0.69–0.96. Practice-changing for the Global South where RHD remains the leading cause of HF; relevant for migrant populations with chronic rheumatic valve disease in Western settings.

Blinded withdrawal of randomized treatment with low-dose digoxin or placebo in patients with heart failure

the DECISION trial

Pre-specified DECISION substudy: 587 patients on active treatment (digoxin or placebo) underwent blinded withdrawal with 6-week in-person follow-up. Pre-withdrawal event rates were similar between groups. Post-withdrawal, digoxin-withdrawn patients had a sharp increase in CV death/worsening HF events (42.8 vs 5.9 per 100 patient-years; RR 7.37; 95% CI 1.56–34.88; p=0.012), accompanied by rising heart rate, falling SBP and rising NT-proBNP. Discontinuing digoxin after long-term exposure is associated with clinical deterioration — a clinically relevant caution for deprescribing reviews.

Low-dose digoxin in patients with heart failure with reduced or mildly reduced ejection fraction

a randomized controlled trial

DECISION (n=1,001, 43 Dutch sites, median 36.5-month follow-up) is the first major modern RCT of low-dose digoxin in contemporary HF(m)rEF on guideline-directed therapy. The primary composite of worsening HF events plus CV mortality was lower with digoxin (RR 0.81; 95% CI 0.61–1.07) but did not reach statistical significance (p=0.133). Worsening HF events trended lower (RR 0.76); CV mortality was unchanged. Drug was well tolerated. Pooled with DIGIT-HF and DIG (n=9,013), digitalis glycosides did significantly reduce the composite (HR 0.85; p<0.001), reopening the case for digitalis as a cheap, safe add-on in HF(m)rEF.

The microRNA inhibitor CDR132L in patients with reduced left ventricular ejection fraction after myocardial infarction

a randomized phase 2 trial

HF-REVERT (n=294) is the first phase 2 randomized trial of an antisense microRNA inhibitor in cardiology. CDR132L (anti-miR-132) given as three IV doses 3–14 days post-MI did not improve the primary endpoint (% change in LVESVi at 6 months) nor any secondary endpoint over placebo. The drug was well tolerated. Pre-specified exploratory analyses suggest potential benefit in patients with marked adverse remodeling at baseline — a hypothesis-generating signal worth pursuing in chronic HF populations. Important null finding for the cardiac RNA-therapeutics pipeline.

Subcutaneous Defibrillator Implantation With or Without Defibrillation Test

The Primary Results of the Randomized PRAETORIAN-DFT Trial

The multinational PRAETORIAN-DFT RCT randomised 965 subcutaneous ICD recipients across 37 centres to defibrillation testing versus no testing — using the PRAETORIAN score (based on chest X-ray) to assess implant position in the no-DFT arm. First-shock failure for spontaneous ventricular arrhythmias was non-inferior without DFT, with comparable mortality and revisions. Routine defibrillation testing can therefore be omitted in patients with a favourable PRAETORIAN score, reducing implant-related risk.

Stroke and Bleeding Risks With Non-Vitamin K Oral Anticoagulants in Nonvalvular Atrial Fibrillation.

A cohort study in the FDA Sentinel System of >173,000 NVAF patients aged 21-64 found that rivaroxaban was associated with higher major extracranial bleeding (HR 1.91) and gastrointestinal bleeding (HR 1.92) versus apixaban, with no difference in thromboembolic stroke. Dabigatran carried a higher thromboembolic stroke risk than both rivaroxaban and apixaban. Apixaban emerged with the most favourable benefit-harm profile — extending Medicare findings into a younger AF population.

Kidney function and risk of heart failure in older adults

findings from a prospective cohort study

A prospective cohort analysis nested in the ASPREE trial and its extension study (17,834 older adults) examined whether elevated urine albumin-creatinine ratio (UACR) or reduced eGFR predicted heart failure hospitalisation or death. Over a median 8.6-year follow-up, 354 (1.98%) had a first HF hospitalisation and 147 (0.82%) died from HF. Albuminuria (UACR ≥3.0 mg/mmol; 11.3% of the cohort) was associated with higher risk of HF events. Routine kidney screening in primary care looks valuable for cardiovascular risk stratification in older adults.

Combined transcatheter mitral and tricuspid edge-to-edge repair or tricuspid edge-to-edge repair alone in moderate mitral regurgitation

a propensity-matched analysis.

In the EuroTR registry of 3,100 patients with severe tricuspid regurgitation, 30% also had moderate mitral regurgitation — associated with higher 2-year mortality (37% vs 23%). After propensity score matching (217 pairs), concomitant mitral TEER added to tricuspid TEER produced greater TR reduction, better NYHA class and 6-minute walk distance, and significantly higher survival (87% vs 76% at 1 year; 81% vs 70% at 2 years). On multivariable analysis, moderate MR predicted death (HR 1.81) and combined M-TEER predicted survival (HR 0.46). Hypothesis-generating — a dedicated RCT is needed.

Risk factors for atherosclerotic cardiovascular disease in individuals with heterozygous familial hypercholesterolemia

a systematic review and meta-analysis.

A systematic review and meta-analysis (21 studies, 23,613 genetically confirmed heterozygous FH patients, 3,489 cardiovascular events) showed independent associations between ASCVD and hypertension (effect size 0.41), male sex (0.33), smoking (0.32), Lp(a) (0.22), age (0.21), BMI (0.11), triglycerides (0.08) and LDL-C (0.02). Beyond intensive LDL lowering, aggressive management of classic risk factors — especially blood pressure and smoking — is essential to limit residual risk in this high-risk group.

Extensive pregnancy-related off-treatment time in women with familial hypercholesterolaemia

A Norwegian cohort within the FH-FEMINA study followed 27 women with familial hypercholesterolaemia from 36 weeks of gestation until one year postpartum or end of breastfeeding. Median pregnancy-related off-treatment time per woman was 2.9 years (range 0.8–12) across all childbirths. The pregnancy itself accounted for only 42% of off-treatment time; the pre- and post-pregnancy windows together accounted for 58%. Including untreated years in childhood and before diagnosis, lifelong off-treatment time reached a median of 66% of total lifespan. The authors — including Jeanine Roeters van Lennep (Erasmus MC) and Janneke Mulder, both active in the Dutch LEEFH cascade screening programme — call for earlier FH diagnosis in girls, prompt resumption of lipid-lowering therapy immediately after breastfeeding and between pregnancies, and urgently needed evidence on statin safety during pregnancy and lactation.

Sex differences in pharmacological treatment of heart failure

a meta-analysis of randomized trials.

A meta-analysis of 139 heart failure RCTs (292,027 patients, 28.1% women) tested whether pharmacological efficacy differs by sex. Across 78 trials reporting sex-stratified results the primary-endpoint effect was identical in women and men (delta ln[REM] 0.00; 95% CI −0.04 to 0.03), and meta-regression found no association between the proportion of women enrolled and treatment effect. Decades of female under-representation are therefore unlikely to have masked clinically meaningful sex differences — though better gender balance in HF trials remains ethically and socially essential.

Continuation vs Switching Direct Oral Anticoagulant Therapy After Breakthrough Stroke.

A registry-based emulated target trial of 1,006 AF patients with ischaemic stroke during DOAC therapy: 463 continued the same DOAC and 543 switched. After IPTW adjustment, 90-day net clinical benefit was 4.9% with switching versus 5.1% with continuation, a difference of −0.3 percentage points (90% CI −2.7 to 2.1) — within the prespecified non-inferiority margin. Recurrent ischaemic events, intracerebral haemorrhage, all-cause mortality and vascular death did not differ. After a breakthrough stroke on DOAC, switching is not better than continuing — the upfront DOAC choice matters more.

Multi-modality non-invasive cardiovascular screening and sex-specific outcomes

the Viborg Screening Program.

The Danish Viborg Screening Program invited all 67-year-olds for population-based screening (carotid plaque, lower-limb arterial disease, abdominal aortic aneurysm, hypertension, arrhythmia/ischaemia and diabetes). Across 5,412 invitees versus 16,236 matched controls, 5-year all-cause mortality was significantly lower (6.9% vs 8.9%; HR 0.76; number-needed-to-invite 49). Benefit was seen in both sexes and was strongest in those without prior CVD (HR 0.70); major adverse limb events also fell (HR 0.70).

RAAS blockade in the kidney Life-Cycle - Treatment Standard.

An ERA-EDTA treatment-standard review on RAAS blockade across the kidney life cycle. ACE inhibitors, ARBs, direct renin inhibitors and mineralocorticoid receptor antagonists remain a cornerstone in proteinuric CKD and even in advanced stages, while benefit in non-proteinuric disease is limited. Non-steroidal MRAs such as finerenone add renal and cardiovascular protection in diabetes and CKD. In dialysis populations RAAS blockade may preserve residual kidney function; in kidney transplantation, early initiation may improve graft and patient survival. SGLT2 inhibitors and GLP-1 receptor agonists complement rather than replace RAAS blockade.

Stereotactic arrhythmia radioablation for refractory ventricular tachycardia

the STOPSTORM.eu study.

The European STOPSTORM registry followed 193 patients (88% male, 53% non-ischaemic cardiomyopathy) treated with stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. Among 107 patients with ≥6-month follow-up, median VT burden fell 80% over the six months after STAR and 72% remained free of ICD shocks. Twelve serious adverse events were adjudicated as possibly or probably treatment-related (including pericardial effusion and coronary events); 12-month overall survival was 77%.

Three Low-Dose Antihypertensive Agents in a Single Pill after Intracerebral Hemorrhage.

In a multinational double-blind RCT of 1670 patients with prior intracerebral haemorrhage, a once-daily low-dose triple pill (telmisartan 20 mg, amlodipine 2.5 mg and indapamide 1.25 mg) added to standard care reduced recurrent stroke by 39% (4.6% vs 7.4%; HR 0.61) over 2.5 years, with mean systolic BP of 127 vs 138 mmHg. Major cardiovascular events were also lower (6.6% vs 9.8%). Early discontinuation for adverse events — mainly serum creatinine rises — was more common with the triple pill (13.6% vs 6.0%).

Early atheroma prevention

a cost-effective approach to healthy cardiovascular ageing

With annual ASCVD deaths projected to rise from 20.5 million (2025) to 35.6 million (2050), the authors make the Lancet case for earlier and longer primary prevention — aimed at slowing atheroma formation rather than intervening only once disease becomes symptomatic. The piece frames prevention as a life-course intervention and provides relevant context for conversations about early statin initiation, Lp(a) screening, and lifestyle measures.

Automated Echocardiographic Detection of Congenital Heart Disease Using Artificial Intelligence

EchoFocus-CHD is a multi-task AI model that automatically detects 12 critical and 8 non-critical congenital heart lesions on standard echocardiography. On an external cohort the model matched expert interpretation — with the promise of extending scarce paediatric echo expertise beyond academic centres. A concrete example of where AI-assisted imaging can rapidly deliver clinical value in primary care and smaller hospitals.

Assessment for Long-Term Cardiovascular Disease Risk in Pregnancy

Adverse pregnancy outcomes — hypertensive disorders, gestational diabetes, preterm birth, SGA — complicate nearly one in five pregnancies and are associated with both short- and long-term maternal CV risk. This review consolidates the growing consensus that pregnancy is a natural stress test and the postpartum period an opportunistic window for targeted CV risk screening and lifestyle counselling. It argues for formally embedding pregnancy history into cardiovascular risk assessment.

Sotatercept for Combined Post- and Pre-capillary Pulmonary Hypertension Associated With Heart Failure

Results from the Phase 2, Randomized, Placebo-Controlled CADENCE Study

In this phase 2, placebo-controlled trial (n=164), sotatercept lowered pulmonary vascular resistance at week 24 in patients with combined post- and pre-capillary pulmonary hypertension associated with HFpEF. The median placebo-adjusted decline was largest in the 0.3 mg/kg arm. Until now no proven therapy existed for this CpcPH–HFpEF population, which involves remodeling in both the heart and pulmonary vasculature.

The Role of Atrial Pacing Support in Cardiac Resynchronization Therapy

A Non-Inferiority Randomized Trial

In this Italian multicenter RCT (n=636), a two-lead CRT-DX system with atrial sensing via a floating dipole on the RV lead was non-inferior to standard three-lead CRT-D on the 1-year composite of mortality, cardiovascular hospitalisation, and lead-related complications. For CRT-D candidates without sinus node dysfunction, the simplification is clinically appealing: fewer leads, fewer complications.

2026 Dietary Guidance to Improve Cardiovascular Health

A Scientific Statement From the American Heart Association

This AHA scientific statement updates food-based guidance for cardiovascular health with seven practical pillars: energy balance, abundant vegetables and fruit, mostly whole grains, healthy protein sources, unsaturated over saturated fats, less ultra-processed food, and less sodium and added sugar. It deliberately emphasises dietary pattern over isolated nutrients — relevant simultaneously for prevention, CKM syndrome, and oncology.

Cardiovascular–Kidney–Metabolic Syndrome Stages, Echocardiographic Characteristics, and Heart Failure Risk

The Atherosclerosis Risk in Communities Study

In 5,646 older ARIC participants (66–90), CKM syndrome staging using the AHA framework showed a clear gradient: higher stages tracked with greater echocardiographic remodelling and significantly increased incident heart failure over follow-up. The results validate the CKM framework as a clinically useful risk model in older adults — the very group where HF prevention yields the highest absolute benefit.

Two Trials Comparing Conduction System Pacing and Biventricular Pacing

Two new RCTs compare conduction system pacing (chiefly left bundle-branch area pacing) with conventional biventricular pacing in heart failure patients with LBBB. Earlier observational data suggested superior electrical resynchronisation and larger LVEF gains with CSP, fuelling rapid clinical adoption. These trials finally test whether the physiologically attractive approach actually outperforms BiVP on hard endpoints.

Effect of APOC3 Inhibition with Olezarsen on Coronary Atherosclerosis

Essence–TIMI 73b Imaging Study

This CCTA sub-study of Essence-TIMI 73b showed that olezarsen — an APOC3 antisense oligonucleotide — lowered triglycerides by ~60% and remnant cholesterol by ~70%, with neutral LDL-C and ~15% apoB reduction. Over 12 months in patients with moderate hypertriglyceridemia and non-calcified coronary plaque, olezarsen produced a placebo-adjusted reduction in non-calcified plaque volume. It provides some of the first imaging evidence that triglyceride-directed therapy favorably modifies coronary atherosclerosis.

Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction

This French multicenter randomized trial assessed whether adding low-dose rivaroxaban to dual antiplatelet therapy reduces left ventricular thrombus incidence at one month in anterior STEMI patients. The strategy targets a persistent problem: subclinical LV thrombus soon after anterior MI with silent embolic implications. The results support targeted thromboprophylaxis in this high-risk subgroup without disproportionate bleeding.

2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

The 2026 ACC/AHA dyslipidemia guideline retires the 2018 cholesterol document and broadens scope to hypertriglyceridemia and elevated lipoprotein(a). Non-HDL-C and apoB gain ground as secondary targets, LDL goals tighten for high-risk groups, and Lp(a) gets formal standing in risk assessment. Clinicians should anticipate broader lipid panels and more frequent escalation to PCSK9 inhibitors and emerging Lp(a)-lowering therapies.

Memantine for Premature Atrial Contractions

A Phase 2 Randomized Clinical Trial

In this phase 2 double-blind randomized trial, memantine — an NMDA-receptor antagonist — suppressed premature atrial contractions in symptomatic adults with ≥1,000 PACs per 24 h. The result opens a genuinely new pharmacological route for atrial arrhythmia, grounded in the recently identified cardiac glutamatergic system. If PAC reduction translates into downstream AF and stroke benefit, it could reshape atrial arrhythmia treatment.

Prehospital Heparin Administration in Patients With STEMI Undergoing Primary PCI

HEPARIN STEMI Randomized Controlled Trial

This single-center RCT in 593 STEMI patients found that unfractionated heparin (70–100 IU/kg) given at first medical contact — prior to PCI-center arrival — significantly improved TIMI 2–3 flow in the infarct-related artery at initial angiography compared with standard UFH at PCI. BARC 3–5 bleeding was similar. The trial supports prehospital heparin as a simple, low-cost reperfusion strategy ahead of primary PCI.

Wearable devices and cardiovascular health

revolutionizing remote monitoring and disease prevention.

This EHJ review maps the current landscape of wearables (smartwatches and activity trackers) in cardiovascular care, from lifestyle coaching to continuous monitoring of heart failure and arrhythmias. It highlights the main barriers — variability in device methodology and validation, EHR incompatibility, and lack of standardised clinical workflows — and discusses AI-assisted interpretation. It offers practical guidance for clinicians integrating wearable data into routine practice.

Lp(a) Has Specific Effects on Coronary Artery Disease Independent of LDL-C

A Mendelian Randomization Study.

A phenome-wide Mendelian randomisation study in the UK Biobank (n=425,677) identified coronary artery disease (OR 1.36) and HbA1c (β 0.099) as the only direct, causal effects of Lp(a) exposure — independent of LDL-C. Very low Lp(a) was not linked to diabetes, addressing earlier safety concerns about Lp(a)-lowering therapies. Ancestry-specific risk thresholds were identified (86 nmol/L European, 93 nmol/L African). The findings support targeted Lp(a) testing and strengthen the mechanistic case for RNA-based Lp(a) lowering.

Impact of Genetic Testing Among Patients With Familial Hypercholesterolemia on Adverse Cardiovascular Events　- The Hokuriku-Plus Familial Hypercholesterolemia Registry Study.

In the Japanese Hokuriku-Plus registry (n=386 heterozygous FH), 52% of patients underwent genetic testing. These patients achieved lower LDL-C (102 vs 130 mg/dL) and had 34% lower MACE risk (HR 0.66) even after adjusting for LDL-C over 3.9-year median follow-up. The results suggest genetic confirmation itself drives better adherence and treatment intensity, arguing for broader FH genetic testing in clinical practice.

Glucagon-like peptide-1 receptor agonists for prevention of heart failure events in type 2 diabetes and/or obesity.

This meta-analysis of 12 placebo-controlled trials (n=95,023) found GLP-1 receptor agonists reduced heart failure events by 12% (NNT 238), and by 19% (NNT 167) in patients without baseline HF. Semaglutide specifically reduced HF events by 16% overall and by 31% in those without prior HF (NNT 80). Absolute benefits are modest but clinically relevant given the widespread use of GLP-1 therapy in type 2 diabetes and obesity management.

Sex differences in cardiovascular-kidney-metabolic syndrome

the FINE-HEART pooled analysis.

This prespecified pooled analysis of FIDELIO-DKD, FIGARO-DKD and FINEARTS-HF (n=18,991) found women with cardiovascular-kidney-metabolic syndrome were older, had more Stage 4 CKM disease, and received fewer guideline-recommended therapies (aspirin, statins, RAS inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists) than men. Rates of HF hospitalisation or CV death were similar across sexes, but women had 17% lower all-cause mortality. Finerenone was equally effective in both sexes. The results highlight a persistent treatment gap that deserves clinical attention.

Lipoprotein(a) and incident venous thromboembolism in pre- and postmenopausal women, and in men.

In the UK Biobank (≈373,000 participants), Lp(a) ≥ 125 nmol/L was associated with incident venous thromboembolism in premenopausal women (aHR 1.32) and in postmenopausal women on menopausal hormone therapy (aHR 1.48), but not in postmenopausal women without hormones or in men. Oral contraceptive use did not modify the relationship in premenopausal women. The findings suggest sex-hormone status modifies Lp(a)-related VTE risk and support considering Lp(a) before starting hormone therapy.

Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes

Results From the VESALIUS-CV Trial.

This prespecified VESALIUS-CV subgroup (n=3655 diabetics with LDL-C ≥ 90 mg/dL and no established atherosclerosis) found that evolocumab on top of optimised statin therapy significantly reduced first MACE over a median 4.8 years of follow-up. The JAMA-published analysis pushes PCSK9 inhibition further upstream in high-risk diabetics without prior arterial disease, calcium score ≥ 100, or stenosis ≥ 50%. It strengthens the case for earlier intensive LDL-C lowering in primary prevention for diabetic patients.

Acute eGFR Changes and Their Mediation of Albuminuria Reduction with Empagliflozin and Finerenone.

This prespecified CONFIDENCE analysis (n=790 with T2D, CKD and albuminuria) found the greatest acute day-14 eGFR decline with combination therapy (-6.6 mL/min) vs finerenone alone (-2.1) or empagliflozin alone (-4.8), but declines were reversible. Finerenone's additive UACR-lowering effect was non-haemodynamic, while empagliflozin's effect was partly eGFR-mediated. The results reinforce that initial eGFR dips should not trigger discontinuation and support combination therapy in diabetic CKD.

Volume vs intensity of physical activity and risk of cardiovascular and non-cardiovascular chronic diseases.

Using wrist-accelerometer data from 96,408 UK Biobank participants, a higher share of vigorous activity (%VPA) showed a non-linear inverse association with MACE, atrial fibrillation, type 2 diabetes, CKD, dementia and all-cause mortality — independent of total activity volume. Participants exceeding 4% VPA had 29–61% lower risk of these outcomes. The study suggests exercise intensity deserves more weight in prevention counselling, alongside the traditional focus on weekly duration.

Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation

In CHAMPION-AF, 3,000 patients with non-valvular AF were randomized to WATCHMAN FLX LAA closure or NOAC therapy. At 36 months, the device was noninferior for the primary efficacy endpoint (stroke, CV death, systemic embolism: 5.7% vs 4.8%; P<0.001 for noninferiority) and superior for non-procedural bleeding (45% reduction: 10.9% vs 19.0%; P<0.001). This contrasts with the negative CLOSURE-AF trial and establishes WATCHMAN FLX as the first LAA closure device to demonstrate noninferiority vs NOACs as first-line therapy.

Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism

In the HI-PEITHO trial, 544 patients with acute intermediate-high-risk PE were randomized to ultrasound-facilitated catheter-directed fibrinolysis (EKOS) vs anticoagulation alone. The primary composite endpoint (PE-related death, cardiorespiratory decompensation, or recurrent PE within 7 days) occurred in 3.7% vs 10.3% — a 61% relative risk reduction (RR 0.4; P=0.005). No intracranial bleeding in either group. First positive hard-outcome trial for catheter-directed intervention in intermediate-risk PE.

Evolocumab Reduces Risk of First Major Cardiovascular Events by 31% in Patients Without Significant Atherosclerosis

Results from VESALIUS-CV

In a subgroup analysis of VESALIUS-CV, 3,655 patients with diabetes but no known significant atherosclerosis were followed for a median of 4.8 years. Evolocumab reduced 3-P MACE by 31% (HR 0.69; P=0.009) and 4-P MACE by 31% (HR 0.69; P=0.001). The effect appeared after 1 year and grew to ~40% reduction thereafter. CV death was reduced by 32% and all-cause mortality by 24%. This supports the use of PCSK9 inhibitors for primary prevention in high-risk diabetes patients.

Intensive Low-density Lipoprotein Cholesterol Targeting in Patients with Atherosclerotic Cardiovascular Disease

In the Ez-PAVE trial, the first randomized head-to-head comparison of LDL-C targets, 3,048 patients with ASCVD were shown to have a 33% lower risk of cardiovascular events with a target of <55 mg/dL vs <70 mg/dL (HR 0.67; P=0.002). At 3 years, the primary composite endpoint occurred in 6.6% vs 9.7%. Safety profiles were similar. This is the first randomized evidence that the lower target in the 2026 ACC/AHA dyslipidemia guideline is superior.

Calcium release channel deficiency syndrome in patients diagnosed with idiopathic ventricular fibrillation and decedents classified as sudden unexplained death in the young.

Calcium release channel deficiency syndrome (CRCDS), caused by loss-of-function RYR2 variants, can lead to ventricular fibrillation without exercise test abnormalities. This study assessed the prevalence of potentially CRCDS-causing variants in idiopathic ventricular fibrillation and unexplained sudden death in young individuals, underscoring the importance of genetic screening.

Deep endotyping of renal damage in type 2 diabetes

ex uno, plures

Kidney damage in type 2 diabetes is highly heterogeneous and poorly captured by traditional markers such as albuminuria and eGFR. This Kidney International review discusses how deep endotyping — integrating clinical trajectory analysis, renal histopathology, and molecular profiling — can identify subgroups with distinct pathophysiology, enabling more targeted therapy selection.

Kidney Disease

Improving Global Outcomes (KDIGO): navigating a rapidly changing landscape

KDIGO has published 17 kidney disease guidelines, but traditional full-revision cycles take years and lag behind rapidly evolving therapies such as SGLT2 inhibitors and finerenone. This article describes KDIGO's transition to modular, faster guideline updates to accelerate evidence translation into cardiometabolic clinical practice.

Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.

In the CLOSURE-AF trial, 912 patients with atrial fibrillation at high risk for both stroke and bleeding were randomized to catheter-based left atrial appendage closure or physician-directed best medical care. After a median follow-up of 3 years, LAA closure was not noninferior to medical therapy for the composite endpoint of stroke, systemic embolism, major bleeding, or cardiovascular death (16.8 vs 13.3 events per 100 patient-years; P=0.44 for noninferiority). Serious adverse events occurred in 82.5% of the device group versus 77.4% of the medical-therapy group. These results provide critical context for the CHAMPION-AF trial results to be presented at ACC.26.

Novel cardiovascular metabolic risk factor mechanisms and therapeutic opportunities.

This European Heart Journal review examines how metabolic disorders — obesity, type 2 diabetes, and dyslipidaemia — drive cardiovascular risk through newly identified mechanisms. The authors highlight unexpected cardiovascular benefits from metabolic drug classes including GLP-1 receptor agonists and SGLT2 inhibitors, and discuss emerging therapeutic opportunities at the intersection of metabolic and cardiovascular disease.

Systemic Inflammation and Recurrence After Atrial Fibrillation-Related Stroke

An Individual Participant Data Meta-Analysis.

This individual participant data meta-analysis showed that systemic inflammatory markers (IL-6 and hsCRP) predict recurrent vascular events after AF-related stroke, irrespective of AF status. The findings support including AF patients in future trials of anti-inflammatory therapy for secondary stroke prevention.

Use of Coronary Artery Calcium Scoring in Individuals With Elevated Lipoprotein(a)

A Multicohort Study

This multicohort study demonstrated that coronary artery calcium scoring remains a useful ASCVD risk assessment tool in individuals with elevated lipoprotein(a). CAC provides incremental risk stratification even when Lp(a) is elevated, supporting its use in Lp(a)-enriched populations.

2026 ACC/AHA Guideline on the Management of Dyslipidemia

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

The 2026 ACC/AHA dyslipidemia guideline introduces a universal LDL-cholesterol target of <100 mg/dL for primary prevention and <55 mg/dL for very-high-risk secondary prevention. The guideline endorses earlier initiation of lipid-lowering therapy, Lp(a) measurement, and expanded indications for PCSK9 inhibitors and inclisiran.

Off-label underdosing of edoxaban antithrombotic therapy for patients with atrial fibrillation and stable coronary artery disease

findings from the EPIC-CAD trial.

This study documented the adverse consequences of off-label edoxaban underdosing in AF patients, showing increased thrombotic risk without meaningful bleeding reduction, reinforcing adherence to approved dosing criteria.

Semaglutide promotes bone marrow-derived progenitor cell flux towards an anti-inflammatory and pro-regenerative profile in high-risk patients

the SEMA-VR CardioLink-15 trial.

This translational study showed that semaglutide mobilizes anti-inflammatory and pro-regenerative progenitor cells from the bone marrow, providing a novel mechanistic explanation for the cardiovascular benefit of GLP-1 receptor agonists.

Effect of baxdrostat on ambulatory blood pressure in patients with resistant hypertension (Bax24)

a phase 3, randomised, double-blind, placebo-controlled trial

The phase 3 Bax24 trial demonstrated that baxdrostat, an aldosterone synthase inhibitor, significantly reduced 24-hour ambulatory systolic blood pressure compared with placebo in patients with resistant hypertension. The results advance aldosterone synthase inhibition as a promising new drug class for treatment-resistant blood pressure.

Atrial fibrillation

This comprehensive Lancet Seminar provides a state-of-the-art overview of atrial fibrillation, covering its rising global prevalence of 37.6 million affected individuals, the impact of wearable device-based detection, contemporary management strategies including early rhythm control and pulsed field ablation, and integrated AF care pathways.

Effect of baxdrostat on ambulatory blood pressure in patients with resistant hypertension (Bax24)

a phase 3, randomised, double-blind, placebo-controlled trial.

The Bax24 phase 3 trial confirmed that baxdrostat significantly reduces ambulatory blood pressure in patients with resistant hypertension. The results replicate the earlier phase 2 findings and advance aldosterone synthase inhibition toward clinical implementation.

Kidney disease and heart failure

recent advances and current challenges: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

This KDIGO consensus conference summary addressed the intersection of heart failure and chronic kidney disease, reviewing advances in cardiorenal understanding and the challenges of managing patients with both conditions, including the role of SGLT2 inhibitors and finerenone.

Direct-acting oral anticoagulant or vitamin K antagonist for the frail elderly patient with atrial fibrillation

does one size fit all?

This EHJ editorial discussed the choice between DOACs and vitamin K antagonists for frail elderly AF patients, reviewing the emerging evidence supporting safe transition to NOACs even in the most vulnerable anticoagulation population.

Semaglutide in peripheral artery disease and diabetes by baseline disease severity and age

the STRIDE trial.

This EHJ article presented STRIDE trial subanalyses of semaglutide in patients with peripheral artery disease and diabetes stratified by baseline disease severity and age, informing the use of GLP-1 agonists in the PAD population.

Oral PCSK9 inhibitor enlicitide lowers LDL cholesterol levels in phase 2 trial.

This phase 2 trial of enlicitide, an oral PCSK9 inhibitor, showed significant LDL cholesterol reduction. As the first oral PCSK9 inhibitor in clinical development, enlicitide could dramatically expand access to advanced lipid-lowering therapy.

Finerenone in Type 1 Diabetes and Chronic Kidney Disease.

This NEJM phase 3 trial demonstrated that finerenone improved kidney outcomes in patients with type 1 diabetes and chronic kidney disease, extending the benefit of nonsteroidal mineralocorticoid receptor antagonism beyond the type 2 diabetes population. The results address a previously unmet therapeutic need in type 1 diabetes nephropathy.

Interplay of Age and Sex With Clinic and Ambulatory Blood Pressure and Mortality

This analysis from the Spanish ABPM registry explored the interplay between age, sex, clinic and ambulatory blood pressure values, and cardiovascular mortality, providing insights into sex-specific blood pressure targets.

Finerenone for Diabetic Kidney Disease in Type 1 Diabetes — A Fine Answer?

This NEJM editorial discussed the implications of finerenone for diabetic kidney disease in type 1 diabetes, evaluating whether the cardiorenal benefit extends beyond the type 2 diabetes population.

Aspirin after PCI in Acute Coronary Syndromes

This NEJM article evaluated the role of aspirin after PCI in acute coronary syndromes in light of contemporary de-escalation evidence from TWILIGHT, T-PASS, and STOPDAPT trials, addressing the shifting paradigm toward aspirin-free antiplatelet strategies.

Blood-Pressure Targets in Hypertension Management

This NEJM article discussed optimal blood pressure targets in hypertension management, reviewing the evidence from SPRINT, STEP, and ESPRIT that supports lower targets while addressing the clinical challenges of implementing aggressive blood pressure control.

2026 Acute Pulmonary Embolism Guideline-at-a-Glance

This JACC guideline-at-a-glance provides a concise visual summary of the 2026 acute pulmonary embolism guideline, distilling the key recommendations into an accessible reference format for rapid clinical decision-making.

Cardiac Screening for Conditions Associated With Sudden Cardiac Death

Yield, Interventions, and SCA/SCD Incidence in 104,369 Young Individuals

This large-scale screening study of over 104,000 young individuals for conditions associated with sudden cardiac death evaluated the diagnostic yield, interventions triggered, and subsequent incidence of sudden cardiac arrest, informing the ongoing debate about population-level cardiac screening.

Cardiac Screening in the Young

Time to Sound the Battle CRY?

This JACC commentary discussed the implications of the CRY cardiac screening study in young individuals, debating the value and limitations of population-level cardiac screening programs for sudden cardiac death prevention.

Comparison of the European Society of Cardiology 0/1-Hour and High-Sensitivity Troponin in the Evaluation of Patients With Suspected Acute Coronary Syndrome 0/2-or-0/3-Hour Algorithms for Rapid Myocardial Infarction Diagnosis

A Prospective Multicenter Study

This prospective multicenter study compared the diagnostic accuracy of the ESC 0/1-hour high-sensitivity troponin algorithm with standard evaluation for patients presenting with suspected acute coronary syndromes, assessing real-world performance of the rapid rule-out/rule-in protocol.

Effect of Baduanjin on Blood Pressure Among Individuals With High-Normal Blood Pressure

A Multicenter, Open-Label, Blinded-Outcome Randomized Controlled Trial

This multicenter randomized trial evaluated Baduanjin, a traditional Chinese exercise form, for blood pressure reduction in individuals with high-normal blood pressure, testing a culturally appropriate lifestyle intervention for hypertension prevention.

High-Dose Influenza Vaccination in Atherosclerotic Cardiovascular Disease

A Multinational Pooled Analysis of DANFLU-2 and GALFLU (FLUNITY-HD)

This multinational pooled analysis of the DANFLU-2 and GALFLU trials evaluated the effect of high-dose versus standard-dose influenza vaccination on cardiovascular outcomes in patients with atherosclerotic cardiovascular disease, addressing whether enhanced immunogenicity translates to better cardiovascular protection.

Impact of Early, Delayed, or Interrupted Treatment in Children With Familial Hypercholesterolemia

This study examined the long-term cardiovascular effects of early, delayed, or interrupted lipid-lowering treatment in children with familial hypercholesterolemia, providing evidence for the importance of early and continuous treatment initiation.

Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis

Six-year outcomes from the comparison of transcatheter versus surgical aortic valve replacement in low-risk patients with aortic stenosis demonstrated sustained comparable results, providing long-term reassurance about TAVR durability in this population.

Some Much-Needed CONFIDENCE to Combat the Risk-Treatment Paradox in Chronic Kidney Disease

This JACC commentary discussed the risk-treatment paradox in chronic kidney disease, where patients at highest cardiovascular risk are least likely to receive evidence-based therapies including SGLT2 inhibitors and statins.

Timing of Cardiovascular and Kidney Benefits With Finerenone in Heart Failure and Chronic Kidney Disease With Type 2 Diabetes

This JACC analysis examined the time course of cardiovascular and kidney benefits with finerenone in patients with heart failure and chronic kidney disease with type 2 diabetes, characterizing how quickly the cardiorenal protection emerges after treatment initiation.

journal club

This Journal Club discussed the clinical implications of the VALIANT trial results from the New England Journal of Medicine, addressing contemporary treatment approaches in nephrology.

Abelacimab vs Rivaroxaban in Older Individuals With Atrial Fibrillation

A Prespecified Analysis of the Phase 2b AZALEA-TIMI 71 Trial.

This AZALEA-TIMI 71 subanalysis confirmed that abelacimab provides less bleeding than rivaroxaban in older AF patients, the population at highest bleeding risk with conventional anticoagulants.

Heart failure in the elderly

epidemiology, mechanisms, and management.

This European Heart Journal review describes the epidemiology, pathophysiology, and management of heart failure in the elderly, highlighting that the lifetime risk exceeds 25% after age 70. The article addresses the challenges of polypharmacy, frailty, and comorbidity that complicate guideline-directed therapy in older patients.

Additive Cardiorenal Benefits of Finerenone and SGLT2 Inhibitor Combination Therapy in Diabetic CKD

A Propensity-Matched Real-World Study.

This real-world propensity-matched study showed that combining finerenone with SGLT2 inhibitors provides additive cardiorenal benefits in diabetic CKD compared with SGLT2 inhibitor monotherapy, supporting dual neurohormonal and metabolic protection.

SGLT2 inhibition in Patients with Type 2 Diabetes and CKD Experiencing a Deterioration in Estimated Glomerular Filtration Rate to <20ml/min/1.73m

This post-hoc CREDENCE analysis showed that SGLT2 inhibition remains safe and effective when eGFR declines below 20 mL/min, supporting continuation of therapy in patients with severely reduced kidney function rather than discontinuation at an arbitrary eGFR threshold.

Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation

a Korean nationwide study.

This Korean nationwide study showed that switching from well-managed warfarin to DOACs in frail elderly patients with atrial fibrillation was associated with similar or improved outcomes. The real-world evidence supports transitioning to DOACs even in the oldest and most vulnerable AF population.

Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy.

This European Heart Journal study demonstrated that carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers independently predict secondary major adverse cardiovascular events beyond traditional risk factors. The findings link plaque inflammation at the cellular level to recurrent cardiovascular risk.

Intensive BP Control and Cognitive Function

A Randomized Clinical Trial

This randomized trial investigated whether intensive blood pressure control preserves cognitive function in an East Asian population, addressing the uncertainty about aggressive BP targets and brain health in this demographic.

Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction

The APERITIF Randomized Clinical Trial.

The APERITIF randomized trial investigated whether adding low-dose rivaroxaban to dual antiplatelet therapy prevents left ventricular thrombus formation after anterior acute myocardial infarction.

Combined associations of GLP-1 receptor agonists and a healthy lifestyle with cardiovascular outcomes among individuals with type 2 diabetes

a prospective cohort study.

This prospective cohort study in Lancet Diabetes & Endocrinology examined the combined effects of GLP-1 receptor agonists and eight healthy lifestyle factors on cardiovascular outcomes. The findings demonstrate additive benefit, with the combination of pharmacotherapy and healthy lifestyle conferring the greatest cardiovascular risk reduction.

Forecasting the Burden of Cardiovascular Disease and Stroke in Women in the United States Through 2050

A Scientific Statement From the American Heart Association

This AHA scientific statement provided forecasts for cardiovascular disease and stroke prevalence in women through 2050, highlighting projected increases driven by aging, obesity, and diabetes, and informing prevention strategies targeting women's cardiovascular health.

Outcomes of heart failure with reduced, mildly reduced, or preserved ejection fraction

the ESC HF III registry.

The ESC Heart Failure III Registry followed 10,162 patients across 41 countries with HFrEF, HFmrEF, and HFpEF, providing contemporary real-world data on in-hospital and 1-year outcomes across the heart failure spectrum in routine clinical practice.

Systemic Embolic Events in Atrial Fibrillation

An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin.

This individual patient data meta-analysis of over 71,000 AF patients characterized systemic embolic events, showing that NOACs effectively prevent both stroke and non-cerebral embolism compared with warfarin.

Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions

A Scientific Statement From the American Heart Association

This AHA scientific statement addressed malnutrition and cachexia in patients with acute cardiovascular conditions beyond heart failure, covering assessment, management, and the impact of nutritional status on clinical outcomes across the spectrum of acute cardiac disease.

Risk of Heart Failure Hospitalization for GLP-1 Receptor Agonists Versus DPP-4 Inhibitors or SGLT-2 Inhibitors in Patients With Type 2 Diabetes

A Target Trial Emulation

This target trial emulation using Swedish population data compared GLP-1 receptor agonists with DPP-4 inhibitors and SGLT2 inhibitors for heart failure hospitalization risk in type 2 diabetes, providing real-world comparative effectiveness data for cardiometabolic drug selection.

Accelerometry-defined physical activity and quality of life in hypertrophic cardiomyopathy

This study used accelerometry to objectively measure physical activity in HCM patients, showing that reduced activity levels are associated with worse quality of life and challenging the assumption that exercise restriction improves safety.

Effect of semaglutide on COVID-19 and other infections

an analysis from the FLOW randomized clinical trial.

This FLOW trial analysis showed that semaglutide reduces the risk of COVID-19 and other infections in patients with type 2 diabetes and CKD, demonstrating an unexpected anti-infectious benefit of GLP-1 receptor agonism.

Mitigating Risk of Kidney Dysfunction After Heart Transplantation and Therapeutic Approaches.

This Circulation Heart Failure review addressed strategies for mitigating kidney dysfunction after heart transplantation, covering recipient risk factors, perioperative management, and therapeutic approaches to preserve renal function.

Diabetes Increases the Risk of Heart Failure in Myocarditis

A Propensity-Matched Nationwide Database Analysis.

This US nationwide database analysis showed that diabetes significantly increases the risk of heart failure in patients hospitalized with myocarditis, highlighting the adverse interaction between metabolic disease and myocardial inflammation.

Primary care Adherence To Heart failure guidelines in post-Discharge, Evaluation & Routine management (PATHFINDER)

a randomised controlled trial.

The PATHFINDER trial tested a combined intervention of inpatient education, a discharge plan with cardiac rehabilitation referral, and primary care support for heart failure, evaluating implementation strategies for guideline adherence.

The year in cardiovascular medicine 2025

the top 10 papers in ischaemic heart disease.

This European Heart Journal annual review highlighted the top 10 papers of 2025 in ischemic heart disease, providing an expert-curated summary of the most impactful developments in coronary artery disease research.

Immunoadsorption in dilated cardiomyopathy

the IASO-DCM trial.

The IASO-DCM trial investigated immunoadsorption as a treatment for dilated cardiomyopathy with cardiac autoantibodies, exploring a novel immunomodulatory approach to this form of heart failure.

Cost-effectiveness of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists for patients with high cardiovascular risk and type 2 diabetes in Canada.

This Canadian simulation study compared the cost-effectiveness of SGLT2 inhibitors versus GLP-1 receptor agonists in type 2 diabetes with high cardiovascular risk, informing formulary and reimbursement decisions for cardiometabolic therapy.

Pelacarsen and lipoprotein(a) apheresis in secondary prevention

the Lp(a)FRONTIERS APHERESIS trial.

The Lp(a)FRONTIERS APHERESIS trial investigated whether pelacarsen can reduce the need for lipoprotein apheresis in patients with elevated Lp(a) and established cardiovascular disease. The study addresses a critical question about the potential of pharmacological Lp(a) lowering to replace this burdensome procedure.

Cardiovascular-Kidney-Metabolic Interplay in Patients with Atrial Fibrillation Receiving Direct Oral Anticoagulants.

This comprehensive review examined the cardiovascular-kidney-metabolic interplay in AF patients on DOACs, exploring how CKM syndrome affects anticoagulation efficacy, safety, and dosing decisions.

Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.

The 7-year PARTNER 3 results confirmed comparable outcomes between TAVR and surgical aortic valve replacement in low-risk patients, with maintained valve durability and no excess structural deterioration. These are the longest-term data supporting TAVR across the full surgical risk spectrum.

Conduction disturbances after transcatheter aortic valve implantation.

This European Heart Journal review addressed conduction disturbances after TAVI, covering the predictors of permanent pacemaker implantation, the impact on long-term outcomes, and strategies for minimizing conduction complications during transcatheter valve procedures.

Secondary Prevention after Ischemic Stroke.

This NEJM review provided a comprehensive update on secondary prevention after ischemic stroke, covering modifiable risk factors, mechanism-specific therapies, and contemporary evidence on anticoagulation, antiplatelet therapy, and lipid lowering for recurrent stroke prevention.

2026 AHA/ACC Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

The 2026 AHA/ACC multisociety guideline provides comprehensive, de novo recommendations for the evaluation and management of acute pulmonary embolism in adults, covering risk stratification, anticoagulation, thrombolysis, catheter-directed therapy, and long-term follow-up.

Beta-Blockers after Myocardial Infarction

This NEJM review article synthesizes the current evidence on beta-blocker use after myocardial infarction, reflecting the paradigm shift from routine long-term therapy to an evidence-based approach where beta-blockers are no longer mandatory when ejection fraction is preserved.

Gene Therapy for Nephropathic Cystinosis

This NEJM article discussed gene therapy as a treatment option for nephropathic cystinosis, a rare lysosomal storage disorder affecting kidney function, exploring the potential for curative genetic intervention.

Albuminuria or proteinuria in glomerular disease and CKD - which one to use?

This NDT discussion addressed the clinical question of whether albuminuria or proteinuria is the preferred measurement in glomerular disease and CKD, informing the standardization of kidney disease monitoring.

Novel Plasma Proteomic Markers and Risk of Venous Thromboembolism

This Circulation study used large-scale, high-throughput proteomics to identify novel plasma protein markers associated with venous thromboembolism risk, advancing the molecular understanding of VTE pathogenesis.

Early versus late anticoagulation treatment after acute ischemic stroke with atrial fibrillation

a meta-analysis of randomized controlled trials.

This meta-analysis of randomized trials compared early versus late anticoagulation initiation after acute ischemic stroke in AF patients, providing the pooled evidence to guide the timing of DOAC start after cerebrovascular events.

Use of kidney-preserving medications in breastfeeding

This Kidney International review addressed the safety of kidney-preserving medications during breastfeeding, providing practical guidance for CKD women on which cardiovascular and renal therapies are compatible with lactation.

Prospective Associations of Obesity and Obesity Severity With 9 Cardiovascular Outcomes

The Cross-Cohort Collaboration

This prospective cross-cohort analysis showed that not only obesity but particularly its severity is strongly predictive of multiple cardiovascular outcomes, with a graded relationship across the full BMI spectrum.

Aspirin dosing after acute coronary syndrome with suspected aspirin resistance

the ANDAMAN trial.

The ANDAMAN trial tested higher aspirin dosing in ACS patients with suspected aspirin resistance, evaluating whether dose escalation overcomes inadequate platelet inhibition in diabetes and high-risk patients.

Improving outcomes of atrial fibrillation ablation by integrated personalized lifestyle interventions

a randomized controlled trial.

This randomized trial confirmed that integrated personalized lifestyle interventions (weight management, fitness, sleep optimization, alcohol reduction) significantly improve catheter ablation outcomes for atrial fibrillation.

Vericiguat and mortality in heart failure and reduced ejection fraction

the VICTOR trial.

The VICTOR trial analysis confirmed that vericiguat reduces mortality in patients with HFrEF and recent decompensation. The mortality benefit adds to the heart failure event reduction shown in VICTORIA, strengthening vericiguat's position in guideline-directed therapy.

Criteria to Assess the Predictive and Clinical Utility of Novel Models, Biomarkers, and Tools for Risk of Cardiovascular Disease

A Scientific Statement From the American Heart Association

This AHA scientific statement described criteria for assessing the predictive and clinical utility of novel cardiovascular risk models, biomarkers, and tools, providing a methodological framework for evaluating new risk assessment technologies.

Renal and urothelial cancer risks with SGLT2 inhibitors vs GLP-1 receptor agonists in type 2 diabetes

a target trial emulation.

This target trial emulation compared renal and urothelial cancer risks between SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes, addressing an important safety question for these widely prescribed cardiometabolic agents.

New drug therapies for hypertension

This Lancet review described new drug therapies for hypertension targeting novel physiological pathways including aldosterone synthase inhibition, endothelin antagonism, and RNA interference-based angiotensinogen silencing, addressing the unmet need for patients with resistant blood pressure.

Transthyretin Cardiac Amyloidosis Evaluation and Management

2025 ACC Concise Clinical Guidance.

This 2025 ACC clinical guidance for transthyretin amyloid cardiomyopathy provides structured recommendations for diagnosis, risk stratification, and treatment including tafamidis. The document addresses the growing recognition and improved detection of this previously underdiagnosed condition.

Clonal Hematopoiesis and Its Cardiovascular Implications

A Scientific Statement From the American Heart Association

This AHA scientific statement reviewed the emerging evidence on clonal hematopoiesis and its cardiovascular implications, describing how somatic mutations in hematopoietic stem cells drive inflammation and increase cardiovascular risk independent of traditional risk factors.

Spontaneous Myocardial Infarction After Left Main Revascularization

The EXCEL Trial

This EXCEL analysis compared rates and prognostic implications of spontaneous MI after PCI versus CABG for left main disease, providing granular data on the long-term ischemic risk profile of each revascularization strategy.

Coronary Atherosclerosis in Patients With Cancer and Survivors

A Scientific Statement From the American Heart Association

This AHA scientific statement addressed the emerging convergence between atherosclerotic cardiovascular disease and cancer, driven by shared risk factors, overlapping pathophysiology, and the cardiovascular toxicity of cancer therapies.

Glucagon-like Peptide Receptor Agonists and Kidney Outcomes in the Era of Personalized Medicine

Focus on Albuminuria.

This review assessed the renoprotective effects of GLP-1 receptor agonists with specific focus on albuminuria reduction, positioning these agents as important kidney-protective therapies alongside SGLT2 inhibitors in the personalized medicine era.

Insulin Resistance Compromises the Pentose Phosphate Pathway and Impairs Left Ventricular Assist Device–Mediated Myocardial Recovery in Obese Patients with Heart Failure

This study demonstrated that insulin resistance compromises the pentose phosphate pathway and impairs LVAD-mediated cardiac recovery, explaining why diabetic patients have worse myocardial recovery during mechanical support.

The Aldehyde Dehydrogenase 2 rs671 Variant Enhances Platelet Activation and Arterial Thrombosis

This study showed that the ALDH2 rs671 variant, present in 30-50% of East Asians, enhances platelet activation and arterial thrombosis, explaining the increased MI risk in carriers of this common genetic polymorphism.

Efimosfermin alfa (BOS-580) once per month in people with metabolic dysfunction-associated steatohepatitis with F2 or F3 fibrosis

results from a 24-week, randomised, double-blind, placebo-controlled, phase 2 trial

This phase 2 trial of efimosfermin alfa (FGF21 analogue) showed favorable tolerability in patients with MASH and F2/F3 fibrosis. The results support further development of metabolic therapies targeting the liver-cardiovascular axis.

Intravenous tenecteplase for acute ischaemic stroke within 24 h due to basilar artery occlusion

This Lancet publication addresses basilar artery occlusion, the most severe presentation of large-vessel ischemic stroke, with new randomized and observational evidence supporting intravenous tenecteplase therapy within an extended 24-hour treatment window.

Tenecteplase versus standard medical treatment for basilar artery occlusion within 24 h (TRACE-5)

a multicentre, prospective, randomised, open-label, blinded-endpoint, superiority, phase 3 trial

The TRACE-5 trial demonstrated that intravenous tenecteplase within 24 hours improved functional outcomes in Chinese patients with ischemic stroke due to basilar artery occlusion. The results support thrombolysis as an effective treatment for this devastating posterior circulation stroke subtype.

Physical activity and risk of adverse events in atrial fibrillation

evidence from European and Asian cohorts.

This post-hoc analysis of European and Asian-Pacific AF registries showed that physical activity levels are associated with different clinical characteristics and outcomes in AF patients, supporting exercise recommendations across diverse populations.

Semaglutide as adjunctive therapy to catheter ablation in obesity-related paroxysmal atrial fibrillation.

This study evaluated semaglutide as adjunctive therapy to catheter ablation in obese patients with paroxysmal AF, testing whether GLP-1 receptor agonist-mediated weight loss improves ablation outcomes in obesity-related arrhythmia.

Contemporary management of atrial fibrillation in patients with cancer-the 2025 European Heart Rhythm Association survey.

This 2025 EHRA position paper addressed the contemporary management of AF in patients with cancer, providing practical guidance for the complex decisions around anticoagulation, rate/rhythm control, and drug interactions in this dual-disease population.

Semaglutide vs tirzepatide in patients with obesity and HFpEF

a report from a global federated research network.

This federated research network analysis provided the first direct comparison of semaglutide versus tirzepatide in patients with obesity and HFpEF, comparing real-world outcomes of these two leading incretin therapies.

Dapagliflozin to Reduce Early Recurrence After Catheter Ablation for Atrial Fibrillation

The DARE-AF Randomized Clinical Trial.

The DARE-AF trial demonstrated that dapagliflozin reduces early AF recurrence after catheter ablation. The finding suggests that SGLT2 inhibitors may have antiarrhythmic properties that complement ablation therapy.

SGLT2 Inhibitor Use and Cardiorenal Outcomes in Type 2 Diabetes With Liver Cirrhosis.

This study evaluated SGLT2 inhibitor use and cardiorenal outcomes in patients with both type 2 diabetes and liver cirrhosis, providing safety and efficacy data for this high-risk and typically excluded population.

Cardiovascular-Kidney Effects of Dapagliflozin in Patients at Cardiovascular Risk With or Without Type 2 Diabetes

Results of a Randomized, Double-Blind, Placebo-Controlled Trial.

This study demonstrated that dapagliflozin improves vascular stiffness and cardiorenal markers in patients at cardiovascular risk regardless of diabetes status, providing mechanistic support for the universal cardiorenal protective effects of SGLT2 inhibitors.

CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity

REDEFINE 1.

The REDEFINE 1 analysis showed that CagriSema (cagrilintide plus semaglutide) significantly reduces blood pressure in adults with overweight or obesity, with the antihypertensive effect adding to the metabolic and weight-loss benefits.

Outcomes After Switching Cardiac Troponin Assays in ACS

This interrupted time-series analysis evaluated the clinical implications of switching high-sensitivity cardiac troponin assays, showing that assay changes affect diagnostic rates and patient management in acute care.

Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease

This SELECT prespecified analysis showed that semaglutide reduces total hospital admissions and length of stay in patients with obesity and established cardiovascular disease, demonstrating healthcare utilization benefits beyond cardiovascular event reduction.

β-Blockers After Myocardial Infarction in Patients With Preserved Ejection Fraction

This meta-analysis of four randomized trials confirmed that beta-blockers after MI in patients with preserved ejection fraction do not improve cardiovascular outcomes. The consolidated evidence definitively supports discontinuation in this population.

Systemic Embolic Events in Atrial Fibrillation

An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin

This individual patient data meta-analysis characterized the incidence, risk factors, and outcomes of systemic embolic events in AF, demonstrating that DOACs effectively prevent both stroke and non-cerebral embolism compared with warfarin.

Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls

A New Perspective From the Master@Heart Study

This study used wearable device-derived training load data to investigate the relationship between exercise volume and coronary atherosclerosis in middle-aged and older athletes, addressing the paradox of increased coronary plaque in endurance athletes.

Olezarsen for Managing Severe Hypertriglyceridemia and Pancreatitis Risk.

This trial evaluated olezarsen specifically in patients with severe hypertriglyceridemia and pancreatitis risk, demonstrating dramatic triglyceride reduction and pancreatitis prevention. The APOC3-targeted antisense therapy offers a definitive solution for this dangerous metabolic condition.

KDIGO 2026 clinical practice guideline for Anemia in Chronic Kidney Disease (CKD)

a commentary from the European Renal Best Practice (ERBP).

This ERA commentary on the KDIGO 2026 anemia in CKD guideline discussed the substantial updates including new recommendations for intravenous iron, HIF-prolyl hydroxylase inhibitors, and ESA targets in the contemporary treatment landscape.

Potent P2Y12 Inhibitor Monotherapy vs DAPT After PCI in Patients With and Without STEMI

The NEO-MINDSET Substudy.

The NEO-MINDSET substudy showed that potent P2Y12 inhibitor monotherapy after very early aspirin withdrawal is noninferior to DAPT after PCI in STEMI patients, with fewer bleeding events. The result extends the de-escalation strategy to the acute STEMI population.

Colchicine in acute coronary syndromes

a systematic review and meta-analysis of randomised controlled trials.

This updated meta-analysis of all colchicine trials in acute coronary syndromes confirmed significant MACE reduction with an acceptable safety profile. The anti-inflammatory concept in ACS is now supported by robust pooled evidence.

Drug stewardship for RAS-inhibitors and SGLT2-inhibitors in chronic kidney disease

stay on, restart.

This NDT article emphasized that RAS inhibitors and SGLT2 inhibitors should not be discontinued in CKD patients, showing that drug stewardship programs focusing on continuation and restart of these cornerstone therapies improve outcomes.

Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation.

This randomized trial investigated the optimal antithrombotic regimen after successful catheter ablation for atrial fibrillation, addressing whether successful ablation eliminates the need for long-term oral anticoagulation.

2026 Heart Disease and Stroke Statistics

A Report of US and Global Data From the American Heart Association

The 2026 AHA Heart Disease and Stroke Statistics report provides comprehensive global data on cardiovascular disease burden, trends, risk factors, and outcomes, serving as the definitive annual reference for cardiovascular epidemiology.

SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria

A Meta-Analysis.

This JAMA meta-analysis confirmed that SGLT2 inhibitors improve kidney outcomes across the entire spectrum of glomerular filtration rate and albuminuria. The universal renoprotective effect supports SGLT2 inhibitor use in virtually all patients with or at risk for chronic kidney disease.

Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome

The ES-BempedACS Randomized Clinical Trial.

The ES-BempedACS trial showed that triple lipid-lowering therapy (statin + ezetimibe + bempedoic acid) achieves lower LDL levels faster than dual therapy after ACS. The early intensive approach may reduce residual cardiovascular risk in the vulnerable post-ACS period.

Environmental Stressors and Cardiovascular Health

Acting Locally for Global Impact in a Changing World: A Statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation

This AHA statement described how environmental stressors — air pollution, extreme temperatures, noise, and climate change — contribute to cardiovascular disease globally. The document provided a framework for integrating environmental health into cardiovascular prevention strategies.

Socioeconomic and Structural Barriers to Addressing Obesity in Communities

A Scientific Statement From the American Heart Association

This AHA scientific statement addressed the socioeconomic and structural barriers to obesity prevention and treatment in communities, highlighting how poverty, food insecurity, and built environment disproportionately affect cardiovascular health in disadvantaged populations.

Glucagon-like receptor agonists and next-generation incretin-based medications

metabolic, cardiovascular, and renal benefits

This comprehensive Lancet review describes how GLP-1 receptor agonists, originally developed for type 2 diabetes, have expanded into cardiovascular prevention, obesity treatment, heart failure with preserved ejection fraction, and chronic kidney disease. The review covers next-generation agents including dual and triple incretin agonists.

Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia

A Randomized Clinical Trial.

This phase 3 trial demonstrated that enlicitide, an oral PCSK9 inhibitor, significantly reduced LDL cholesterol in adults with heterozygous familial hypercholesterolemia. An oral daily tablet offers a practical alternative to injectable PCSK9-lowering therapies for patients with genetic hypercholesterolemia.

Efficacy and Safety of Treatment With Low Doses of Spironolactone in Patients With Primary Aldosteronism

A Retrospective Observational Study in a Tertiary Center

This retrospective study evaluated the efficacy and safety of low-dose spironolactone in primary aldosteronism, showing that reduced doses may achieve adequate blood pressure and potassium control with fewer side effects.

CXCR6+ T Cells Drive Immune Checkpoint Inhibitor Myocarditis

This study identified CXCR6+ T cells as key drivers of immune checkpoint inhibitor-associated myocarditis, particularly with combination ICI therapy including anti-LAG-3 agents. The mechanistic insight may guide future prevention and treatment strategies for this serious complication.

DASH-Patterned Groceries and Effects on Blood Pressure

The GoFresh Randomized Clinical Trial.

The GoFresh randomized trial showed that home delivery of DASH-patterned groceries improves dietary quality and lowers blood pressure in Black adults, demonstrating that removing food access barriers translates to measurable health benefit.

Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure

The ANDES Randomized Clinical Trial.

This trial compared short-term anticoagulation with DAPT for preventing device thrombosis after LAA closure, providing the first randomized comparison of antithrombotic strategies in the early post-LAAC period.

Orforglipron, an oral small-molecule GLP-1 receptor agonist, for the treatment of obesity in people with type 2 diabetes (ATTAIN-2)

a phase 3, double-blind, randomised, multicentre, placebo-controlled trial.

The ATTAIN-2 trial demonstrated that orforglipron, an oral GLP-1 receptor agonist, achieved approximately 15% weight loss in adults with obesity and type 2 diabetes. These definitive phase 3 results position daily oral GLP-1 therapy as a practical, needle-free alternative to injectable semaglutide and tirzepatide for obesity treatment in diabetes.

Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes.

This NEJM trial compared tirzepatide with dulaglutide head-to-head on cardiovascular outcomes in type 2 diabetes, providing the first direct comparison of dual versus single incretin agonism for cardiovascular protection.

IMPROVE-DiCE, a 2-Part, Open-Label, Phase 2a Trial Evaluating the Safety and Effectiveness of Ninerafaxstat in Patients With Cardiometabolic Syndromes

The IMPROVE-DiCE phase 2a trial evaluated ninerafaxstat, a novel agent designed to improve diabetic cardiac energetics, in patients with diabetic cardiomyopathy. The study explores a new therapeutic mechanism targeting myocardial metabolism.

2025 ACC/AHA Guideline for the Management of Adults With Congenital Heart Disease

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

The 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for adults with congenital heart disease (Circulation edition) provides comprehensive, updated recommendations covering surgical indications, electrophysiology management, pregnancy counseling, and lifelong follow-up for this growing patient population.

Pharmacologic Treatment of Heart Failure With Reduced Ejection Fraction

An Updated Systematic Review and Network Meta-Analysis.

This updated systematic review and network meta-analysis of pharmacological HFrEF treatment confirmed that the four-pillar combination (SGLT2i + ARNI + beta-blocker + MRA) provides the optimal mortality and hospitalization reduction, with quantified contributions from each drug class.

Long-Term Effect of ICDs in Nonischemic Heart Failure With Reduced Ejection Fraction

Extended Follow-Up Analysis of DANISH.

Extended DANISH follow-up confirmed that ICDs in nonischemic HFrEF do not provide significant long-term survival benefit, even with over a decade of follow-up. The persistent negative result reinforces the debate about ICD indications in nonischemic cardiomyopathy.

Complete versus culprit lesion-only revascularisation for acute myocardial infarction (Complete Revascularisation Trialists' Collaboration)

an individual patient data meta-analysis of randomised trials.

This individual patient data meta-analysis from the Complete Revascularisation Trialists provided definitive evidence that complete revascularization reduces cardiovascular death and MI compared with culprit-only PCI in patients with acute MI and multivessel disease. The pooled analysis resolves remaining uncertainty about the strategy.

Major Bleeding With Apixaban vs Aspirin

A Subanalysis of the ARTESiA Randomized Clinical Trial.

This ARTESIA subanalysis detailed the major bleeding events with apixaban versus aspirin in subclinical AF, characterizing the bleeding types and clinical consequences that inform the anticoagulation risk-benefit discussion.

Aggressive Risk Factor Reduction Study for Atrial Fibrillation Implications for Ablation Outcomes

The ARREST-AF Randomized Clinical Trial.

The ARREST-AF study confirmed that aggressive risk factor reduction (weight loss, fitness improvement, sleep apnea treatment) significantly improves catheter ablation outcomes in AF patients, establishing upstream therapy as an essential adjunct to ablation.

Biomarker-Based ABC-AF Risk Scores for Personalized Treatment to Reduce Stroke or Death in Atrial Fibrillation

A Registry-Based, Multicenter, Randomized, Controlled Study.

This study validated biomarker-based ABC-AF risk scores for personalized treatment decisions in AF, showing that prospective application of these scores improves clinical outcomes compared with standard care.

Cardiovascular Effects and Tolerability of GLP-1 Receptor Agonists

A Systematic Review and Meta-Analysis of 99,599 Patients.

This comprehensive meta-analysis of 9 GLP-1 receptor agonist trials summarized all cardiovascular effects and tolerability data, confirming the class-wide benefit on MACE, heart failure, and kidney outcomes with a defined side effect profile.

Dapagliflozin in Patients Hospitalized for Heart Failure

Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure.

The DAPA ACT HF-TIMI 68 trial showed that dapagliflozin initiated during heart failure hospitalization was safe and reduced heart failure events. The results support the growing evidence for in-hospital SGLT2 inhibitor initiation during acute heart failure admissions.

2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure

A Report of the American College of Cardiology.

This ACC scientific statement provided a structured framework for obesity management in adults with heart failure, integrating evidence on GLP-1 receptor agonists, tirzepatide, and bariatric surgery as disease-modifying interventions for the obesity-heart failure phenotype.

Beta-Blockers after Myocardial Infarction in Patients without Heart Failure.

This additional definitive trial confirmed that beta-blockers after MI in patients without heart failure do not reduce cardiovascular events or mortality. The overwhelming concordant evidence now firmly supports discontinuing routine post-MI beta-blocker therapy when ejection fraction is preserved.

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction.

This definitive meta-analysis confirmed that beta-blockers after myocardial infarction without reduced ejection fraction provide no cardiovascular benefit. Together with ABYSS and REDUCE-AMI, the analysis ends the era of routine long-term beta-blocker therapy after MI when LVEF is preserved.

High-Dose vs. Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults

The FLUNITY-HD Prespecified Pooled Analysis

This FLUNITY-HD pooled analysis of over 466,000 older adults demonstrated that high-dose influenza vaccine provides superior cardiovascular protection compared with standard-dose vaccine. The data support preferential use of high-dose formulations in elderly patients with cardiovascular disease.

Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment.

This phase 3 trial demonstrated that orforglipron, an oral small-molecule GLP-1 receptor agonist, produced dose-dependent weight loss of up to 15% in adults with obesity, comparable to subcutaneous semaglutide. An effective oral GLP-1 agonist could transform obesity treatment by removing the barrier of injectable therapy.

2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Simultaneous Circulation edition of the 2025 AHA/ACC hypertension guideline with updated definitions (130/80 mmHg), combination therapy emphasis, and home blood pressure monitoring recommendations.

Safety of Factor XI Inhibition With Abelacimab in Atrial Fibrillation by Kidney Function

A Prespecified Analysis of the AZALEA-TIMI 71 Randomized Clinical Trial.

This AZALEA-TIMI 71 subanalysis confirmed that abelacimab maintains its favorable safety profile across different levels of kidney function in AF, supporting FXI inhibition as a safer anticoagulation option in CKD.

Intensive Blood Pressure Control in Older Patients With Hypertension

6-Year Results of the STEP Trial.

Six-year STEP follow-up confirmed the durable benefit of intensive blood pressure control (SBP <130 mmHg) in older patients with hypertension. The sustained cardiovascular advantage supports long-term commitment to lower blood pressure targets in the elderly.

Effect of Intensive Blood Pressure Control on Stroke

A Prespecified Secondary Analysis of the ESPRIT Trial.

This ESPRIT subanalysis showed that intensive blood pressure control significantly reduces stroke risk, with the greatest benefit in patients with the highest baseline blood pressure. The data support aggressive targets specifically for stroke prevention.

Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction

This NEJM study examined the optimal timing of nonculprit lesion PCI in patients with myocardial infarction and multivessel disease, comparing immediate complete revascularization during the index procedure with a deferred staged approach.

Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years

The 7-year follow-up of TAVR versus surgery in low-risk aortic stenosis patients showed durable outcomes for transcatheter intervention, with mortality and stroke rates remaining comparable to surgical aortic valve replacement. These long-term data support TAVR as a viable option across the full surgical risk spectrum.

Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation.

This NEJM study examined whether adding aspirin to oral anticoagulation benefits patients with chronic coronary syndrome, finding that OAC monotherapy is sufficient without additional antiplatelet therapy in stable disease.

Heparin administration at first medical contact vs immediately before primary percutaneous coronary intervention

the HELP-PCI trial.

This study evaluated whether early heparin administration at first medical contact improves STEMI outcomes compared with administration immediately before PCI, informing the timing of antithrombotic therapy in acute MI care pathways.

Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation

The ALONE-AF Randomized Clinical Trial.

The ALONE-AF trial investigated whether anticoagulation can be safely discontinued after successful catheter ablation for atrial fibrillation. The study addresses one of the most consequential unresolved questions in AF management.

Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension.

This study confirmed the efficacy and safety of baxdrostat in patients with both uncontrolled and resistant hypertension. The aldosterone synthase inhibitor demonstrated consistent blood pressure reduction across these challenging treatment populations.

Left atrial appendage occlusion in patients with end-stage renal disease

an individual patient-level meta-analysis.

This individual patient data meta-analysis evaluated LAA occlusion in patients with end-stage renal disease and AF, showing feasibility and potential effectiveness in this high-risk population with limited anticoagulation options.

The relationship between obesity and chronic kidney disease

conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

This KDIGO conference addressed the complex relationship between obesity and CKD, providing consensus conclusions on the direct and indirect mechanisms linking excess adiposity to kidney disease progression and cardiovascular risk.

Impact of Obicetrapib on Major Adverse Cardiovascular Events in High-Risk Patients

A Pooled Analysis.

This pooled analysis suggested that obicetrapib may reduce MACE in high-risk patients, providing the first signal of clinical cardiovascular benefit from a CETP inhibitor after decades of setbacks with earlier agents in this class.

2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2025 AHA/ACC hypertension guideline (Hypertension edition) redefines high blood pressure at 130/80 mmHg, endorses combination therapy as first-line treatment, and prioritizes out-of-office blood pressure measurement. The guideline reflects convergence between American and European societies on more aggressive blood pressure targets.

Pulmonary congestion relief by adding dapagliflozin to intravenous loop diuretic in acute heart failure patients.

This study showed that adding dapagliflozin to IV loop diuretics in acute heart failure accelerates pulmonary congestion relief, supporting early SGLT2 inhibitor initiation as an adjunctive decongestion strategy.

Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction.

This NEJM trial showed that digitoxin reduced heart failure hospitalization in patients with HFrEF receiving contemporary guideline-directed medical therapy. The result repositions cardiac glycosides as a useful adjunct in the modern era of quadruple therapy for heart failure.

Effect of evolocumab on saphenous vein graft patency after coronary artery bypass surgery (NEWTON-CABG CardioLink-5)

an international, randomised, double-blind, placebo-controlled trial.

The NEWTON-CABG trial showed that evolocumab improved saphenous vein graft patency after CABG through intensive LDL cholesterol lowering. The finding establishes aggressive lipid therapy as a graft-protective strategy after coronary bypass surgery.

Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes.

This phase 3 NEJM trial demonstrated that orforglipron, an oral GLP-1 receptor agonist, significantly improved HbA1c and body weight in patients with early type 2 diabetes. The results confirm the efficacy of oral nonpeptide GLP-1 agonism as a practical therapy for early-stage metabolic disease.

2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2025 AHA/ACC hypertension guideline lowered the definition of hypertension to 130/80 mmHg, converging with the 2024 ESC guidelines. The document emphasizes home blood pressure monitoring, initial combination therapy, and integrates GLP-1 receptor agonists as blood pressure-lowering agents in patients with obesity and hypertension.

β blockers after myocardial infarction with mildly reduced ejection fraction

an individual patient data meta-analysis of randomised controlled trials.

This individual patient data meta-analysis examined beta-blockers after MI with mildly reduced ejection fraction (40-49%), a gray zone between preserved and reduced EF. The data suggest a modest benefit in this subgroup, informing the nuanced decision about beta-blocker continuation.

Multidomain Rehabilitation for Older Patients with Myocardial Infarction.

This NEJM trial evaluated multidomain rehabilitation (physical, cognitive, nutritional, psychosocial) in older patients after MI. The comprehensive approach improved functional outcomes, supporting holistic rehabilitation for elderly cardiac patients.

Influence of Type 2 Diabetes on the Effects of Tirzepatide in Patients With Heart Failure and a Preserved Ejection Fraction With Obesity

A Prespecified Stratification-Based Analysis.

This SUMMIT analysis confirmed that tirzepatide's benefit in HFpEF is consistent regardless of type 2 diabetes status, showing that the dual incretin agonist works through obesity-related mechanisms independent of glycemic effects.

Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease

the CENTURY trial.

The CENTURY randomized trial tested a comprehensive strategy integrating coronary flow capacity-guided revascularization with intensive lifestyle modification against usual care for chronic coronary disease, exploring a physiologically optimized management approach.

Cost-effectiveness of apixaban vs. aspirin for the reduction of thrombo-embolism in high-risk patients with device-detected atrial fibrillation

insights from the ARTESiA trial.

This cost-effectiveness analysis showed that apixaban is cost-effective compared with aspirin for thromboembolic prevention in high-risk patients with subclinical AF, supporting anticoagulation in device-detected arrhythmia.

Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation

A Secondary Analysis of the EAST-AFNET 4 Randomized Clinical Trial.

This EAST-AFNET 4 subanalysis confirmed that the benefit of early rhythm control in AF is consistent in patients with and without diabetes and obesity, supporting universal early rhythm management.

Conduction system pacing vs. biventricular pacing for cardiac resynchronization

the CSP-SYNC randomized single centre study.

The CSP-SYNC trial comparing conduction system pacing (His bundle or left bundle branch area) with biventricular pacing for CRT showed that conduction system pacing is noninferior and potentially superior. The results support physiologic pacing as a viable CRT alternative.

Blood pressure-lowering efficacy of antihypertensive drugs and their combinations

a systematic review and meta-analysis of randomised, double-blind, placebo-controlled trials.

This comprehensive meta-analysis quantified the blood pressure-lowering efficacy of all antihypertensive drug classes and their combinations, providing an evidence-based reference for estimating expected blood pressure reduction with different regimens.

Preventive percutaneous coronary intervention for non-flow-limiting vulnerable atherosclerotic coronary plaques in diabetes

the PREVENT trial.

Long-term PREVENT data confirmed the benefit of preventive PCI for vulnerable plaques identified by IVUS/OCT in diabetic patients. The paradigm of treating non-flow-limiting high-risk lesions continues to gain evidence.

Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.

This pivotal trial of CagriSema (cagrilintide plus semaglutide) in adults with overweight or obesity demonstrated up to 25% body weight reduction, substantially exceeding semaglutide monotherapy. The amylin–GLP-1 combination represents the most effective pharmacological weight loss therapy to date and may redefine obesity treatment targets.

Outcomes in Older Patients After Switching to a Newer Anticoagulant or Remaining on Warfarin

The COMBINE-AF Substudy.

This COMBINE-AF analysis showed that switching from warfarin to a NOAC in older AF patients is associated with improved outcomes compared with remaining on warfarin, supporting anticoagulant modernization even in the elderly.

Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction

The SOGALDI-PEF Trial.

This analysis showed that combining SGLT2 inhibitors with aldosterone antagonists in HFpEF provides additive cardiovascular benefit beyond either drug class alone, supporting the emerging four-pillar approach for preserved ejection fraction heart failure.

Abelacimab Versus Rivaroxaban in Patients With Atrial Fibrillation on Antiplatelet Therapy

A Prespecified Analysis of the AZALEA-TIMI 71 Trial.

This AZALEA-TIMI 71 subanalysis confirmed that abelacimab causes less bleeding than rivaroxaban even in AF patients on concurrent antiplatelet therapy, the highest-bleeding-risk scenario for anticoagulation.

Lorundrostat in Participants With Uncontrolled Hypertension and Treatment-Resistant Hypertension

The Launch-HTN Randomized Clinical Trial.

Phase 3 results of lorundrostat confirmed significant blood pressure reduction in both uncontrolled and treatment-resistant hypertension. The aldosterone synthase inhibitor class is now supported by multiple positive phase 3 trials.

Impact of Body Mass Index, Central Adiposity, and Weight Loss on the Benefits of Tirzepatide in HFpEF

The SUMMIT Trial.

This SUMMIT analysis confirmed that tirzepatide benefits HFpEF patients consistently regardless of BMI, central adiposity measures, or degree of weight loss achieved, supporting the drug across the obesity spectrum.

Long-term benefits of atorvastatin on the incidence of cardiovascular events

the ASCOT-Legacy 20-year follow-up.

The ASCOT-Legacy 20-year follow-up showed that cardiovascular benefits of atorvastatin remain measurable two decades after the original trial, demonstrating one of the longest legacy effects of statin therapy ever documented.

COOPERATIVE-PFA

A Three-Arm Randomized Controlled Trial.

The COOPERATIVE-PFA three-arm randomized trial directly compared pulsed field ablation, radiofrequency ablation, and cryoablation for atrial fibrillation, providing the first head-to-head-to-head comparison of all three energy sources for pulmonary vein isolation.

10-Year Outcome of Complete or Infarct Artery-Only Revascularization in STEMI With Multivessel Disease

The DANAMI-3-PRIMULTI Study.

Ten-year DANAMI-3-PRIMULTI results confirmed the durable benefit of complete revascularization over culprit-only PCI in patients with STEMI and multivessel disease. The survival advantage persisted over a decade of follow-up.

Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously

results from a phase 1b/2a randomised controlled study.

Phase 2 results of subcutaneous amycretin confirmed dose-dependent weight loss and metabolic improvement. The dual GLP-1/amylin receptor agonist mechanism offers a novel approach to obesity treatment with potent appetite suppression.

Safety, tolerability, pharmacokinetics, and pharmacodynamics of the first-in-class GLP-1 and amylin receptor agonist, amycretin

a first-in-human, phase 1, double-blind, randomised, placebo-controlled trial.

This first-in-human phase 1 trial of amycretin, a unimolecular dual GLP-1 and amylin receptor agonist, demonstrated up to 10% weight loss in 12 weeks with potent appetite suppression. The single-molecule dual agonist approach offers manufacturing and dosing advantages over combination products like CagriSema.

Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation

PRAGUE-25 Trial.

The PRAGUE-25 trial compared catheter ablation with lifestyle modification plus antiarrhythmic drugs in AF patients with obesity. The results inform the choice between invasive and comprehensive conservative management strategies for atrial fibrillation.

Colchicine for secondary prevention of vascular events

a meta-analysis of trials.

This meta-analysis of all colchicine trials in secondary cardiovascular prevention confirmed a 20-30% reduction in MACE with an acceptable safety profile. The pooled evidence from COLCOT, LoDoCo2, and CLEAR SYNERGY consolidates colchicine as a cost-effective anti-inflammatory strategy for atherosclerotic disease.

Long-term trials of colchicine for secondary prevention of vascular events

a meta-analysis.

This meta-analysis of long-term colchicine trials confirmed that colchicine significantly reduces recurrent vascular events in secondary prevention. After COLCOT, LoDoCo2, and CLEAR SYNERGY, the pooled long-term data consolidate colchicine as a cost-effective anti-inflammatory strategy.

Collaboration on the optimal timing of anticoagulation after ischaemic stroke and atrial fibrillation

a systematic review and prospective individual participant data meta-analysis of randomised controlled trials (CATALYST).

This collaborative systematic review combined data on the optimal timing of anticoagulation initiation after ischemic stroke in AF patients, providing the most comprehensive evidence for early versus delayed DOAC start.

Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk.

Phase 3 data confirmed that obicetrapib, a highly selective CETP inhibitor, significantly lowers LDL cholesterol with an acceptable safety profile in patients at high cardiovascular risk. The results position obicetrapib as the first CETP inhibitor with genuine clinical promise.

Near-universal prevalence of central adiposity in heart failure with preserved ejection fraction

the PARAGON-HF trial.

This PARAGON-HF analysis showed that central adiposity is nearly universal in HFpEF regardless of BMI category, reinforcing the concept that visceral fat — not just body weight — is central to the obesity-HFpEF phenotype.

Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

The KARDIA-2 Randomized Clinical Trial.

The KARDIA-2 trial showed that zilebesiran, an siRNA targeting hepatic angiotensinogen, significantly reduced blood pressure when added to existing antihypertensive therapy in patients with inadequately controlled hypertension. The twice-yearly injectable represents a novel approach to treatment-resistant blood pressure.

Long-Acting Factor XI Inhibition and Periprocedural Bleeding

An Analysis From AZALEA-TIMI 71.

This AZALEA-TIMI 71 analysis showed that abelacimab (long-acting factor XI inhibitor) reduces periprocedural bleeding compared with rivaroxaban, demonstrating the safety advantage of factor XI inhibition around invasive procedures.

Spironolactone vs Amiloride for Resistant Hypertension

A Randomized Clinical Trial.

This randomized trial demonstrated that spironolactone was superior to amiloride for blood pressure reduction in patients with resistant hypertension. The result confirmed spironolactone as the preferred fourth-line agent and defined the comparative effectiveness of potassium-sparing diuretics.

Antihypertensive Medication Timing and Cardiovascular Events and Death

The BedMed Randomized Clinical Trial.

The BedMed trial definitively confirmed that the timing of antihypertensive medication (morning versus evening) has no effect on cardiovascular outcomes or death. Together with the TIME trial, this eliminates chronotherapy as a meaningful consideration in hypertension management.

The Impact of frailty on the effectiveness of intensive blood pressure control for patients with type 2 diabetes

a secondary analysis of a randomised controlled trial.

This analysis showed that moderately frail patients with type 2 diabetes still benefit from intensive blood pressure control, while the benefit may be attenuated in the most severely frail, guiding treatment intensity by frailty status.

Oral Semaglutide and Cardiovascular Outcomes in People With Type 2 Diabetes, According to SGLT2i Use

Prespecified Analyses of the SOUL Randomized Trial.

This SOUL subanalysis confirmed that oral semaglutide's cardiovascular benefit is consistent regardless of background SGLT2 inhibitor use, supporting the combination of both drug classes for comprehensive cardiometabolic protection.

Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency

The FAIR-HF2 DZHK05 Randomized Clinical Trial.

The FAIR-HF2 trial confirmed that intravenous ferric carboxymaltose in patients with chronic heart failure and iron deficiency significantly reduced the composite of cardiovascular death and heart failure hospitalization. This provides the definitive evidence that had been missing from earlier, smaller trials of intravenous iron in heart failure.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2025 ACC/AHA ACS guideline (JACC edition) provides updated recommendations for acute coronary syndromes incorporating evidence from ABYSS, REDUCE-AMI, COMPLETE, and other contemporary trials, endorsing DAPT de-escalation, optional beta-blockers after MI with preserved EF, and troponin-guided management pathways.

An Oral PCSK9 Inhibitor for Treatment of Hypercholesterolemia

The PURSUIT Randomized Trial.

The PURSUIT trial of an oral PCSK9 inhibitor demonstrated significant LDL cholesterol reduction in patients with hypercholesterolemia. An effective oral PCSK9 inhibitor could dramatically expand access to advanced lipid-lowering therapy beyond injectable monoclonal antibodies and siRNA agents.

Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure.

This randomized trial confirmed that dapagliflozin does not worsen renal function when added for acute decompensated heart failure, providing safety data for early SGLT2 inhibitor initiation during AHF hospitalization.

Novel Controlled Metabolic Accelerator for Obesity-Related HFpEF

The HuMAIN-HFpEF Randomized Clinical Trial.

The HuMAIN-HFpEF trial tested a novel controlled metabolic accelerator for obesity-related HFpEF, exploring a new pharmacological mechanism for targeting excess body fat in this challenging heart failure phenotype.

FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Diabetes.

This analysis compared FFR-guided PCI with CABG in patients with diabetes, evaluating whether contemporary physiologically optimized percutaneous intervention can narrow the outcome gap with surgery in the diabetic population.

Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes.

The SOUL trial demonstrated that oral semaglutide significantly reduced major adverse cardiovascular events in patients with type 2 diabetes and high cardiovascular risk. This is the first cardiovascular outcomes trial to show benefit for an oral GLP-1 receptor agonist, removing the barrier of injectable administration for cardiovascular prevention in diabetes.

Fixed-dose combination of obicetrapib and ezetimibe for LDL cholesterol reduction (TANDEM)

a phase 3, randomised, double-blind, placebo-controlled trial.

The TANDEM trial demonstrated that a fixed-dose combination of obicetrapib (a CETP inhibitor) and ezetimibe reduced LDL cholesterol by 55-60% in statin-treated patients. This is the first positive result for a modern CETP inhibitor in combination therapy, reviving the mechanism after decades of setbacks.

Effect of Empagliflozin on the Mechanisms Driving Erythropoiesis and Iron Mobilization in Patients With Heart Failure

The EMPEROR Program.

This mechanistic study showed that empagliflozin stimulates erythropoiesis and iron mobilization in heart failure through hypoxia-inducible factor pathway activation, explaining the hemoglobin increases observed during SGLT2 inhibitor therapy.

Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity

The SUMMIT Trial.

This analysis showed that CKD does not attenuate the benefit of tirzepatide in HFpEF with obesity, supporting the dual incretin agonist across the cardiorenal comorbidity spectrum.

Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension.

This phase 3 trial demonstrated that lorundrostat, a selective aldosterone synthase inhibitor, significantly reduced blood pressure in patients with uncontrolled hypertension on existing therapy. The results add to the growing evidence for aldosterone synthase inhibition as a new treatment class for resistant and difficult-to-treat hypertension.

Semaglutide and walking capacity in people with symptomatic peripheral artery disease and type 2 diabetes (STRIDE)

a phase 3b, double-blind, randomised, placebo-controlled trial.

The STRIDE trial investigated whether semaglutide improves walking capacity in patients with symptomatic peripheral artery disease and type 2 diabetes, testing GLP-1 receptor agonism for PAD-specific functional outcomes.

Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation.

This randomized trial showed that pulsed field ablation was noninferior to cryoballoon ablation for pulmonary vein isolation in paroxysmal atrial fibrillation, with comparable efficacy and safety. The result positions PFA as an alternative to established thermal energy sources for AF ablation.

Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve Implantation.

This NEJM trial evaluated dapagliflozin in patients undergoing TAVI, exploring whether SGLT2 inhibition provides additional cardiac protection in this high-risk valvular heart disease population.

Empagliflozin in resistant hypertension and heart failure with preserved ejection fraction

the EMPEROR-Preserved trial.

This EMPEROR-Preserved subanalysis showed that empagliflozin improves blood pressure in patients with resistant hypertension and HFpEF, providing additional hemodynamic benefit in this difficult-to-treat overlap population.

Sodium-glucose co-transporter 2 inhibitors and new-onset diabetes in cardiovascular or kidney disease.

This analysis showed that SGLT2 inhibitors reduce the risk of new-onset diabetes in patients with cardiovascular or kidney disease, adding a metabolic prevention benefit to their established cardiorenal protection.

Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.

This NEJM trial investigated whether left atrial appendage closure combined with catheter ablation for atrial fibrillation can reduce stroke risk and enable anticoagulation cessation. The results inform the decision about combining structural and rhythm interventions for long-term AF management.

2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2025 ACC/AHA ACS guideline integrates contemporary evidence on DAPT de-escalation, routine complete revascularization, troponin-based diagnosis, and post-MI therapy. Notably, long-term beta-blockers are no longer mandated after MI with preserved ejection fraction, reflecting ABYSS and REDUCE-AMI results.

Efficacy and Safety of Aldosterone Synthase Inhibitors for Hypertension

A Meta-Analysis of Randomized Controlled Trials and Systematic Review.

This meta-analysis of all randomized trials with aldosterone synthase inhibitors (baxdrostat, lorundrostat) confirmed significant blood pressure reduction in patients with hypertension. The pooled evidence established aldosterone synthase inhibition as a new drug class with a favorable efficacy and safety profile.

Meta-analysis of sotagliflozin, a dual sodium-glucose-cotransporter 1/2 inhibitor, for heart failure in type 2 diabetes.

This meta-analysis confirmed that sotagliflozin, a dual SGLT1/2 inhibitor, reduces cardiovascular events and hospitalizations in heart failure patients with type 2 diabetes, supporting the dual transporter inhibition approach.

Flecainide acetate inhalation solution for cardioversion of recent-onset, symptomatic atrial fibrillation

results of the phase 3 RESTORE-1 trial.

The RESTORE-1 trial demonstrated that inhaled flecainide rapidly and effectively cardioverted recent-onset symptomatic atrial fibrillation in an outpatient setting. The needle-free, self-administered formulation offers a patient-controlled 'pill-in-the-pocket' alternative with faster onset than oral antiarrhythmic drugs.

Intensive Blood-Pressure Control in Patients with Type 2 Diabetes.

This large randomized trial showed that intensive blood pressure control (systolic <120 mmHg) significantly reduced cardiovascular events compared with standard treatment (<140 mmHg) in patients with type 2 diabetes and elevated cardiovascular risk. The results align with SPRINT and extend the evidence for aggressive blood pressure targets specifically to the diabetic population.

Antithrombotic Therapy to Minimize Total Events After ACS or PCI in Atrial Fibrillation

Insights From AUGUSTUS.

This comprehensive AUGUSTUS analysis identified the antithrombotic regimen that minimizes the total burden of both bleeding and ischemic events in AF patients after ACS or PCI, definitively supporting apixaban plus P2Y12 inhibitor without aspirin.

Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease

Meta-Analysis of Randomized Trials.

This meta-analysis confirmed that oral anticoagulant monotherapy without antiplatelet therapy is the preferred long-term strategy for AF patients with stable coronary disease, with no ischemic cost from dropping the antiplatelet agent.

Age and Sex Differences in Efficacy of Treatments for Type 2 Diabetes

A Network Meta-Analysis.

This network meta-analysis showed that the efficacy of SGLT2 inhibitors and GLP-1 agonists for type 2 diabetes treatment is consistent across age and sex subgroups, supporting equitable prescribing.

Transcatheter Aortic Valve Replacement in Patients With Systolic Heart Failure and Moderate Aortic Stenosis

TAVR UNLOAD.

The TAVR UNLOAD trial explored TAVR in patients with HFrEF and moderate (not severe) aortic stenosis. The results inform the growing debate about the role of valve intervention in patients where hemodynamic afterload reduction may benefit ventricular recovery even below conventional severity thresholds for aortic stenosis.

Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia.

The VANISH2 trial confirmed that catheter ablation was superior to escalation of antiarrhythmic drug therapy for recurrent ventricular tachycardia in patients with ischemic cardiomyopathy, significantly reducing VT recurrence and ICD shocks. The results strengthen the position of early ablation in VT management.

Colchicine in Acute Myocardial Infarction.

The CLEAR SYNERGY trial demonstrated that colchicine initiated within days of acute MI reduced major cardiovascular events by 33% compared with placebo over a median of 3 years. This is the third major positive trial of colchicine in atherosclerotic disease, after COLCOT and LoDoCo2, consolidating anti-inflammatory therapy as a pillar of secondary prevention.

Routine Spironolactone in Acute Myocardial Infarction.

This NEJM trial showed that routine spironolactone after acute MI in patients without heart failure or reduced ejection fraction did not significantly reduce the primary composite endpoint. The result limits MRA use after MI to those with established HF or reduced LVEF.

Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity.

The SUMMIT trial showed that tirzepatide, a dual GIP/GLP-1 receptor agonist, significantly reduced heart failure hospitalization and cardiovascular death in patients with HFpEF and obesity, with substantial improvements in symptoms, quality of life, and body weight. This establishes tirzepatide alongside semaglutide as a transformative therapy for obesity-related heart failure.

Continuation versus Interruption of Oral Anticoagulation during TAVI.

This NEJM trial showed that continuation of oral anticoagulation during TAVI was noninferior to interruption for the composite of bleeding and thromboembolic events. The result simplifies periprocedural management by avoiding the complexity of anticoagulation bridging.

Coronary CT angiography-guided management of patients with stable chest pain

10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland.

The 10-year SCOT-HEART follow-up confirmed that coronary CT angiography-guided management of stable chest pain provides sustained cardiovascular benefit, with persistent reductions in MI. The long-term data support CCTA as a cost-effective first-line investigation.

Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation.

This trial demonstrated that abelacimab, a factor XI-targeting monoclonal antibody, significantly reduced major bleeding compared with rivaroxaban while maintaining comparable efficacy in stroke prevention in patients with atrial fibrillation. After the failure of the small-molecule FXIa inhibitor asundexian, abelacimab revives the prospect of safer anticoagulation through factor XI inhibition.

Oral Muvalaplin for Lowering of Lipoprotein(a)

A Randomized Clinical Trial.

This randomized trial demonstrated that muvalaplin, the first oral lipoprotein(a) inhibitor, produced dose-dependent Lp(a) reductions of up to 85% with an acceptable safety profile. An oral Lp(a)-lowering agent could dramatically expand access to treatment compared with injectable alternatives like olpasiran and pelacarsen.

Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis

The EVOLVED Randomized Clinical Trial.

The EVOLVED trial demonstrated that early aortic valve intervention guided by myocardial fibrosis on cardiac MRI reduced all-cause death and unplanned heart failure hospitalization in patients with asymptomatic severe aortic stenosis. The results support an imaging-guided, proactive approach to valve replacement timing.

Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid Regurgitation

The Tri.Fr Randomized Clinical Trial.

The Tri.Fr trial showed that transcatheter edge-to-edge repair for severe isolated tricuspid regurgitation significantly improved functional capacity and quality of life compared with optimal medical therapy alone. The results advance the interventional management of tricuspid valve disease.

Transcatheter Valve Replacement in Severe Tricuspid Regurgitation.

This NEJM trial showed that transcatheter tricuspid valve replacement significantly improved symptoms, quality of life, and functional status in patients with severe tricuspid regurgitation. The results establish transcatheter replacement as a viable option for severe TR when repair alone may be insufficient.

Plozasiran for Managing Persistent Chylomicronemia and Pancreatitis Risk.

This NEJM trial demonstrated that plozasiran, an siRNA targeting APOC3, dramatically reduced triglycerides and prevented pancreatitis episodes in patients with persistent chylomicronemia from both genetic and multifactorial causes. The twice-yearly injectable provides a definitive solution for this life-threatening lipid disorder.

Efficacy and Safety of Finerenone Across the Ejection Fraction Spectrum in Heart Failure With Mildly Reduced or Preserved Ejection Fraction

A Prespecified Analysis of the FINEARTS-HF Trial.

This FINEARTS-HF subanalysis confirmed that finerenone's benefit on heart failure events is consistent across the entire ejection fraction spectrum from 40% to 100%. The uniform effect establishes finerenone as a broadly applicable therapy for heart failure with mildly reduced or preserved ejection fraction.

Asundexian versus Apixaban in Patients with Atrial Fibrillation.

The OCEANIC-AF trial showed that asundexian, a factor XIa inhibitor, was inferior to apixaban in preventing stroke and systemic embolism in patients with atrial fibrillation, without a meaningful reduction in bleeding. This definitive negative result dampened expectations for factor XIa inhibition as a replacement for standard anticoagulation in AF.

PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation.

This NEJM trial showed that PCI of coronary stenoses before TAVR did not improve the composite of death or cardiovascular hospitalization compared with conservative management. The result argued against routine pre-TAVR coronary revascularization in patients with stable coronary disease.

Cardiovascular, Kidney, and Safety Outcomes With GLP-1 Receptor Agonists Alone and in Combination With SGLT2 Inhibitors in Type 2 Diabetes

A Systematic Review and Meta-Analysis.

This comprehensive meta-analysis confirmed that GLP-1 receptor agonists and SGLT2 inhibitors provide complementary cardiovascular and kidney protection in patients with type 2 diabetes. The combination yields additive benefits on MACE, heart failure, and renal outcomes, supporting dual cardiometabolic therapy.

Effect of Screening for Undiagnosed Atrial Fibrillation on Stroke Prevention.

This randomized trial of AF screening versus usual care demonstrated that screening detects more undiagnosed AF and increases anticoagulation initiation, though the impact on stroke incidence was not statistically significant. Larger, longer-term studies are needed to demonstrate the clinical benefit of population-level AF screening.

Transcatheter Repair versus Mitral-Valve Surgery for Secondary Mitral Regurgitation.

The MATTERHORN trial demonstrated that transcatheter edge-to-edge mitral valve repair was noninferior to surgical mitral valve intervention for reducing mitral regurgitation severity in patients with heart failure and secondary MR, with fewer perioperative complications. The results support the transcatheter approach as a less invasive alternative.

Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation.

The RESHAPE-HF2 trial showed that transcatheter mitral valve repair improved outcomes in patients with heart failure and moderate-to-severe secondary mitral regurgitation, adding to the COAPT evidence for device therapy in functional MR. The positive result helps define the patient population that benefits from intervention.

Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe)

a multicentre, randomised, non-inferiority trial.

The FAVOR III Europe trial demonstrated that quantitative flow ratio (QFR) was noninferior to fractional flow reserve (FFR) for guiding coronary revascularization decisions. The wire-free, computational approach offers a practical and time-saving alternative to pressure-based physiological assessment.

Invasive Treatment Strategy for Older Patients with Myocardial Infarction.

This NEJM trial demonstrated that an invasive treatment strategy in patients aged 80 years or older with non-STEMI significantly reduced the composite of MI, urgent revascularization, stroke, and death compared with conservative management. The results support active intervention even in the oldest-old MI population.

Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction

An Individual Patient Meta-Analysis.

This individual patient data analysis confirmed that complete revascularization is superior to culprit-only PCI in older patients with STEMI and multivessel disease, consistent with the primary FIRE trial results. The pooled evidence supports complete revascularization regardless of age.

Adjudication of Hospitalizations and Deaths in the IRONMAN Trial of Intravenous Iron for Heart Failure.

This adjudicated reanalysis of the IRONMAN trial confirmed that intravenous ferric derisomaltose reduces heart failure hospitalization in patients with heart failure and iron deficiency, strengthening the evidence when accounting for misclassified events in the original analysis.

Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

The FINEARTS-HF trial demonstrated that finerenone significantly reduced heart failure events in patients with HFmrEF and HFpEF, extending the benefit of mineralocorticoid receptor antagonism beyond HFrEF. This landmark result establishes finerenone as the first nonsteroidal MRA with proven efficacy across the broader heart failure spectrum.

Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW Trial.

This FLOW subanalysis demonstrated that semaglutide significantly reduces heart failure events in patients with type 2 diabetes and chronic kidney disease. The cardiorenal protective effect positions GLP-1 receptor agonists alongside SGLT2 inhibitors as foundational therapy for the diabetic cardiorenal population.

Beta-Blocker Interruption or Continuation after Myocardial Infarction.

The REDUCE-AMI trial showed that continuation versus interruption of long-term beta-blocker therapy after myocardial infarction in patients with preserved ejection fraction made no difference in the composite of death or MI. Together with ABYSS, this provides definitive evidence that beta-blockers can be safely discontinued after MI when LVEF is preserved.

Semaglutide and blood pressure

an individual patient data meta-analysis.

This individual patient data meta-analysis showed that semaglutide produces dose-dependent and clinically significant blood pressure reduction independent of weight loss. The antihypertensive effect adds another mechanism through which GLP-1 receptor agonists provide cardiovascular protection.

2024 ESC Guidelines for the management of elevated blood pressure and hypertension.

The 2024 ESC hypertension guidelines lowered the treatment threshold to 130/80 mmHg and set a target of 120–129/70–79 mmHg for most patients, converging with the evidence from SPRINT and STEP. The guideline endorses initial combination therapy and emphasizes home blood pressure monitoring as central to management.

2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).

The 2024 ESC atrial fibrillation guidelines introduced the AF-CARE pathway (Comorbidities and risk factors, Anticoagulation, Rate and Rhythm control, Evaluation and reassessment) as a structured management approach. The guideline recognized pulsed field ablation as a new technique and emphasized weight management and early rhythm control.

2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2024 ACC Expert Consensus provided a structured decision pathway for clinical assessment, management, and trajectory of HFpEF patients during hospitalization, including fluid management, SGLT2 inhibitor initiation, and transition to outpatient care.

Mineralocorticoid receptor antagonists in heart failure

an individual patient level meta-analysis.

This individual patient data meta-analysis confirmed that mineralocorticoid receptor antagonists significantly improve survival in patients with HFrEF, with consistent benefit across subgroups. The analysis found insufficient evidence for benefit in HFpEF, underscoring the distinct role of nonsteroidal MRAs like finerenone in that population.

Temporary mechanical circulatory support in infarct-related cardiogenic shock

an individual patient data meta-analysis of randomised trials with 6-month follow-up.

This individual patient data meta-analysis of mechanical circulatory support in cardiogenic shock showed that Impella CP (from DanGer Shock) provides survival benefit, while ECMO (from ECLS-SHOCK) does not. The analysis established Impella as the preferred percutaneous support device for infarct-related cardiogenic shock.

Zodasiran, an RNAi Therapeutic Targeting ANGPTL3, for Mixed Hyperlipidemia.

This NEJM trial of zodasiran, an siRNA targeting ANGPTL3, demonstrated significant reductions in triglycerides, LDL cholesterol, and non-HDL cholesterol in patients with mixed hyperlipidemia. The results establish a new RNA-based mechanism for comprehensive lipid lowering beyond PCSK9 and APOC3 targets.

Plozasiran, an RNA Interference Agent Targeting APOC3, for Mixed Hyperlipidemia.

This NEJM trial of plozasiran, an RNA interference agent targeting APOC3, demonstrated dramatic triglyceride and VLDL reduction in patients with mixed hyperlipidemia. The twice-yearly injectable offers a durable approach to treating triglyceride-rich lipoprotein excess, a key driver of residual cardiovascular risk.

Semaglutide versus placebo in patients with heart failure and mildly reduced or preserved ejection fraction

a pooled analysis of the SELECT, FLOW, STEP-HFpEF, and STEP-HFpEF DM randomised trials.

This pooled analysis of semaglutide trials in HFpEF with ejection fraction ≥40% and obesity confirmed significant improvements in symptoms, exercise function, body weight, and inflammation markers. The consistent benefit across the mildly reduced and preserved ejection fraction spectrum supports semaglutide as a core therapy for the obesity-HFpEF phenotype.

Ticagrelor monotherapy for acute coronary syndrome

an individual patient data meta-analysis of TICO and T-PASS trials.

This individual patient data meta-analysis of four trials confirmed that ticagrelor monotherapy after short-duration DAPT in ACS patients reduces bleeding without increasing ischemic events. The pooled patient-level data provide the highest level of evidence for this de-escalation strategy.

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure

a prespecified analysis of the SELECT trial.

This SELECT subanalysis showed that semaglutide reduces cardiovascular events in obese patients with prevalent heart failure, with consistent benefit across heart failure subtypes. The finding supports GLP-1 receptor agonists for cardiovascular prevention in the obesity-heart failure overlap population.

Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke

an open-label, blinded-outcome, randomised trial.

This meta-analysis confirmed that targeting a systolic blood pressure below 120 mmHg versus below 140 mmHg significantly reduces cardiovascular events and mortality in patients with high cardiovascular risk, including those with diabetes. The data reinforce aggressive blood pressure targets.

Long-term colchicine for the prevention of vascular recurrent events in non-cardioembolic stroke (CONVINCE)

a randomised controlled trial.

The CONVINCE trial showed that long-term colchicine did not significantly reduce recurrent vascular events after non-cardioembolic stroke. The negative result suggested that the anti-inflammatory benefit of colchicine in coronary disease may not extend to all atherothrombotic vascular beds.

Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes.

The FLOW trial demonstrated that semaglutide significantly slowed kidney disease progression in patients with type 2 diabetes and CKD, reducing the composite of sustained eGFR decline, kidney failure, and renal or cardiovascular death. The trial was stopped early for efficacy, establishing GLP-1 receptor agonists as a new renoprotective therapy alongside SGLT2 inhibitors.

Plozasiran (ARO-APOC3) for Severe Hypertriglyceridemia

The SHASTA-2 Randomized Clinical Trial.

The SHASTA-2 trial demonstrated that plozasiran, an siRNA targeting APOC3, dramatically reduces triglycerides in patients with severe hypertriglyceridemia. The twice-yearly injectable offers a transformative approach for this hard-to-treat lipid disorder and its associated pancreatitis risk.

Revisiting Race and the Benefit of RAS Blockade in Heart Failure

A Meta-Analysis of Randomized Clinical Trials.

This JAMA meta-analysis demonstrated that RAAS blockade provides equal mortality benefit in Black and non-Black patients with HFrEF, debunking the long-held assumption that RAAS inhibitors are less effective in Black patients. The finding supports equitable heart failure treatment regardless of race.

Invasive vs. conservative management of older patients with non-ST-elevation acute coronary syndrome

individual patient data meta-analysis.

This individual patient data meta-analysis confirmed that early invasive management reduces MI and repeat revascularization in older patients with NSTE-ACS compared with conservative management. The pooled evidence supports active intervention in elderly ACS patients.

Self-Expanding or Balloon-Expandable TAVR in Patients with a Small Aortic Annulus.

The SMART trial showed that balloon-expandable TAVR achieved significantly better hemodynamic performance than self-expanding TAVR in patients with a small aortic annulus. The results provided guidance for device selection in this challenging anatomical subset.

Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes

A SMART-C Collaborative Meta-Analysis.

This SMART-C collaborative meta-analysis of all major SGLT2 inhibitor trials confirmed that the class reduces heart failure hospitalization and kidney outcomes across all patient populations, while MACE reduction was primarily seen in patients with type 2 diabetes and atherosclerotic disease. The analysis provides the definitive summary of SGLT2 inhibitor cardiovascular evidence.

Pulmonary arterial hypertension treatment

an individual participant data network meta-analysis.

This individual participant data network meta-analysis of all PAH therapies demonstrated that initial combination therapy, including regimens with sotatercept, was superior to monotherapy for improving exercise capacity and clinical outcomes. The results support upfront combination treatment as the standard of care in PAH.

Intensive Ambulance-Delivered Blood-Pressure Reduction in Hyperacute Stroke.

This NEJM trial evaluated intensive ambulance-delivered blood pressure reduction in the hyperacute stroke phase, before distinction between ischemic and hemorrhagic subtypes. The prehospital intervention approach represents a novel strategy to improve neurological outcomes through very early blood pressure management.

Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage.

The ANNEXA-I trial demonstrated that andexanet alfa, a factor Xa inhibitor reversal agent, significantly reduced hematoma expansion compared with usual care in patients with acute intracerebral hemorrhage while taking factor Xa inhibitors. This provides the first randomized evidence for a specific reversal strategy in anticoagulant-associated intracranial bleeding.

Olezarsen for Hypertriglyceridemia in Patients at High Cardiovascular Risk.

This NEJM trial showed that olezarsen reduced triglycerides by more than 50% in patients with hypertriglyceridemia and high cardiovascular risk. Unlike fibrates (PROMINENT), APOC3 inhibition reduces both triglycerides and apolipoprotein B-containing lipoproteins, positioning it as a more promising triglyceride-lowering strategy.

Olezarsen, Acute Pancreatitis, and Familial Chylomicronemia Syndrome.

This NEJM trial demonstrated that olezarsen, an antisense oligonucleotide targeting APOC3, dramatically reduced triglyceride levels and virtually eliminated acute pancreatitis episodes in patients with familial chylomicronemia syndrome. The results represent a transformative therapy for this severe, previously intractable genetic condition.

Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS)

a two-stage, multicentre, randomised trial.

The IVUS-ACS trial showed that IVUS-guided PCI significantly reduced target vessel failure compared with angiography-guided PCI in patients with acute coronary syndromes. This was the first randomized trial demonstrating the superiority of intravascular imaging guidance specifically in the ACS setting.

Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT)

a randomised, placebo-controlled, double-blind clinical trial.

This Lancet trial confirmed that ticagrelor monotherapy after 1 month of DAPT in ACS patients reduces bleeding without increasing ischemic events, adding to the robust evidence for early aspirin discontinuation in P2Y12-based antiplatelet strategies.

Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT)

a multicentre, open-label, randomised controlled trial.

The PREVENT trial demonstrated that preventive PCI of vulnerable atherosclerotic plaques identified by intravascular imaging (IVUS/OCT) reduced future coronary events compared with optimal medical therapy alone. This landmark result established a new treatment paradigm of prophylactic intervention for high-risk non-flow-limiting lesions.

Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction.

The AEGIS-II trial showed that infusion of recombinant apolipoprotein A1 (CSL112) after acute MI did not reduce the risk of MACE compared with placebo. The HDL-mimetic approach to reverse cholesterol transport did not translate to clinical cardiovascular benefit.

Ticagrelor or Clopidogrel Monotherapy vs Dual Antiplatelet Therapy After Percutaneous Coronary Intervention

A Systematic Review and Patient-Level Meta-Analysis.

This patient-level meta-analysis confirmed that P2Y12 inhibitor monotherapy (ticagrelor or clopidogrel) after a short course of DAPT reduces major bleeding compared with standard 12-month DAPT without increasing ischemic events. The pooled evidence definitively supports de-escalation to single antiplatelet therapy.

Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction

a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials.

This pooled analysis of STEP-HFpEF and STEP-HFpEF DM confirmed that semaglutide consistently improves quality of life, body weight, CRP, and NT-proBNP in patients with obesity-related HFpEF regardless of diabetes status. The combined data strengthened the evidence for GLP-1 receptor agonists in this population.

FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction.

The FRAME-AMI trial showed that FFR-guided complete revascularization of nonculprit lesions resulted in fewer stent implantations with comparable clinical outcomes versus routine angiography-guided complete PCI in patients with STEMI and multivessel disease. FFR guidance may reduce overtreatment without compromising safety.

Empagliflozin after Acute Myocardial Infarction.

The DAPA-MI trial showed that empagliflozin after acute MI in patients without heart failure or diabetes did not significantly improve the hierarchical composite of cardiovascular outcomes. The result suggested that the benefit of SGLT2 inhibitors in MI may be limited to patients with established heart failure or diabetes.

Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction.

The ABYSS trial showed that long-term beta-blocker therapy after myocardial infarction in patients with preserved left ventricular ejection fraction did not reduce the composite of death, MI, or stroke. This challenges the decades-long standard of routine post-MI beta-blocker therapy in the modern era of early reperfusion and comprehensive secondary prevention.

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock.

The DanGer Shock trial demonstrated that the Impella CP microaxial flow pump significantly reduced 180-day all-cause mortality compared with standard care in patients with STEMI-related cardiogenic shock. This is the first positive randomized trial of a percutaneous mechanical circulatory support device in cardiogenic shock.

Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes.

The STEP-HFpEF-DM trial demonstrated that semaglutide 2.4 mg significantly improved heart failure symptoms, physical limitations, and body weight in patients with HFpEF, obesity, and type 2 diabetes. The findings extended the benefit seen in STEP-HFpEF to the diabetes subpopulation, confirming that GLP-1 receptor agonists address the obesity-HFpEF phenotype regardless of glycemic status.

2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2024 ACC Expert Consensus for HFrEF endorsed simultaneous initiation of four-pillar therapy (SGLT2 inhibitor, ARNI, beta-blocker, MRA) rather than sequential titration, with practical algorithms for rapid optimization, including in-hospital initiation during heart failure admissions.

Transcatheter or surgical aortic valve implantation

10-year outcomes of the NOTION trial.

The 10-year NOTION results showed comparable survival between TAVR and surgical aortic valve replacement in low-risk patients, though more TAVR patients required reintervention for valve degeneration. The long-term data raised questions about structural valve durability that newer-generation devices may address.

Direct Oral Anticoagulants for Stroke Prevention in Patients With Device-Detected Atrial Fibrillation

A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials.

This meta-analysis of NOAH-AFNET 6 and ARTESIA showed that DOACs modestly reduce stroke in patients with device-detected subclinical AF but significantly increase bleeding. The pooled data suggest that anticoagulation may be warranted only in selected high-risk patients with subclinical AF.

Intravascular imaging-guided coronary drug-eluting stent implantation

an updated network meta-analysis.

This updated Lancet network meta-analysis confirmed that intravascular imaging-guided DES implantation (either IVUS or OCT) is superior to angiography-guided PCI for reducing cardiovascular death, MI, and stent thrombosis. The comprehensive analysis supported routine imaging guidance for coronary stenting.

Impact of Bempedoic Acid on Total Cardiovascular Events

A Prespecified Analysis of the CLEAR Outcomes Randomized Clinical Trial.

This CLEAR Outcomes analysis of total cardiovascular events (including recurrent) showed that bempedoic acid significantly reduces the total burden of cardiovascular events in statin-intolerant patients, with greater absolute benefit than suggested by first-event analysis alone.

An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting

STOPDAPT-3 Randomized Trial.

The STOPDAPT-3 trial tested an aspirin-free strategy (prasugrel monotherapy from day 1) versus standard DAPT after PCI. While the aspirin-free approach was noninferior for a net clinical benefit endpoint, the study raised questions about the bleeding-ischemia trade-off with immediate aspirin omission.

Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome

The T-PASS Randomized Noninferiority Trial.

The T-PASS trial showed that stopping aspirin within 1 month after DES implantation for ticagrelor monotherapy in ACS patients was noninferior to 12-month DAPT for ischemic events and reduced major bleeding. The results supported very early aspirin discontinuation specifically in the ACS population.

Safety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized Trials.

This individual patient data meta-analysis confirmed that early aspirin cessation with ticagrelor monotherapy after ACS and PCI is safe with significantly less bleeding, without increasing the risk of ischemic events. The pooled patient-level evidence provides the strongest support for this de-escalation strategy.

Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction.

This analysis demonstrated that implantable pulmonary artery pressure monitors not only reduce heart failure hospitalization but also improve survival in patients with HFrEF. The mortality benefit adds a new dimension to the value proposition of hemodynamic-guided heart failure management.

Long-Term Outcomes of Resynchronization-Defibrillation for Heart Failure.

The RAFT trial 14-year follow-up showed that CRT-D provides sustained survival benefit over ICD alone in patients with HFrEF and wide QRS. These are among the longest-term randomized data supporting cardiac resynchronization therapy.

Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation.

The ARTESIA trial showed that apixaban reduced the risk of stroke and systemic embolism by 37% compared with aspirin in patients with subclinical atrial fibrillation detected by implanted cardiac devices, but at the cost of increased major bleeding. The results support individualized anticoagulation decisions based on stroke risk factors in patients with device-detected AF.

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2023 ACC/AHA/ACCP/HRS AF guideline (JACC edition) provides comprehensive updated recommendations for atrial fibrillation, including a new staging classification, early rhythm-control strategy, catheter ablation as first-line therapy in selected patients, and integrated management of AF risk factors including obesity.

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline introduced a new four-stage classification system (stages 1–4), emphasized early rhythm control, endorsed catheter ablation as a first-line option for selected patients, and highlighted weight management as a disease-modifying intervention. The guideline represents a fundamental shift toward proactive AF management.

Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia.

The REALITY trial demonstrated that a restrictive transfusion strategy (hemoglobin threshold <8 g/dL) was noninferior to a liberal strategy (<10 g/dL) for the composite of death, MI, stroke, or emergency revascularization in patients with acute MI and anemia. The results support conservative transfusion thresholds even in acute coronary syndromes.

A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina.

ORBITA-2, a double-blind, placebo-controlled trial in patients with stable angina who were not receiving antianginal medications, showed that PCI significantly improved angina symptoms compared with a sham procedure. This resolved the debate from ORBITA-1 by confirming a true symptomatic benefit of PCI in appropriately selected patients with objectified ischemia.

Efficacy of ferric carboxymaltose in heart failure with iron deficiency

an individual patient data meta-analysis.

This individual patient data meta-analysis of all ferric carboxymaltose trials in heart failure confirmed that IV iron reduces heart failure hospitalization and cardiovascular death, with the most robust benefit in reducing recurrent hospitalizations. The analysis provided the pooled evidence that individual trials alone could not deliver.

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.

The SELECT trial demonstrated that semaglutide 2.4 mg reduced major adverse cardiovascular events by 20% in patients with overweight or obesity and established atherosclerotic disease but without diabetes. This landmark result established GLP-1 receptor agonists as a cardiovascular preventive therapy independent of glycemic control.

Zibotentan in combination with dapagliflozin compared with dapagliflozin in patients with chronic kidney disease (ZENITH-CKD)

a multicentre, randomised, active-controlled, phase 2b, clinical trial.

The ZENITH-CKD trial showed that adding zibotentan (an endothelin A receptor antagonist) to dapagliflozin significantly reduced albuminuria in patients with CKD compared with dapagliflozin alone. The combination approach offers enhanced kidney protection through complementary mechanisms.

Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years.

The 5-year PARTNER 3 follow-up confirmed that outcomes after TAVR remained comparable to surgical aortic valve replacement in low-risk patients with severe aortic stenosis. Valve durability was maintained with no excess structural valve deterioration, supporting TAVR as a viable long-term option across risk categories.

Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation.

The ADVENT trial demonstrated that pulsed field ablation was noninferior to conventional thermal ablation (radiofrequency or cryoablation) for the treatment of paroxysmal atrial fibrillation, with a comparable safety profile. This established PFA as a safe and effective tissue-selective alternative for pulmonary vein isolation.

Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes of Patients With Acute Myocardial Infarction

The CTS-AMI Randomized Clinical Trial.

The CTS-AMI mega-trial demonstrated that Tongxinluo, a traditional Chinese medicine compound, significantly reduced cardiovascular events after STEMI when added to guideline-directed therapy. The large, rigorous trial provided the first high-quality randomized evidence for a TCM compound in acute coronary care.

Optical Coherence Tomography-Guided versus Angiography-Guided PCI.

The ILUMIEN IV trial showed that OCT-guided PCI improved the procedural quality (minimum stent area) but did not significantly reduce the clinical composite of cardiac death or MI compared with angiography-guided PCI at 2 years. The study highlighted the gap between procedural optimization and hard clinical outcomes.

OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions.

The OCTOBER trial demonstrated that OCT-guided PCI for complex bifurcation lesions reduced the composite of cardiac death, target-lesion MI, or target-lesion revascularization by 57% compared with angiography-guided PCI. This established OCT as a valuable guidance tool specifically for bifurcation intervention.

Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease

An Individual Participant Meta-Analysis.

This individual participant meta-analysis showed that patients with orthostatic hypotension derive equal cardiovascular benefit from intensive blood pressure treatment as those without, without an increased risk of falls or syncope. The results argued against withholding aggressive treatment due to orthostatic hypotension.

Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention

The OCTIVUS Randomized Clinical Trial.

The OCTIVUS trial demonstrated that OCT-guided PCI was noninferior to IVUS-guided PCI for clinical outcomes. The result established OCT and IVUS as interchangeable intravascular imaging modalities for guiding coronary intervention.

Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock

an individual patient data meta-analysis of randomised trials.

This individual patient data meta-analysis confirmed that VA-ECMO does not improve survival in patients with infarct-related cardiogenic shock, with pooled data from randomized trials showing no mortality benefit but increased limb complications. The analysis definitively discouraged routine ECMO use in this setting.

Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction.

The MULTISTARS AMI trial showed that immediate complete revascularization during the index primary PCI procedure was superior to staged revascularization within 45 days for reducing cardiovascular death or MI in patients with STEMI and multivessel disease. The results support a one-stop-shop approach when feasible.

Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation.

The CASTLE-HTx trial demonstrated that catheter ablation for atrial fibrillation in patients with end-stage heart failure (on LVAD or transplant waiting list) dramatically improved survival, with a 44% relative reduction in the composite of death, LVAD implantation, or urgent heart transplantation. The results extend the benefit of AF ablation to the most severely ill heart failure patients.

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock.

The ECLS-SHOCK trial showed that routine extracorporeal membrane oxygenation (ECMO) did not improve 30-day survival compared with standard care in patients with infarct-related cardiogenic shock. This large, definitive trial ended the enthusiasm for routine ECLS in MI-associated cardiogenic shock.

Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

This PURE study analysis demonstrated that five modifiable risk factors (hypertension, dyslipidemia, diabetes, obesity, and smoking) account for the majority of cardiovascular disease and mortality worldwide, with regional variation in their relative contributions. The individual-level data across 21 countries provided the definitive global picture of attributable cardiovascular risk.

Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes

An Individual-Participant Data Meta-Analysis.

This mega-scale individual participant data meta-analysis confirmed that low eGFR and albuminuria independently and additively predict cardiovascular events and mortality. The combined assessment provides superior risk stratification compared with either marker alone.

Mineralocorticoid receptor antagonists with sodium-glucose co-transporter-2 inhibitors in heart failure

a meta-analysis.

This meta-analysis showed that combining an MRA with an SGLT2 inhibitor in heart failure provides additive reductions in cardiovascular death and heart failure hospitalization beyond either drug class alone. The findings support the four-pillar approach including dual neurohormonal and metabolic modulation.

Efficacy of pulmonary artery pressure monitoring in patients with chronic heart failure

a meta-analysis of three randomized controlled trials.

This meta-analysis of CHAMPION, GUIDE-HF, and MONITOR-HF confirmed that implantable pulmonary artery pressure monitoring significantly reduces heart failure hospitalization in chronic heart failure. The pooled evidence across three continents supported the clinical utility of hemodynamic monitoring.

Anticoagulation with Edoxaban in Patients with Atrial High-Rate Episodes.

The NOAH-AFNET 6 trial found that edoxaban did not significantly reduce cardiovascular events compared with placebo in patients with device-detected atrial high-rate episodes (AHREs) but without clinical atrial fibrillation, while increasing major bleeding. The results do not support routine anticoagulation for subclinical atrial arrhythmias detected by cardiac devices.

Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity.

The STEP-HFpEF trial showed that weekly semaglutide 2.4 mg in patients with HFpEF and obesity dramatically improved heart failure symptoms, physical limitations, and quality of life, with a mean 13% body weight reduction. This landmark result established GLP-1 receptor agonists as a transformative therapy for the obesity-HFpEF phenotype.

Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease

3-Year Follow-Up of the FAME 3 Trial.

Three-year FAME 3 follow-up confirmed that FFR-guided PCI did not achieve noninferiority versus CABG for three-vessel coronary disease, with CABG maintaining lower rates of revascularization and MI. The extended data reinforced CABG as the standard for complex multivessel disease.

Ferric Carboxymaltose in Heart Failure with Iron Deficiency.

The HEART-FID trial showed that intravenous ferric carboxymaltose in patients with HFrEF and iron deficiency did not significantly improve the hierarchical composite of death, heart failure hospitalization, and 6-minute walk distance. The neutral result contrasted with positive findings from AFFIRM-AHF and IRONMAN.

Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction.

The FIRE trial demonstrated that complete revascularization reduced cardiovascular death or MI compared with culprit-only PCI in patients aged 75 or older with MI and multivessel disease. The results extended the benefit of complete revascularization to the elderly population previously excluded from major trials.

Daily Oral GLP-1 Receptor Agonist Orforglipron for Adults with Obesity.

This NEJM phase 2 trial demonstrated that orforglipron, an oral nonpeptide GLP-1 receptor agonist, produced dose-dependent weight loss of up to 14.7% in adults with obesity. The results positioned oral GLP-1 therapy as a practical alternative to injectable formulations for obesity treatment.

Pitavastatin to Prevent Cardiovascular Disease in HIV Infection.

The REPRIEVE trial demonstrated that pitavastatin reduced major cardiovascular events by 35% in people living with HIV who had low-to-moderate cardiovascular risk. The trial was stopped early for efficacy, providing the first definitive evidence for statin therapy in primary cardiovascular prevention among HIV-infected individuals.

Fixed dose combination therapies in primary cardiovascular disease prevention in different groups

an individual participant meta-analysis.

This individual participant data meta-analysis from three randomized trials confirmed that fixed-dose combination therapy (polypill) reduces cardiovascular events in primary prevention across different age groups. The consistent benefit supports the polypill strategy as a population-level intervention.

Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction

a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF.

This participant-level pooled analysis of PARAGON-HF, PARADIGM-HF, and PARAGLIDE-HF confirmed that sacubitril-valsartan reduces NT-proBNP and heart failure events in patients with HFmrEF and HFpEF (EF ≥40%), particularly those with lower LVEF within this range.

Retatrutide, a GIP, GLP-1 and glucagon receptor agonist, for people with type 2 diabetes

a randomised, double-blind, placebo and active-controlled, parallel-group, phase 2 trial conducted in the USA.

This Lancet phase 2 trial of retatrutide, a triple GIP/GLP-1/glucagon receptor agonist, demonstrated up to 24% weight loss and dramatic HbA1c improvement in patients with type 2 diabetes. The results surpassed those of dual incretin agonists, establishing triple agonism as the next frontier in metabolic therapeutics.

Atorvastatin for Anthracycline-Associated Cardiac Dysfunction

The STOP-CA Randomized Clinical Trial.

The STOP-CA trial showed that atorvastatin significantly attenuated the decline in left ventricular ejection fraction in patients receiving anthracycline chemotherapy. The result established statins as a potential cardioprotective strategy during cancer treatment.

GLP-1 Receptor Agonist Therapy With and Without SGLT2 Inhibitors in Patients With Type 2 Diabetes.

This analysis demonstrated that GLP-1 receptor agonists and SGLT2 inhibitors provide complementary cardiovascular benefits when used together in type 2 diabetes, with additive reductions in MACE and heart failure events. The findings support dual cardiometabolic therapy in eligible patients.

Zilebesiran, an RNA Interference Therapeutic Agent for Hypertension.

This first-in-human study of zilebesiran, an RNA interference agent targeting hepatic angiotensinogen, demonstrated sustained blood pressure reduction for up to 24 weeks after a single subcutaneous injection. The findings represent a potential paradigm shift toward ultra-long-acting antihypertensive therapy requiring only biannual dosing.

Phase 1 Trial of Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid.

This first-in-human phase 1 trial showed that NI006, a monoclonal antibody targeting transthyretin amyloid deposits, can reduce cardiac amyloid burden in patients with ATTR cardiomyopathy. This represents the first therapeutic approach aimed at clearing existing amyloid deposits rather than just preventing new deposition.

Cardiovascular Safety of Testosterone-Replacement Therapy.

The TRAVERSE trial demonstrated that testosterone-replacement therapy in middle-aged and older men with hypogonadism and cardiovascular risk factors did not increase the incidence of major adverse cardiovascular events. This large safety trial resolved decades of uncertainty about the cardiovascular risks of testosterone therapy.

P2Y12 Inhibitor or Aspirin Monotherapy for Secondary Prevention of Coronary Events.

This meta-analysis confirmed that P2Y12 inhibitor monotherapy is superior to aspirin for long-term secondary prevention of coronary events, with fewer ischemic events (especially stroke) and no increase in bleeding. The data support replacing aspirin with clopidogrel as the default post-DAPT agent.

The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3)

an international, stepped wedge cluster randomised controlled trial.

The INTERACT3 trial showed that a goal-directed care bundle with early intensive blood pressure lowering improved functional outcomes in patients with acute intracerebral hemorrhage. The pragmatic, cluster-randomized design demonstrated that structured care protocols can improve outcomes at scale.

Early versus Later Anticoagulation for Stroke with Atrial Fibrillation.

The ELAN trial showed that early initiation of DOACs (within 48 hours for mild stroke, within 6–7 days for moderate stroke) after ischemic stroke in patients with atrial fibrillation was safe and associated with fewer recurrent strokes compared with later initiation. The results support a move toward earlier anticoagulation in this high-risk population.

Effect of SGLT2 Inhibitors on Cardiovascular Outcomes Across Various Patient Populations.

This comprehensive JACC review summarized the effects of SGLT2 inhibitors across all studied populations — HFrEF, HFpEF, CKD, and type 2 diabetes — providing a unified overview of their cardiovascular and renal benefits and positioning them as foundational cardiometabolic therapy.

Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF)

a randomised clinical trial.

The MONITOR-HF trial confirmed that remote pulmonary artery pressure monitoring (CardioMEMS) improved quality of life and reduced heart failure hospitalization in European patients with chronic heart failure treated with contemporary guideline-directed therapy. The results extended the evidence from the US-based CHAMPION trial.

Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy.

This NEJM trial demonstrated that treatment of gestational diabetes diagnosed before 20 weeks of pregnancy improved neonatal outcomes, with fewer macrosomic infants and less need for neonatal intensive care. The results extended the benefit of GDM treatment to earlier gestational ages.

Uptitrating Treatment After Heart Failure Hospitalization Across the Spectrum of Left Ventricular Ejection Fraction.

This STRONG-HF subanalysis showed that rapid up-titration of guideline-directed therapy after heart failure hospitalization was effective across the entire ejection fraction spectrum, including patients with HFpEF. The results expanded the aggressive post-discharge optimization approach beyond HFrEF.

Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function

Patient-Level Network Meta-Analyses From COMBINE AF.

This COMBINE AF patient-level meta-analysis confirmed that DOACs are superior to warfarin for stroke prevention across the full spectrum of kidney function in AF patients, including those with moderate-to-severe CKD. The data address a key uncertainty in anticoagulation management.

Efficacy and Safety of Low-Dose Triple and Quadruple Combination Pills vs Monotherapy, Usual Care, or Placebo for the Initial Management of Hypertension

A Systematic Review and Meta-analysis.

This meta-analysis confirmed that low-dose triple and quadruple combination antihypertensive pills are more effective than monotherapy for initial blood pressure treatment, with better control rates and comparable tolerability. The evidence supports multi-drug low-dose combinations as a first-line strategy.

Five-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation.

The 5-year COAPT follow-up confirmed durable benefit of transcatheter mitral valve repair with MitraClip in patients with heart failure and severe secondary mitral regurgitation, with sustained reductions in mortality and heart failure hospitalization compared with medical therapy alone.

A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2)

an open-label, randomised, multicentre, phase 3 trial.

The BEST-CLI trial demonstrated that vein bypass surgery was superior to endovascular therapy as the initial revascularization strategy for patients with chronic limb-threatening ischemia when a good-quality great saphenous vein was available. The result re-established surgical bypass as the preferred option in suitable candidates.

Transcatheter Repair for Patients with Tricuspid Regurgitation.

The TRILUMINATE trial demonstrated that transcatheter edge-to-edge repair (TriClip) for severe tricuspid regurgitation was safe and significantly reduced regurgitation severity, though it did not meet the primary composite endpoint of death or tricuspid-related surgery. The trial opened the door to transcatheter tricuspid valve intervention.

2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2023 ACC Expert Consensus provided a structured decision pathway for HFpEF management, positioning SGLT2 inhibitors as a cornerstone therapy alongside diuretics for volume management, GLP-1 receptor agonists for obesity, and targeted treatment of comorbidities.

Intravascular Imaging-Guided or Angiography-Guided Complex PCI.

The RENOVATE-COMPLEX-PCI trial showed that intravascular imaging-guided PCI (using IVUS or OCT) significantly reduced the composite of cardiac death, MI, or revascularization compared with angiography-guided PCI in patients with complex coronary lesions. The results provided definitive evidence for routine imaging guidance in complex interventions.

Phase 2b Randomized Trial of the Oral PCSK9 Inhibitor MK-0616.

This phase 2b trial of MK-0616, the first oral macrocyclic peptide PCSK9 inhibitor, demonstrated dose-dependent LDL cholesterol reductions of up to 60% with an acceptable safety profile. An oral PCSK9 inhibitor could dramatically expand access beyond injectable monoclonal antibodies and siRNA therapies.

Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension.

The STELLAR trial demonstrated that sotatercept, a first-in-class activin receptor fusion protein, dramatically improved exercise capacity, hemodynamics, and WHO functional class in patients with pulmonary arterial hypertension on background therapy. This represents the most significant therapeutic advance in PAH in over a decade, targeting the underlying proliferative pathophysiology.

Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes

An Analysis of FOURIER-OLE.

This long-term FOURIER analysis showed that very low achieved LDL cholesterol levels (below 20 mg/dL) with evolocumab were associated with the greatest cardiovascular risk reduction without excess safety concerns. The data supported pushing LDL targets as low as achievable.

Dual antiplatelet therapy de-escalation in acute coronary syndrome

an individual patient meta-analysis.

This individual patient data meta-analysis confirmed that de-escalation from potent P2Y12 inhibitors to clopidogrel after the acute phase of ACS safely reduces bleeding without increasing ischemic events. The pooled patient-level evidence definitively supported the de-escalation approach.

Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy

a collaborative analysis of three randomised trials.

This collaborative analysis of three major statin trials demonstrated that residual inflammation (hsCRP) and residual cholesterol (LDL) independently predict cardiovascular events in statin-treated patients. Patients with dual residual risk derive the most benefit from additional interventions.

Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients.

The CLEAR Outcomes trial showed that bempedoic acid, an oral ACL inhibitor that does not act in skeletal muscle, reduced major cardiovascular events by 13% in statin-intolerant patients with elevated LDL cholesterol. This provided a new evidence-based treatment option for patients unable to tolerate statin therapy.

Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs

A Randomized Clinical Trial.

This randomized crossover trial revealed substantial individual heterogeneity in blood pressure response to four different antihypertensive drug classes, with rotation of medications identifying the best-responding agent for each patient. The findings support personalized antihypertensive therapy through systematic drug rotation.

Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC)

a prospective, open-label, non-inferiority, randomised trial.

The BIOVASC trial showed that immediate complete revascularization during the index procedure was noninferior to staged complete PCI in patients with ACS and multivessel coronary disease, with similar rates of the composite primary endpoint at 1 year.

Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease

A Randomized Clinical Trial.

The LODESTAR trial showed that a treat-to-target approach (targeting LDL <70 mg/dL with dose adjustment) was noninferior to fixed high-intensity statin therapy for cardiovascular outcomes in patients with coronary artery disease. The results supported either strategy as acceptable in clinical practice.

Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP)

an open-label, blinded-endpoint, cluster-randomised trial.

This Lancet trial demonstrated that a community health worker-led intensive blood pressure intervention significantly reduced cardiovascular events compared with usual care in rural China. The scalable model addressed the critical shortage of physicians in low-resource settings.

Endovascular Ultrasound Renal Denervation to Treat Hypertension

The RADIANCE II Randomized Clinical Trial.

The RADIANCE II trial confirmed that ultrasound renal denervation significantly reduced blood pressure compared with a sham procedure in patients with mild-to-moderate hypertension, replicating the findings from RADIANCE-HTN SOLO with a refined study design.

Incidental Coronary Artery Calcium

Opportunistic Screening of Previous Nongated Chest Computed Tomography Scans to Improve Statin Rates (NOTIFY-1 Project).

The NOTIFY study demonstrated that AI-detected coronary artery calcium on non-gated chest CT scans, when reported to clinicians and patients, significantly increased statin prescribing. The opportunistic screening approach leveraged existing imaging to improve cardiovascular prevention without additional testing.

Catheter ablation improves cardiovascular outcomes in patients with atrial fibrillation and heart failure

a meta-analysis of randomized controlled trials.

This meta-analysis of randomized trials confirmed that catheter ablation for atrial fibrillation in heart failure patients significantly improves cardiovascular outcomes, including reductions in mortality and heart failure hospitalization. The pooled evidence strengthened the indication for AF ablation in the HF population.

Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock

Results of the ECMO-CS Randomized Clinical Trial.

The ECMO-CS trial showed that veno-arterial ECMO in cardiogenic shock was not associated with improved survival compared with standard medical therapy, consistent with the ECLS-SHOCK results. The negative finding discourages routine ECMO use in non-infarction cardiogenic shock.

Phase 2 Trial of Baxdrostat for Treatment-Resistant Hypertension.

This phase 2 NEJM trial of baxdrostat, the first selective aldosterone synthase inhibitor, demonstrated dose-dependent blood pressure reduction in patients with treatment-resistant hypertension. The results validated a new pharmacological target for the hardest-to-treat hypertension population.

Combining loop with thiazide diuretics for decompensated heart failure

the CLOROTIC trial.

The CLOROTIC trial showed that adding hydrochlorothiazide to furosemide in acute decompensated heart failure improved weight loss and urine output compared with furosemide alone, though it did not affect dyspnea or all-cause mortality. The results supported sequential nephron blockade as a diuretic strategy.

Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure

The TRANSFORM-HF Randomized Clinical Trial.

The TRANSFORM-HF trial found no difference in all-cause mortality between torsemide and furosemide in patients hospitalized for heart failure. This definitive pragmatic trial ended the long-standing hypothesis that torsemide's anti-aldosterone properties might confer a survival advantage over furosemide.

Cost-effectiveness of population screening for atrial fibrillation

the STROKESTOP study.

The STROKESTOP cost-effectiveness analysis showed that population-level screening for atrial fibrillation in 75-76-year-olds using intermittent ECG recordings is cost-effective, with favorable incremental cost per QALY gained. The economic evaluation complemented the clinical benefit demonstrated in the main trial.

Progression of Atrial Fibrillation after Cryoablation or Drug Therapy.

The 2-year EARLY-AF results showed that initial cryoablation therapy not only maintained better rhythm control but also significantly reduced progression from paroxysmal to persistent atrial fibrillation compared with antiarrhythmic drugs. This disease-modifying effect strengthened the case for early ablation intervention.

Empagliflozin in Patients with Chronic Kidney Disease.

The EMPA-KIDNEY trial demonstrated that empagliflozin reduced kidney disease progression and cardiovascular death in a broad population of patients with chronic kidney disease, including those without diabetes and those with only mildly reduced eGFR. The trial was stopped early for efficacy and extended the renal protection of SGLT2 inhibitors to virtually all CKD patients.

Effect of Catheter Ablation Using Pulmonary Vein Isolation With vs Without Posterior Left Atrial Wall Isolation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation

The CAPLA Randomized Clinical Trial.

The CAPLA trial showed that adding posterior left atrial wall isolation to standard pulmonary vein isolation did not significantly reduce AF recurrence in patients with persistent atrial fibrillation. The result argued against routine posterior wall ablation as an adjunctive strategy.

Prospective Association of Daily Steps With Cardiovascular Disease

A Harmonized Meta-Analysis.

This harmonized meta-analysis demonstrated a dose-response relationship between daily step count and cardiovascular disease risk, with as few as 2,000-3,000 steps per day providing measurable benefit. The findings established a practical, evidence-based physical activity target for cardiovascular prevention.

Aspirin Versus Clopidogrel for Long-Term Maintenance Monotherapy After Percutaneous Coronary Intervention

The HOST-EXAM Extended Study.

The HOST-EXAM Extended study confirmed the sustained superiority of clopidogrel over aspirin for long-term maintenance antiplatelet monotherapy after PCI, with fewer cardiovascular events and similar bleeding rates over extended follow-up.

Phase 2 Study of Aficamten in Patients With Obstructive Hypertrophic Cardiomyopathy.

This phase 2 study of aficamten, a next-generation cardiac myosin inhibitor, showed dose-dependent reduction of the LVOT gradient and symptom improvement in patients with obstructive hypertrophic cardiomyopathy. The results advanced aficamten toward phase 3 development as an alternative to mavacamten.

Comparative Effects of Low-Dose Rosuvastatin, Placebo, and Dietary Supplements on Lipids and Inflammatory Biomarkers.

This JACC study compared low-dose rosuvastatin with six popular dietary supplements (fish oil, cinnamon, garlic, turmeric, plant sterols, red yeast rice) for lipid and inflammatory biomarker effects. Only rosuvastatin significantly lowered LDL cholesterol, definitively demonstrating the inefficacy of supplements for cholesterol management.

Survival After Invasive or Conservative Management of Stable Coronary Disease.

Extended ISCHEMIA follow-up confirmed that an initial invasive strategy provided no survival benefit over conservative management in patients with stable coronary disease and moderate-to-severe ischemia. The durable finding reinforced medical therapy as a safe initial approach in this population.

Impact of empagliflozin on decongestion in acute heart failure

the EMPULSE trial.

This EMPULSE subanalysis showed that empagliflozin started during acute heart failure hospitalization significantly improved decongestion markers, including weight loss and hemoconcentration, supporting SGLT2 inhibitors as an adjunctive decongestion strategy.

Chlorthalidone vs. Hydrochlorothiazide for Hypertension-Cardiovascular Events.

This large pragmatic NEJM trial in 13,000 hypertensive veterans demonstrated that chlorthalidone was not superior to hydrochlorothiazide for preventing major cardiovascular events. The results challenged the assumption of chlorthalidone's superiority and supported continued use of either thiazide diuretic.

Blood pressure lowering and prevention of dementia

an individual patient data meta-analysis.

This individual patient data meta-analysis demonstrated that blood pressure lowering reduces the risk of incident dementia, with no evidence of a U-shaped relationship at lower blood pressure levels. The analysis provided the strongest evidence yet for blood pressure control as a dementia prevention strategy.

Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN)

an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial.

The IRONMAN trial showed a trend toward reduced heart failure hospitalization and cardiovascular death with intravenous ferric derisomaltose in patients with heart failure and iron deficiency, though the primary endpoint did not reach statistical significance. COVID-19 pandemic disruptions affected enrollment and follow-up.

Apixaban for Patients With Atrial Fibrillation on Hemodialysis

A Multicenter Randomized Controlled Trial.

This first randomized trial of apixaban in AF patients on hemodialysis showed no significant improvement over usual care (mostly warfarin) for stroke prevention, with similar rates of bleeding and thrombotic events. The result highlighted the persistent evidence gap in anticoagulation for dialysis patients with AF.

Dual endothelin antagonist aprocitentan for resistant hypertension (PRECISION)

a multicentre, blinded, randomised, parallel-group, phase 3 trial.

The PRECISION trial showed that aprocitentan, a dual endothelin receptor antagonist, significantly reduced blood pressure in patients with resistant hypertension on triple therapy. This was the first positive phase 3 trial of an endothelin antagonist for systemic hypertension, opening a new mechanism of action for treatment-resistant blood pressure.

Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF)

a multinational, open-label, randomised, trial.

The STRONG-HF trial demonstrated that rapid, intensive up-titration of guideline-directed medical therapy (beta-blocker, RAAS inhibitor, MRA) within two weeks of hospital discharge for acute heart failure was safe and significantly reduced heart failure readmission and death compared with usual care. The study established early, aggressive optimization as the standard post-discharge approach.

LY3437943, a novel triple GIP, GLP-1, and glucagon receptor agonist in people with type 2 diabetes

a phase 1b, multicentre, double-blind, placebo-controlled, randomised, multiple-ascending dose trial.

This phase 1b trial of a triple GIP/GLP-1/glucagon receptor agonist (retatrutide) demonstrated dramatic HbA1c reduction and weight loss in patients with type 2 diabetes. The triple agonism concept showed additive metabolic benefit beyond dual GIP/GLP-1 agonists.

Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk.

The PROMINENT trial showed that pemafibrate, a selective PPARα agonist, effectively lowered triglycerides but did not reduce cardiovascular events in patients with type 2 diabetes and elevated triglycerides despite statin therapy. This definitive negative result, together with earlier fibrate failures, largely closed the door on triglyceride lowering as a cardiovascular prevention strategy.

Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Artery Disease

Extended Follow-Up Outcomes of Multicenter Randomized Controlled BEST Trial.

This extended follow-up of multiple randomized trials comparing PCI with everolimus-eluting stents versus CABG for multivessel disease confirmed that CABG provides superior long-term outcomes, particularly for complex coronary anatomy. The results reinforced CABG as the preferred strategy for extensive multivessel disease.

Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes

collaborative meta-analysis of large placebo-controlled trials.

This collaborative meta-analysis of major SGLT2 inhibitor trials demonstrated that the kidney-protective effects of SGLT2 inhibition are independent of diabetes status and baseline kidney function. The findings support SGLT2 inhibitors as a universal renoprotective therapy across diverse CKD populations.

Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease.

The OCEAN(a)-DOSE trial demonstrated that olpasiran, a small interfering RNA targeting hepatic apolipoprotein(a) synthesis, reduced lipoprotein(a) levels by more than 95% in patients with established atherosclerotic cardiovascular disease. This represented the first pharmacological agent capable of near-complete Lp(a) elimination, opening a new therapeutic frontier.

Hospitalizations and Mortality in Patients With Secondary Mitral Regurgitation and Heart Failure

The COAPT Trial.

Long-term COAPT analysis confirmed that transcatheter edge-to-edge repair (MitraClip) durably reduces hospitalizations and mortality in patients with heart failure and severe secondary mitral regurgitation, with sustained benefit beyond the initial follow-up period.

Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT)

a multicentre, open-label, blinded-endpoint, randomised controlled trial.

The ENCHANTED2/MT trial demonstrated that intensive blood pressure lowering to <120 mmHg after endovascular thrombectomy for acute ischemic stroke worsened functional outcomes compared with a higher target. The trial was stopped early for futility and potential harm.

Empagliflozin in acute myocardial infarction

the EMMY trial.

The EMMY trial showed that empagliflozin started after acute MI significantly reduced NT-proBNP levels and attenuated left ventricular remodeling compared with placebo. The results provided early evidence of SGLT2 inhibitor cardioprotection in the acute post-MI setting.

Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction

the DIAMOND trial.

The DIAMOND trial showed that patiromer effectively reduced serum potassium in patients with HFrEF, enabling more patients to reach target doses of RAAS inhibitors without hyperkalemia-related dose reductions. The results addressed a key barrier to optimal heart failure pharmacotherapy.

Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study)

a prospective, randomised, open-label, blinded-endpoint clinical trial.

The TIME trial showed that evening dosing of antihypertensive medications offered no cardiovascular benefit over morning dosing in hypertensive adults, definitively refuting the chronotherapy hypothesis. The pragmatic result simplified clinical practice by confirming that dosing time does not matter.

Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest.

The BOX trial found no difference between a high (77 mmHg) versus low (63 mmHg) mean arterial pressure target in comatose survivors of out-of-hospital cardiac arrest. The result indicated that there is a broad acceptable blood pressure range in post-cardiac arrest intensive care.

Efficacy and Safety of Dapagliflozin According to Frailty in Patients With Heart Failure

A Prespecified Analysis of the DELIVER Trial.

This DELIVER subanalysis demonstrated that dapagliflozin provides similar relative benefit in frail and non-frail patients with HFpEF, with even greater absolute benefit in frail patients due to their higher baseline risk. The results supported SGLT2 inhibitor use regardless of frailty status.

Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction.

The REVIVED-BCIS2 trial showed that PCI did not improve survival or left ventricular function compared with optimal medical therapy in patients with severe ischemic cardiomyopathy and viable myocardium. The result challenged the long-held assumption that revascularization improves outcomes in ischemic left ventricular dysfunction and supports a medical-therapy-first approach.

Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART)

a multicentre, prospective, randomised, open-label, blinded-endpoint trial.

The ALL-HEART trial showed that allopurinol did not improve cardiovascular outcomes in patients with ischemic heart disease without gout, despite its theoretical benefits on endothelial function and oxidative stress. The large, pragmatic negative result argued against using allopurinol for cardiovascular prevention.

Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING)

A Registry-Based Randomized Controlled Noninferiority Study.

The Swedish TIMING trial demonstrated that early NOAC initiation (within 4 days) after acute ischemic stroke in patients with AF was safe and noninferior to delayed start (5-10 days) for the composite of stroke, major bleeding, or death. The results supported a move toward earlier anticoagulation.

Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction.

This DELIVER subanalysis confirmed that dapagliflozin is effective in patients recently hospitalized for heart failure with mildly reduced or preserved ejection fraction, with early benefit seen within weeks of treatment initiation. The data supported in-hospital SGLT2 inhibitor use in HFpEF.

2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2022 ACC Expert Consensus updated the decision pathway for nonstatin lipid-lowering therapies, integrating evidence on bempedoic acid and inclisiran alongside ezetimibe and PCSK9 monoclonal antibodies. The document provided practical algorithms for escalating therapy to achieve LDL-cholesterol targets.

Acetazolamide in Acute Decompensated Heart Failure with Volume Overload.

The ADVOR trial showed that adding intravenous acetazolamide to loop diuretics in patients hospitalized for acute decompensated heart failure significantly improved decongestion success at 3 days compared with placebo. This pragmatic result revived interest in combination diuretic strategies and provided the first large-scale evidence for sequential nephron blockade in acute heart failure.

Randomized Trial of Left Bundle Branch vs Biventricular Pacing for Cardiac Resynchronization Therapy.

This first randomized trial comparing left bundle branch area pacing with biventricular pacing for cardiac resynchronization therapy showed that LBBP achieved comparable or superior echocardiographic response with a simpler implantation procedure. The results positioned LBBP as a viable CRT alternative.

Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial.

The 5-year MOMENTUM 3 results confirmed sustained superiority of the HeartMate 3 over the HeartMate II, with significantly better event-free survival and fewer device-related complications. These long-term data solidified the HeartMate 3 as the definitive standard in durable mechanical circulatory support.

Effects of salt substitutes on clinical outcomes

a systematic review and meta-analysis.

This systematic review and meta-analysis confirmed that potassium-enriched salt substitutes lower blood pressure and reduce cardiovascular events and all-cause mortality, reinforcing the SSaSS results and supporting salt substitution as a scalable public health intervention.

Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes.

The GRADE trial compared four glucose-lowering agents added to metformin over 5 years and found that liraglutide and insulin glargine were most durable for glycemic control, while liraglutide had the most favorable cardiovascular profile. The results provided comparative effectiveness data to guide second-line agent selection in type 2 diabetes.

Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

The DELIVER trial demonstrated that dapagliflozin significantly reduced the composite of worsening heart failure or cardiovascular death in patients with heart failure and an ejection fraction above 40%, regardless of diabetes status. Together with EMPEROR-Preserved, this confirmed the benefit of SGLT2 inhibitors across the full ejection fraction spectrum.

Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines

Comparisons, Reflections, and Recommendations.

This harmonization document analyzed the similarities and differences between the ACC/AHA and ESC/ESH hypertension guidelines, highlighting converging evidence on treatment initiation thresholds and targets while acknowledging remaining disagreements on classification and risk assessment.

Rivaroxaban in Rheumatic Heart Disease-Associated Atrial Fibrillation.

The INVICTUS trial showed that rivaroxaban was inferior to warfarin for preventing cardiovascular events in patients with rheumatic heart disease-associated atrial fibrillation, with higher rates of stroke, systemic embolism, and death. This landmark negative result confirmed that DOACs cannot replace warfarin in valvular AF due to rheumatic heart disease.

Polypill Strategy in Secondary Cardiovascular Prevention.

The SECURE trial demonstrated that a cardiovascular polypill containing aspirin, ramipril, and atorvastatin reduced major adverse cardiovascular events by 24% compared with separate medications in patients after myocardial infarction. The benefit was attributed to improved adherence, validating the polypill as a practical secondary prevention strategy.

Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden.

This EAST-AFNET4 subanalysis showed that early rhythm control reduces cardiovascular events even in AF patients with high comorbidity burden, including those with heart failure, diabetes, and chronic kidney disease. The benefit was not attenuated by comorbidity complexity.

Effect of statin therapy on muscle symptoms

an individual participant data meta-analysis of large-scale, randomised, double-blind trials.

This individual participant data meta-analysis of large-scale, double-blind statin trials in the Lancet showed that statins cause only a small excess of muscle symptoms (about 11 per 1,000 patients over 5 years), with most patient-reported muscle complaints being attributable to the nocebo effect. The findings provide robust reassurance for clinicians managing statin-associated myalgia concerns.

Routine Functional Testing or Standard Care in High-Risk Patients after PCI.

The POST-PCI trial demonstrated that routine functional testing after PCI in high-risk patients did not improve clinical outcomes compared with standard care at 2 years. The results argued against routine surveillance testing as a post-PCI follow-up strategy.

Prevalence of statin intolerance

a meta-analysis.

This meta-analysis estimated that true statin intolerance affects 7-29% of patients depending on the definition used, with nocebo-confirmed intolerance rates being much lower. The data highlighted the gap between perceived and actual statin intolerance and supported rechallenge strategies.

SGLT-2 inhibitors in patients with heart failure

a comprehensive meta-analysis of five randomised controlled trials.

This comprehensive meta-analysis of five major SGLT2 inhibitor trials in heart failure (DAPA-HF, EMPEROR-Reduced, DELIVER, EMPEROR-Preserved, SOLOIST-WHF) confirmed that SGLT2 inhibition reduces heart failure hospitalization and cardiovascular death across the full range of ejection fraction. The analysis provided definitive class-level evidence supporting their use in all heart failure phenotypes.

Fractional Flow Reserve or Intravascular Ultrasonography to Guide PCI.

The FLAVOUR trial demonstrated that FFR-guided PCI was noninferior to IVUS-guided PCI for the composite of death, MI, or revascularization at 24 months in patients with intermediate coronary stenoses. The results validated both physiological and anatomical guidance strategies as acceptable approaches.

Empagliflozin for Heart Failure With Preserved Left Ventricular Ejection Fraction With and Without Diabetes.

This EMPEROR-Preserved subanalysis confirmed that empagliflozin's benefit on heart failure outcomes in HFpEF is consistent regardless of diabetes status, extending the evidence for SGLT2 inhibitors as a universal heart failure therapy beyond glycemic management.

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults

Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

This updated USPSTF evidence review reaffirmed that statin use for primary cardiovascular prevention is associated with reduced cardiovascular events and mortality, supporting continued recommendation for statin therapy in adults at elevated 10-year CVD risk.

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults

US Preventive Services Task Force Recommendation Statement.

The 2022 USPSTF reaffirmation recommended statin use for primary cardiovascular prevention in adults aged 40-75 with at least one CVD risk factor and a 10-year CVD risk of 10% or greater, maintaining the 2016 recommendation with updated evidence review.

Initial Decline (Dip) in Estimated Glomerular Filtration Rate After Initiation of Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction

Insights From DAPA-HF.

This DAPA-HF post-hoc analysis showed that the initial eGFR decline ('dip') commonly seen after dapagliflozin initiation is not associated with worse clinical outcomes and is followed by a slower long-term rate of kidney function decline. The finding provided reassurance about the hemodynamic kidney effects of SGLT2 inhibitors.

Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING)

a randomised, open-label, non-inferiority trial.

This Lancet long-term study demonstrated that moderate-intensity statin combined with ezetimibe was equally effective as high-intensity statin monotherapy for preventing cardiovascular events, with fewer adverse effects. The results supported combination therapy as an alternative to high-dose statins.

Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Disease Risk Factors

US Preventive Services Task Force Recommendation Statement.

This USPSTF systematic review confirmed that behavioral counseling on diet and physical activity produces modest but consistent cardiovascular risk factor improvements in adults. The evidence supported population-level lifestyle counseling as a component of cardiovascular prevention.

Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF).

The EMPAG-HF trial demonstrated that early empagliflozin initiation in acute decompensated heart failure significantly increased urinary output without worsening kidney function. The results supported SGLT2 inhibitors as a useful adjunct to loop diuretics for decongestion.

Effects of Empagliflozin on Symptoms, Physical Limitations, and Quality of Life in Patients Hospitalized for Acute Heart Failure

Results From the EMPULSE Trial.

The EMPULSE trial demonstrated that empagliflozin initiated during hospitalization for acute heart failure significantly improved a hierarchical composite of death, heart failure events, and symptoms compared with placebo. The results support in-hospital initiation of SGLT2 inhibitors in acute heart failure.

Effect of Omecamtiv Mecarbil on Exercise Capacity in Chronic Heart Failure With Reduced Ejection Fraction

The METEORIC-HF Randomized Clinical Trial.

The METEORIC-HF trial showed that omecamtiv mecarbil did not improve exercise capacity in patients with HFrEF, despite its positive effects on heart failure events in GALACTIC-HF. The disconnect between clinical outcomes and functional capacity measures remains unexplained.

Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation

The DECAAF II Randomized Clinical Trial.

The DECAAF II trial showed that MRI-guided fibrosis ablation did not improve freedom from atrial arrhythmia compared with conventional catheter ablation in patients with persistent AF. The negative result suggested that current MRI-based fibrosis mapping does not reliably guide ablation targets.

Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial.

The PARTITA trial demonstrated that early VT ablation after the first appropriate ICD shock reduced the composite of heart failure hospitalization or death compared with delayed ablation after subsequent shocks. The results supported a proactive ablation strategy rather than waiting for recurrent VT.

Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in Patients With Heart Failure and Atrial Fibrillation

Results from the RAFT-AF trial.

The RAFT-AF trial showed that ablation-based rhythm control improved left ventricular function and NT-proBNP levels compared with rate control in patients with heart failure and AF, though it did not significantly reduce the composite of mortality and heart failure events. The echocardiographic benefit supported ablation for AF in heart failure.

Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study.

After 21 years of follow-up in the Diabetes Prevention Program, neither lifestyle intervention nor metformin reduced the incidence of cardiovascular events compared with placebo, despite their proven diabetes prevention effects. The result indicated that metabolic prevention alone does not translate to cardiovascular event reduction.

Bariatric surgery and cardiovascular disease

a systematic review and meta-analysis.

This systematic review and meta-analysis showed that bariatric surgery is associated with significant reductions in cardiovascular events and cardiovascular mortality compared with nonsurgical management of obesity. The quantified cardiovascular benefit supports consideration of bariatric surgery as a cardiovascular prevention strategy.

Treatment for Mild Chronic Hypertension during Pregnancy.

The CHAP trial demonstrated that treatment of mild chronic hypertension during pregnancy (targeting blood pressure <140/90 mmHg) significantly reduced the risk of preeclampsia and preterm birth with no adverse fetal effects. This landmark result reversed the prevailing watchful-waiting approach and established active treatment as beneficial in pregnancy-associated hypertension.

Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction

The PACMAN-AMI Randomized Clinical Trial.

The PACMAN-AMI trial demonstrated that adding alirocumab to high-intensity statin therapy after acute MI produced greater reductions in coronary plaque volume and improved plaque composition on multimodality intravascular imaging compared with statin alone. The results provided direct evidence that early PCSK9 inhibition favorably modifies vulnerable plaques.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Executive summary of the 2022 AHA/ACC/HFSA heart failure guideline, providing key recommendations, decision pathways, and the four-pillar treatment algorithm for HFrEF including SGLT2 inhibitors, ARNI, beta-blockers, and MRAs.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2022 AHA/ACC/HFSA heart failure guideline published in JACC replaced the 2013 guidelines and integrated contemporary evidence on SGLT2 inhibitors and ARNI into structured treatment algorithms for heart failure across the ejection fraction spectrum.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

The 2022 AHA/ACC/HFSA heart failure guideline was the first comprehensive update since 2013, integrating SGLT2 inhibitors, sacubitril-valsartan, and vericiguat into guideline-directed medical therapy. The document codified the four-pillar approach to HFrEF and provided new recommendations for HFpEF management based on emerging evidence.

Aspirin Use to Prevent Cardiovascular Disease

US Preventive Services Task Force Recommendation Statement.

The 2022 USPSTF recommendation statement downgraded the role of aspirin in primary cardiovascular prevention, advising against initiation in adults 60 years or older and recommending individualized decision-making in those aged 40–59 with elevated CVD risk. This reflected accumulating evidence from ASPREE, ARRIVE, and ASCEND showing unfavorable bleeding-to-benefit ratios.

Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF)

a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study.

The PACIFIC-AF phase 2 trial showed that asundexian, an oral factor XIa inhibitor, had significantly less bleeding than apixaban in AF patients while maintaining preliminary signals of anticoagulant efficacy. This early positive result set the stage for the subsequent (failed) OCEANIC-AF phase 3 trial.

Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF)

an international, open-label, randomised, controlled trial.

The SODIUM-HF trial showed that strict dietary sodium restriction (<100 mmol/day) in heart failure patients did not significantly reduce the composite of cardiovascular hospitalization, emergency department visit, or death compared with usual care. The neutral result questioned the clinical benefit of intensive sodium restriction.

Systematic, early rhythm control strategy for atrial fibrillation in patients with or without symptoms

the EAST-AFNET 4 trial.

This EAST-AFNET 4 analysis showed that early rhythm control improves outcomes in AF patients regardless of symptom status, expanding the indication beyond symptomatic patients. The finding challenged the guideline restriction of rhythm control to symptomatic AF.

Comparative effects of guided vs. potent P2Y12 inhibitor therapy in acute coronary syndrome

a network meta-analysis of 61 898 patients from 15 randomized trials.

This network meta-analysis of nearly 62,000 ACS patients compared guided de-escalation with potent P2Y12 inhibitor therapy, finding that guided approaches reduce bleeding without increasing ischemic events. The comprehensive analysis supported precision antiplatelet strategies as a superior alternative.

Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease

the FIDELITY pooled analysis.

The FIDELITY pooled analysis combined FIDELIO-DKD and FIGARO-DKD data to demonstrate consistent cardiovascular and kidney benefits of finerenone across the full spectrum of CKD severity in patients with type 2 diabetes. This definitive analysis established finerenone's position in the cardiorenal protection armamentarium.

Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes

Analyses From the FIGARO-DKD Trial.

This FIDELITY pooled analysis demonstrated that finerenone reduces the risk of new-onset heart failure in patients with CKD and type 2 diabetes, adding heart failure prevention to the established renal and cardiovascular benefits of nonsteroidal mineralocorticoid receptor antagonism.

Screening for Atrial Fibrillation

US Preventive Services Task Force Recommendation Statement.

The 2022 USPSTF reaffirmed the insufficient evidence ('I' statement) for ECG screening for atrial fibrillation in asymptomatic older adults, despite advancing wearable technology, due to the lack of randomized trials demonstrating that screening-detected AF treatment improves outcomes.

Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation

Patient-Level Network Meta-Analyses of Randomized Clinical Trials With Interaction Testing by Age and Sex.

This patient-level network meta-analysis of all four DOACs versus warfarin in atrial fibrillation confirmed the class-wide superiority of DOACs for stroke prevention with less intracranial hemorrhage. The analysis also provided the first robust head-to-head indirect comparisons between individual DOACs.

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.

The 2021 ACC/AHA/SCAI coronary revascularization guideline executive summary integrated evidence from ISCHEMIA, EXCEL, NOBLE, and contemporary trials to update recommendations for PCI versus CABG decision-making. The document emphasized heart team consultation, functional ischemia testing, and patient-centered shared decision-making for complex coronary disease.

Fractional Flow Reserve-Guided PCI as Compared with Coronary Bypass Surgery.

The FAME 3 trial showed that FFR-guided PCI was not noninferior to CABG for the composite of death, MI, stroke, or repeat revascularization at 1 year in patients with three-vessel coronary artery disease. The result reinforced CABG as the preferred strategy for extensive multivessel disease.

Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.

The CLICK trial demonstrated that chlorthalidone effectively lowered blood pressure in patients with advanced CKD (eGFR 15-30 mL/min), a population traditionally thought unresponsive to thiazide diuretics. This evidence-changing result supported the use of thiazide-like diuretics even in severe kidney disease.

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation.

The TOMAHAWK trial confirmed that immediate coronary angiography did not improve 30-day survival compared with a delayed approach in patients resuscitated from out-of-hospital cardiac arrest without ST-segment elevation. Together with COACT, this definitively argued against routine emergent catheterization in this setting.

Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes

A Systematic Review and Meta-Analysis.

This meta-analysis of randomized controlled trials confirmed that long-term marine omega-3 fatty acid supplementation is associated with a significantly increased risk of atrial fibrillation. The definitive safety signal raised concerns about the cardiovascular use of fish oil supplements.

Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease

an individual patient data meta-analysis.

The PRECOMBAT 10-year follow-up showed no significant difference in the composite of death, MI, stroke, or revascularization between PCI with DES and CABG for left main coronary disease, though individual event rates favored CABG numerically. The long-term Korean data added to the revascularization debate.

Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China)

a multicentre, randomised, sham-controlled trial.

The FAVOR III China trial demonstrated that angiographic quantitative flow ratio (QFR)-guided PCI significantly improved 1-year outcomes compared with angiography-guided PCI. The wire-free virtual physiological assessment offered a practical alternative to pressure wire-based FFR measurement.

Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes.

The FIGARO-DKD trial demonstrated that finerenone reduced cardiovascular events in patients with type 2 diabetes and a broader range of CKD severity than FIDELIO, including those with earlier-stage kidney disease and less severely elevated albuminuria. Together with FIDELIO, the FIDELITY program established finerenone's cardiorenal benefit across the full CKD spectrum in diabetes.

AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS

the APAF-CRT mortality trial.

The APAF-CRT mortality analysis confirmed that AV junction ablation combined with cardiac resynchronization therapy significantly reduced all-cause mortality in patients with permanent atrial fibrillation, narrow QRS, and heart failure. The result established this strategy as a life-saving intervention in drug-refractory AF with HF.

Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery

an adaptive, single-centre, single-blind, randomised, controlled trial.

The PALACS trial demonstrated that posterior left pericardiotomy, a simple 30-second surgical addition during cardiac surgery, significantly reduced the incidence of postoperative atrial fibrillation. The low-cost, low-risk intervention offered an elegant preventive strategy.

Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR.

The ENVISAGE-TAVI AF trial showed that edoxaban was noninferior to vitamin K antagonists for the composite of net adverse clinical events in patients with AF after TAVR, but was associated with more gastrointestinal bleeding. The results informed DOAC use in the growing post-TAVR AF population.

Blood pressure lowering and risk of new-onset type 2 diabetes

an individual participant data meta-analysis.

This BPLTTC meta-analysis revealed that pharmacological blood pressure lowering reduces the risk of new-onset type 2 diabetes, with an estimated 11% relative risk reduction per 5 mmHg systolic blood pressure decrease. The unexpected metabolic benefit adds a new dimension to the argument for aggressive blood pressure management.

Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4)

a randomised, open-label, parallel-group, multicentre, phase 3 trial.

The SURPASS-4 trial showed that tirzepatide was superior to insulin glargine for HbA1c reduction and weight loss in patients with type 2 diabetes and increased cardiovascular risk, while demonstrating cardiovascular safety in this high-risk population.

Angiotensin Receptor-Neprilysin Inhibition in Acute Myocardial Infarction.

The PARADISE-MI trial found that sacubitril-valsartan did not significantly reduce the composite of cardiovascular death or heart failure events compared with ramipril in patients with acute MI and reduced left ventricular function. The result indicated that ARNI therapy does not provide additional benefit over ACE inhibition in the post-MI setting.

Influenza Vaccination After Myocardial Infarction

A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.

The IAMI trial showed that influenza vaccination administered within 72 hours of myocardial infarction or high-risk coronary intervention reduced the composite of all-cause death, MI, or stent thrombosis at 12 months. This is the first large, placebo-controlled trial demonstrating the cardiovascular protective effect of influenza vaccination after acute coronary events.

Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk.

The MASTER DAPT trial showed that abbreviated 1-month dual antiplatelet therapy followed by single antiplatelet therapy was noninferior to standard DAPT for net adverse clinical events in high-bleeding-risk patients after drug-eluting stent implantation. The results support a shortened DAPT duration in this vulnerable population.

Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP)

a multicentre, parallel group, unmasked, randomised controlled trial.

The STROKESTOP trial demonstrated that systematic screening for atrial fibrillation in 75-76-year-olds using intermittent ECG recordings, followed by anticoagulation when AF was detected, reduced the composite of ischemic stroke, systemic embolism, bleeding, and death compared with no screening. This is the first randomized trial showing clinical benefit from population-level AF screening.

Effect of Empagliflozin on Worsening Heart Failure Events in Patients With Heart Failure and Preserved Ejection Fraction

EMPEROR-Preserved Trial.

This EMPEROR-Preserved analysis detailed that empagliflozin reduced worsening heart failure events across the ejection fraction spectrum in HFpEF, with consistent benefit regardless of baseline LVEF, diabetes status, or renal function.

Empagliflozin in Heart Failure with a Preserved Ejection Fraction.

The EMPEROR-Preserved trial was the first to demonstrate that an SGLT2 inhibitor (empagliflozin) reduces heart failure hospitalization in patients with HFpEF. This landmark result extended the benefit of SGLT2 inhibition across the full ejection fraction spectrum, addressing an area with previously no proven pharmacological therapy.

Empagliflozin and Major Renal Outcomes in Heart Failure.

This EMPEROR-Reduced renal analysis showed that empagliflozin slowed the decline in eGFR and reduced the risk of serious kidney outcomes in patients with heart failure, demonstrating renoprotective effects of SGLT2 inhibition in the heart failure population.

Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI)

an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial.

The TALOS-AMI trial demonstrated that unguided de-escalation from ticagrelor to clopidogrel one month after MI reduced bleeding without increasing ischemic events. The pragmatic approach, requiring no platelet function testing, offered a simpler de-escalation strategy than guided protocols.

Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension.

The STEP trial demonstrated that intensive blood pressure control (target 110–130 mmHg) significantly reduced cardiovascular events compared with standard treatment (130–150 mmHg) in Chinese patients aged 60–80 with hypertension. The results confirmed the benefits of intensive blood pressure targets in older adults, extending the findings of SPRINT to an Asian population.

Initial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET)

a phase 3, randomised, double-blind, active-controlled trial.

The QUARTET trial showed that initial treatment with a quarter-dose quadruple combination blood pressure pill achieved superior blood pressure control compared with standard care monotherapy at 12 weeks. The results support ultra-low-dose combination therapy as an effective strategy to overcome treatment inertia in hypertension.

Effect of Salt Substitution on Cardiovascular Events and Death.

The SSaSS trial showed that replacing regular salt with a potassium-enriched salt substitute in 20,995 participants significantly reduced stroke, cardiovascular events, and all-cause mortality without increasing hyperkalemia. This is the largest dietary intervention trial in cardiovascular prevention and demonstrates a scalable public health strategy.

Haemodynamic-guided management of heart failure (GUIDE-HF)

a randomised controlled trial.

The GUIDE-HF trial of hemodynamic-guided heart failure management with implantable PA pressure sensors showed no significant overall benefit, though a pre-COVID subanalysis suggested reduced heart failure events. The results highlighted the confounding impact of the pandemic on heart failure trials.

Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes.

The AMPLITUDE-O trial demonstrated that efpeglenatide, an exendin-based GLP-1 receptor agonist, reduced cardiovascular events and kidney outcomes in patients with type 2 diabetes at high cardiovascular risk. This was the sixth positive GLP-1 RA cardiovascular outcomes trial, extending the class benefit to a structurally distinct agent.

2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2021 ACC Expert Consensus addressed ASCVD risk reduction in patients with persistent hypertriglyceridemia, providing decision algorithms integrating icosapent ethyl, fibrates, and lifestyle modification based on the REDUCE-IT and STRENGTH evidence.

Lowering cholesterol, blood pressure, or both to prevent cardiovascular events

results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants.

The HOPE-3 extended 8.7-year follow-up showed that the cardiovascular benefits of rosuvastatin observed during the active treatment period persisted after trial completion, suggesting a legacy effect of intermediate-risk lipid lowering on long-term cardiovascular protection.

Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3)

a randomised, open-label, parallel-group, phase 3 trial.

The SURPASS-3 trial demonstrated that tirzepatide was superior to insulin degludec for glycemic control and weight loss when added to metformin with or without an SGLT2 inhibitor in type 2 diabetes. The results positioned tirzepatide as a potent alternative to basal insulin.

Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock.

The DOREMI trial found no significant difference between milrinone and dobutamine for the primary outcome in patients with cardiogenic shock. As the first large head-to-head comparison of inotropes in shock, it established that neither agent is clearly superior.

Multivessel PCI Guided by FFR or Angiography for Myocardial Infarction.

The FLOWER-MI trial showed that FFR-guided complete revascularization of nonculprit lesions did not reduce the composite of death, MI, or urgent revascularization compared with angiography-guided PCI in patients with STEMI and multivessel disease. The surprising negative result questioned the added value of FFR guidance in the acute MI setting.

Efficacy and safety of low-dose colchicine in patients with coronary disease

a systematic review and meta-analysis of randomized trials.

This meta-analysis of colchicine trials in coronary disease confirmed that low-dose colchicine reduces cardiovascular events with an acceptable safety profile, integrating COLCOT, LoDoCo2, and COPS data. The pooled evidence supported colchicine as a cost-effective anti-inflammatory strategy.

Physical Rehabilitation for Older Patients Hospitalized for Heart Failure.

The REHAB-HF trial showed that a tailored physical rehabilitation intervention improved physical function and frailty in older patients hospitalized for acute heart failure, though it did not significantly reduce rehospitalization or death. The functional benefit supports rehabilitation in elderly heart failure patients.

Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1)

a double-blind, randomised, phase 3 trial.

The SURPASS-1 trial demonstrated that tirzepatide, a novel dual GIP/GLP-1 receptor agonist, produced superior HbA1c reduction and weight loss compared with placebo as monotherapy in type 2 diabetes. These first phase 3 results foreshadowed the transformative potential of dual incretin agonism.

Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM)

an investigator-initiated, prospective, randomised, open-label, multicentre trial.

The HOST-EXAM trial showed that clopidogrel was superior to aspirin for chronic maintenance antiplatelet monotherapy after PCI, reducing the composite of cardiovascular death, MI, stroke, readmission for ACS, or stent thrombosis at 24 months. The result challenged aspirin as the default long-term antiplatelet agent after coronary stenting.

Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO)

a randomised, multicentre, single-blind, sham-controlled trial.

The RADIANCE-HTN TRIO trial demonstrated that ultrasound-based renal denervation significantly reduced daytime ambulatory systolic blood pressure compared with a sham procedure in patients with resistant hypertension on a standardized triple combination pill. This was the first positive renal denervation trial in true resistant hypertension.

Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke.

The LAAOS III trial demonstrated that surgical left atrial appendage occlusion performed during cardiac surgery significantly reduced the risk of ischemic stroke or systemic embolism in patients with atrial fibrillation. This simple addition to planned cardiac surgery provides lasting stroke protection as an adjunct to anticoagulation.

Assessment of Catheter Ablation or Antiarrhythmic Drugs for First-line Therapy of Atrial Fibrillation

A Meta-analysis of Randomized Clinical Trials.

This JAMA Cardiology meta-analysis of randomized trials confirmed that catheter ablation as first-line therapy for atrial fibrillation is superior to antiarrhythmic drugs for maintaining sinus rhythm, with potential benefits on cardiovascular outcomes. The pooled data supported the shift toward earlier ablation.

Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease.

The ADAPTABLE trial, the first large pragmatic trial comparing aspirin doses in cardiovascular disease, found no significant difference between 81 mg and 325 mg daily for preventing cardiovascular events or causing major bleeding. The results support low-dose aspirin as the standard for secondary prevention.

Final Report of a Trial of Intensive versus Standard Blood-Pressure Control.

The final SPRINT report, including post-trial follow-up, confirmed the durable benefit of intensive systolic blood pressure control (target <120 mmHg) versus standard treatment (target <140 mmHg) in reducing cardiovascular events and mortality. The sustained benefit after treatment cessation strengthened the case for aggressive blood pressure targets.

Do β-Blockers Cause Depression?

Systematic Review and Meta-Analysis of Psychiatric Adverse Events During β-Blocker Therapy.

This systematic review and meta-analysis found no significant association between beta-blocker therapy and increased risk of depression, debunking a widely held clinical belief. The evidence addressed one of the most common reasons patients and clinicians avoid beta-blockers.

Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure

an individual participant-level data meta-analysis.

This individual-participant-data meta-analysis from the BPLTTC demonstrated that pharmacological blood pressure lowering reduces cardiovascular events across all baseline blood pressure levels, including in individuals with normal or high-normal pressure. The findings support a strategy of treating based on absolute cardiovascular risk rather than blood pressure thresholds alone.

Guided versus standard antiplatelet therapy in patients undergoing percutaneous coronary intervention

a systematic review and meta-analysis.

This Lancet meta-analysis showed that guided antiplatelet therapy selection (pharmacogenomic or pharmacodynamic testing) after PCI reduces ischemic and bleeding events compared with standard unguided therapy. The results supported precision medicine approaches to antiplatelet management.

2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.

The 2020 ESC Guidelines for non-ST-elevation acute coronary syndromes updated risk stratification, timing of invasive management, and antithrombotic strategies incorporating evidence from ISCHEMIA, TWILIGHT, and contemporary trials. The guideline refined the balance between ischemic protection and bleeding risk in ACS patients.

Effects of dapagliflozin on mortality in patients with chronic kidney disease

a pre-specified analysis from the DAPA-CKD randomized controlled trial.

This pre-specified DAPA-CKD mortality analysis confirmed that dapagliflozin significantly reduces all-cause mortality in patients with chronic kidney disease, independent of diabetes status. The survival benefit strengthened the case for universal SGLT2 inhibitor use in CKD.

Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation

A Randomized Clinical Trial.

The VITAL-AF trial unexpectedly showed that marine omega-3 fatty acid supplementation was associated with increased risk of atrial fibrillation, while vitamin D had no effect. The pro-arrhythmic signal contradicted the assumed cardiovascular benefit of fish oil supplements.

3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure.

The COAPT 3-year results confirmed sustained benefit of transcatheter mitral valve repair with MitraClip in heart failure with severe secondary mitral regurgitation, with persistent reductions in hospitalization and mortality beyond the 2-year primary endpoint.

2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment

Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2021 ACC Expert Consensus update addressed 10 pivotal questions on heart failure treatment optimization, integrating evidence for SGLT2 inhibitors across the ejection fraction spectrum, vericiguat in recently decompensated HFrEF, and practical implementation of quadruple therapy.

Effect of High-Intensity Interval Training, Moderate Continuous Training, or Guideline-Based Physical Activity Advice on Peak Oxygen Consumption in Patients With Heart Failure With Preserved Ejection Fraction

A Randomized Clinical Trial.

The SMARTEX-HF trial showed that high-intensity interval training was not superior to moderate continuous training for improving peak VO2 in patients with HFrEF. The result supported moderate exercise as safe and effective, without an incremental benefit from more intense training in heart failure.

2020 ACC Expert Consensus Decision Pathway for Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation or Venous Thromboembolism Undergoing Percutaneous Coronary Intervention or With Atherosclerotic Cardiovascular Disease

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2020 ACC Expert Consensus provided a comprehensive decision pathway for managing antithrombotic therapy in patients with atrial fibrillation or venous thromboembolism who require antiplatelet agents, with practical algorithms for diverse clinical scenarios.

Finerenone and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Type 2 Diabetes.

The FIDELIO-DKD trial demonstrated that finerenone, a nonsteroidal mineralocorticoid receptor antagonist, significantly reduced both kidney failure progression and cardiovascular events in patients with chronic kidney disease and type 2 diabetes. This established finerenone as a new therapeutic pillar in cardiorenal protection alongside SGLT2 inhibitors and GLP-1 receptor agonists.

Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes

A Meta-analysis.

This JAMA Cardiology meta-analysis updated the evidence on SGLT2 inhibitor cardiovascular and kidney outcomes in type 2 diabetes, confirming class-consistent reductions in heart failure hospitalization, cardiovascular death, and kidney disease progression across all available agents.

Inhaled Treprostinil in Pulmonary Hypertension Due to Interstitial Lung Disease.

The INCREASE trial demonstrated that inhaled treprostinil improved exercise capacity in patients with pulmonary hypertension associated with interstitial lung disease. This was the first therapy proven effective for this specific, previously untreatable form of pulmonary hypertension.

Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation.

The STOP AF First trial confirmed that cryoablation was superior to antiarrhythmic drug therapy as initial treatment for paroxysmal atrial fibrillation, with significantly fewer patients experiencing treatment failure at 1 year. Together with EARLY-AF, the trial established the evidence base for first-line ablation in AF.

Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation.

The EARLY-AF trial showed that cryoballoon ablation as initial therapy for symptomatic paroxysmal atrial fibrillation was superior to antiarrhythmic drug therapy in maintaining sinus rhythm at 1 year. This landmark result challenged the guideline recommendation of a drug-first approach and supported ablation as a first-line strategy.

Randomized Trial of Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection Fraction.

This EMPEROR-Reduced subanalysis in nondiabetic patients confirmed that empagliflozin reduces cardiovascular death and heart failure hospitalization regardless of diabetes status. The finding was pivotal for regulatory approval of SGLT2 inhibitors in heart failure independent of glycemic indication.

Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs. prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents

a systematic review and meta-analysis of randomized clinical trials.

This meta-analysis confirmed that short DAPT followed by P2Y12 inhibitor monotherapy significantly reduces bleeding compared with prolonged DAPT after PCI with second-generation DES, without increasing ischemic events. The pooled evidence consolidated the de-escalation paradigm.

Polypill with or without Aspirin in Persons without Cardiovascular Disease.

The PolyPill-TIPS-3 trial showed that a polypill containing a statin and two blood-pressure-lowering drugs, with or without aspirin, reduced the incidence of cardiovascular disease in intermediate-risk individuals without established CVD. The study validated the polypill strategy as a practical approach to primary cardiovascular prevention at the population level.

Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure.

The SOLOIST-WHF trial demonstrated that sotagliflozin initiated before or shortly after hospital discharge for worsening heart failure significantly reduced cardiovascular death and heart failure events in patients with diabetes. The study provided the first evidence for starting SGLT inhibitor therapy during an acute heart failure hospitalization.

Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease.

The SCORED trial showed that sotagliflozin, a dual SGLT1/SGLT2 inhibitor, reduced cardiovascular death, heart failure hospitalization, and urgent heart failure visits in patients with type 2 diabetes and chronic kidney disease. The results established dual SGLT inhibition as an effective cardiorenal strategy.

Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure.

The GALACTIC-HF trial demonstrated that omecamtiv mecarbil, a selective cardiac myosin activator, modestly reduced the composite of heart failure events or cardiovascular death in patients with HFrEF. The trial validated a novel mechanism targeting cardiac contractility without increasing intracellular calcium or myocardial oxygen demand.

Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life

The RATE-AF Randomized Clinical Trial.

The RATE-AF trial showed that digoxin was noninferior to bisoprolol for quality-of-life outcomes in patients with permanent AF and symptoms of heart failure, with fewer treatment-related adverse events. The pragmatic result supported digoxin as a reasonable first-line rate control agent in this population.

Ferric carboxymaltose for iron deficiency at discharge after acute heart failure

a multicentre, double-blind, randomised, controlled trial.

The AFFIRM-AHF trial showed that intravenous ferric carboxymaltose in patients with iron deficiency discharged after acute heart failure reduced the composite of heart failure rehospitalization and cardiovascular death versus placebo. This landmark result established IV iron as a guideline-recommended therapy for iron-deficient heart failure patients.

Evinacumab in Patients with Refractory Hypercholesterolemia.

This NEJM trial demonstrated that evinacumab significantly reduced LDL cholesterol in patients with refractory hypercholesterolemia who had not reached LDL goals despite maximum tolerated lipid-lowering therapy. The results extended the utility of ANGPTL3 inhibition beyond homozygous FH to a broader treatment-resistant population.

Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk

The STRENGTH Randomized Clinical Trial.

The STRENGTH trial showed that high-dose omega-3 fatty acids (EPA plus DHA) did not reduce major cardiovascular events compared with corn oil in statin-treated patients at high cardiovascular risk. The contrasting result with REDUCE-IT (EPA only) suggested that DHA may attenuate EPA's cardiovascular benefit or that the mineral oil placebo in REDUCE-IT may have influenced outcomes.

Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve.

The RIVER trial demonstrated that rivaroxaban was noninferior to warfarin for the composite of stroke, TIA, systemic embolism, valve thrombosis, or death in patients with atrial fibrillation and a bioprosthetic mitral valve. The result expanded the evidence for DOAC use in patients with bioprosthetic heart valves.

N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects.

The StatinWISE N-of-1 trial demonstrated that muscle symptoms attributed to statins were largely not reproducible under blinded conditions, with similar symptom scores during statin and placebo periods. This provided rigorous evidence that most statin-associated side effects are attributable to the nocebo effect rather than the drug itself.

Efficacy and safety of lowering LDL cholesterol in older patients

a systematic review and meta-analysis of randomised controlled trials.

This Lancet meta-analysis of randomized controlled trials confirmed that LDL cholesterol-lowering therapy reduces cardiovascular events in older patients to a similar extent as in younger patients. The analysis definitively countered the notion that lipid lowering is ineffective or unsafe in elderly populations.

Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering

ODYSSEY OUTCOMES trial.

This ODYSSEY OUTCOMES analysis showed that alirocumab-mediated Lp(a) reduction independently contributed to lowering the total burden of cardiovascular events, beyond LDL cholesterol effects. The finding strengthened the evidence for Lp(a) as an actionable therapeutic target.

Colchicine in Patients With Acute Coronary Syndrome

The Australian COPS Randomized Clinical Trial.

The Australian COPS trial showed that colchicine initiated during ACS hospitalization did not reduce cardiovascular events and was associated with a signal toward increased noncardiovascular mortality. The unexpected negative result contrasted with COLCOT and contributed to ongoing uncertainty about colchicine's role in ACS.

Screening for High Blood Pressure in Children and Adolescents

US Preventive Services Task Force Recommendation Statement.

The 2020 USPSTF recommendation on blood pressure screening in children and adolescents addressed the evidence for routine screening and identification of primary and secondary hypertension in the pediatric population.

Complete revascularization reduces cardiovascular death in patients with ST-segment elevation myocardial infarction and multivessel disease

systematic review and meta-analysis of randomized clinical trials.

This meta-analysis demonstrated that complete revascularization of nonculprit lesions in patients with STEMI and multivessel disease significantly reduces cardiovascular death, providing the strongest evidence yet for a mortality benefit from the complete revascularization strategy.

Redevelopment and validation of the SYNTAX score II to individualise decision making between percutaneous and surgical revascularisation in patients with complex coronary artery disease

secondary analysis of the multicentre randomised controlled SYNTAXES trial with external cohort validation.

The redeveloped SYNTAX Score II integrates clinical and anatomical variables to provide individualized predictions of outcomes after PCI versus CABG, enabling personalized revascularization decisions based on predicted benefit rather than average trial results.

Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation.

The ELDERCARE-AF trial showed that low-dose edoxaban (15 mg daily) significantly reduced stroke and systemic embolism compared with placebo in very elderly (≥80 years) Japanese patients with atrial fibrillation who were deemed inappropriate for standard-dose anticoagulation. The findings addressed a critical evidence gap in the frailest AF population.

Dual Antiplatelet Therapy After Percutaneous Coronary Intervention and Drug-Eluting Stents

A Systematic Review and Network Meta-Analysis.

This comprehensive network meta-analysis evaluated the optimal duration and intensity of DAPT after PCI with drug-eluting stents, comparing short-term, standard, and extended regimens. The analysis provided quantitative guidance for personalizing DAPT duration based on individual risk profiles.

Prasugrel-based de-escalation of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (HOST-REDUCE-POLYTECH-ACS)

an open-label, multicentre, non-inferiority randomised trial.

This Lancet trial of prasugrel dose de-escalation (from 10 mg to 5 mg) after the acute phase of ACS demonstrated that dose reduction provides a less bleeding-prone alternative to switching agents. The approach offered a practical de-escalation strategy within a single P2Y12 inhibitor.

Dapagliflozin in Patients with Chronic Kidney Disease.

The DAPA-CKD trial demonstrated that dapagliflozin significantly reduced the composite of sustained decline in eGFR, end-stage kidney disease, or death from renal or cardiovascular causes in patients with CKD, regardless of diabetes status. The trial was stopped early for efficacy and expanded the role of SGLT2 inhibitors to all chronic kidney disease.

Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes.

The VERTIS CV trial confirmed the cardiovascular safety (noninferiority) of ertugliflozin in patients with type 2 diabetes and established atherosclerotic disease but did not demonstrate superiority for MACE reduction. The result differentiated ertugliflozin from empagliflozin and canagliflozin within the SGLT2 inhibitor class.

Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure.

The EMPEROR-Reduced trial showed that empagliflozin significantly reduced the composite of cardiovascular death or heart failure hospitalization in patients with HFrEF, regardless of diabetes status. Together with DAPA-HF, this confirmed the class effect of SGLT2 inhibitors in heart failure and supported their addition to guideline-directed therapy.

Early Rhythm-Control Therapy in Patients with Atrial Fibrillation.

The EAST-AFNET 4 trial demonstrated that early, systematic rhythm-control therapy within one year of atrial fibrillation diagnosis reduced cardiovascular death, stroke, and hospitalization for heart failure compared with usual care. This paradigm-shifting result reversed decades of rate-control-first thinking and established early rhythm control as the preferred strategy.

Evolocumab in Pediatric Heterozygous Familial Hypercholesterolemia.

The HAUSER-RCT trial demonstrated that evolocumab safely and effectively lowered LDL cholesterol in children and adolescents (10-17 years) with heterozygous familial hypercholesterolemia, providing the first randomized evidence for PCSK9 inhibitor use in the pediatric FH population.

Natural History of Asymptomatic Severe Aortic Stenosis and the Association of Early Intervention With Outcomes

A Systematic Review and Meta-analysis.

This JAMA Cardiology meta-analysis of asymptomatic severe aortic stenosis showed that early intervention may be associated with improved survival compared with conservative management. The analysis fueled the growing debate about expanding intervention indications beyond symptomatic disease.

SGLT2 inhibitors in patients with heart failure with reduced ejection fraction

a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials.

This landmark meta-analysis combined individual patient data from DAPA-HF and EMPEROR-Reduced, confirming that SGLT2 inhibition as a class significantly reduces cardiovascular death and heart failure hospitalization in patients with HFrEF regardless of diabetes status. The analysis cemented SGLT2 inhibitors as the fourth pillar of guideline-directed heart failure therapy.

Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with Type 2 diabetes mellitus with or without established cardiovascular disease

a meta-analysis of randomized controlled trials.

This meta-analysis showed that GLP-1 receptor agonists reduce major cardiovascular events in patients with type 2 diabetes both with and without established cardiovascular disease, though the absolute benefit is greater in the secondary prevention population.

Mortality after drug-eluting stents vs. coronary artery bypass grafting for left main coronary artery disease

a meta-analysis of randomized controlled trials.

This meta-analysis comparing mortality after DES versus CABG for left main coronary disease found that CABG was associated with significantly lower long-term all-cause and cardiovascular mortality. The updated data strengthened the evidence favoring surgery for left main revascularization.

2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2020 ACC Expert Consensus updated the decision pathway for SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes, integrating evidence from DAPA-HF, CREDENCE, and other contemporary trials to guide agent selection based on predominant cardiovascular or renal comorbidity.

Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy on Ischemic Outcomes After Percutaneous Coronary Intervention

The TAILOR-PCI Randomized Clinical Trial.

The TAILOR-PCI trial of genotype-guided P2Y12 inhibitor selection showed a trend toward fewer ischemic events with pharmacogenomic-guided therapy versus standard clopidogrel, though the primary endpoint was not statistically significant. The study advanced the concept of precision antiplatelet therapy.

Evinacumab for Homozygous Familial Hypercholesterolemia.

This pivotal trial showed that evinacumab, an ANGPTL3 inhibitor, reduced LDL cholesterol by 47% in patients with homozygous familial hypercholesterolemia, a condition where conventional therapies including PCSK9 inhibitors are often ineffective due to absent LDL receptors. Evinacumab represents the first LDL-receptor-independent approach to cholesterol lowering.

The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y12 Inhibitor in Patients After Percutaneous Coronary Intervention

A Systematic Review and Meta-Analysis.

This meta-analysis confirmed that discontinuing aspirin while continuing a P2Y12 inhibitor after PCI significantly reduces bleeding without increasing ischemic events. The consolidated evidence supported P2Y12 inhibitor monotherapy as a safe de-escalation strategy.

Integrated management of atrial fibrillation in primary care

results of the ALL-IN cluster randomized trial.

The ALL-IN cluster-randomized trial showed that integrated AF management orchestrated in primary care achieved excellent adherence to guideline recommendations and was associated with improved clinical outcomes. The results demonstrated that comprehensive AF care can be effectively delivered in the general practice setting.

2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants

A Report of the American College of Cardiology Solution Set Oversight Committee.

The 2020 ACC Expert Consensus on managing bleeding in patients on oral anticoagulants provided practical algorithms for assessment, reversal agent selection, and resumption of anticoagulation after bleeding events, addressing a common clinical challenge.

Complete vs Culprit-Lesion-Only Revascularization for ST-Segment Elevation Myocardial Infarction

A Systematic Review and Meta-analysis.

This JAMA Cardiology meta-analysis confirmed that complete revascularization of nonculprit lesions significantly reduces cardiovascular death and MI compared with culprit-only PCI in patients with STEMI and multivessel disease. The pooled analysis provided definitive evidence favoring the complete revascularization approach.

Association of Radial Artery Graft vs Saphenous Vein Graft With Long-term Cardiovascular Outcomes Among Patients Undergoing Coronary Artery Bypass Grafting

A Systematic Review and Meta-analysis.

This JAMA meta-analysis of individual patient data confirmed that radial artery grafts provide superior long-term cardiovascular outcomes compared with saphenous vein grafts in patients undergoing CABG, supporting the use of arterial conduits to improve coronary bypass durability.

Comparative Efficacy and Safety of Oral P2Y12 Inhibitors in Acute Coronary Syndrome

Network Meta-Analysis of 52 816 Patients From 12 Randomized Trials.

This network meta-analysis of oral P2Y12 inhibitors in ACS incorporating over 52,000 patients from contemporary trials provided updated comparative efficacy and safety data, informing personalized antiplatelet selection based on the balance of ischemic and bleeding risk.

Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction

a comparative analysis of three randomised controlled trials.

This Lancet analysis estimated the lifetime benefit of comprehensive disease-modifying pharmacotherapy in HFrEF, showing that adding an MRA, ARNI, and SGLT2 inhibitor to standard therapy could yield several additional years of event-free survival. The analysis provided a compelling quantitative rationale for the four-pillar approach to heart failure treatment.

Systemic Amyloidosis Recognition, Prognosis, and Therapy

A Systematic Review.

This JAMA systematic review provided a comprehensive overview of systemic amyloidosis, including AL and ATTR subtypes, covering diagnostic pathways, prognostic assessment, and emerging therapies. The review addressed the growing recognition that cardiac amyloidosis is underdiagnosed.

Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome

The TICO Randomized Clinical Trial.

The TICO results showed that ticagrelor monotherapy after 3 months of DAPT significantly reduced major bleeding compared with continued ticagrelor plus aspirin at 1 year after PCI for ACS, without increasing cardiovascular events. The study reinforced the safety of early aspirin discontinuation.

Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older

The OPTIMISE Randomized Clinical Trial.

The OPTIMISE trial demonstrated that reducing the number of antihypertensive medications in older patients with well-controlled blood pressure is safe, with the majority maintaining adequate control at 12 weeks. The results supported deprescribing as a reasonable strategy in elderly patients with polypharmacy.

Worldwide Prevalence of Familial Hypercholesterolemia

Meta-Analyses of 11 Million Subjects.

This meta-analysis of 11 million subjects established that familial hypercholesterolemia is far more prevalent than previously estimated, affecting approximately 1 in 250 individuals worldwide and up to 1 in 17 among patients with ischemic heart disease. The data highlighted the massive global underdiagnosis of FH.

Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment

A Systematic Review and Meta-analysis.

This JAMA meta-analysis showed that blood pressure lowering is associated with a significant reduction in the risk of incident dementia and cognitive impairment. The findings supported blood pressure control as a potentially modifiable strategy for dementia prevention.

Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction.

The VICTORIA trial demonstrated that vericiguat, a novel oral soluble guanylate cyclase stimulator, reduced the composite of cardiovascular death or heart failure hospitalization in patients with HFrEF who had recently decompensated. This established a new mechanism of action for heart failure treatment, targeting the nitric oxide–sGC–cGMP pathway.

Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus

A Scientific Statement From the American Heart Association.

This AHA scientific statement addressed the clinical management of stable coronary artery disease specifically in patients with type 2 diabetes, integrating ISCHEMIA results with contemporary evidence on SGLT2 inhibitors and GLP-1 agonists for comprehensive cardiometabolic risk management.

Monotherapy with a P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis

a systematic review and meta-analysis.

This Lancet meta-analysis demonstrated that P2Y12 inhibitor monotherapy is superior to aspirin monotherapy for secondary cardiovascular prevention, reducing ischemic events (particularly stroke) without increasing major bleeding. The findings challenged aspirin's position as the default long-term antiplatelet agent.

Ten-Year Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Left Main Coronary Disease

Extended Follow-Up of the PRECOMBAT Trial.

The EXCEL 10-year extended follow-up showed higher all-cause and cardiovascular mortality with PCI compared with CABG for left main disease, diverging from the earlier 5-year results. The long-term data reignited the debate about the optimal revascularization strategy for left main stenosis.

Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal)

a multicentre, randomised, sham-controlled trial.

The pivotal SPYRAL HTN-OFF MED trial confirmed that catheter-based renal denervation significantly reduced 24-hour ambulatory blood pressure compared with a sham procedure in patients with hypertension not taking antihypertensive medications. This definitive sham-controlled result rehabilitated renal denervation as a genuine blood pressure-lowering intervention.

Optimal Antithrombotic Regimens for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

An Updated Network Meta-analysis.

This updated network meta-analysis of antithrombotic regimens in AF patients undergoing PCI, integrating AUGUSTUS, RE-DUAL PCI, PIONEER AF-PCI, and ENTRUST-AF PCI, confirmed that dual therapy with a DOAC plus P2Y12 inhibitor offers the optimal balance of bleeding reduction and ischemic protection.

Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE)

the randomised, open-label, non-inferiority trial.

The POPular AGE trial showed that clopidogrel was associated with less bleeding than ticagrelor or prasugrel in patients aged 70 years and older with non-ST-elevation ACS, without a significant increase in ischemic events. The results supported clopidogrel as the preferred antiplatelet in elderly ACS patients.

Management of Coronary Disease in Patients with Advanced Kidney Disease.

The ISCHEMIA-CKD trial showed that an initial invasive strategy did not reduce cardiovascular events compared with conservative management in patients with stable coronary disease and advanced chronic kidney disease. The findings underscored the heightened procedural risk and attenuated benefit of revascularization in severe CKD.

Inclisiran for the Treatment of Heterozygous Familial Hypercholesterolemia.

The ORION-9 trial demonstrated that twice-yearly inclisiran injections reduced LDL cholesterol by approximately 40% in patients with heterozygous familial hypercholesterolemia on maximally tolerated statin therapy. The results confirmed the efficacy of RNA interference-based lipid lowering in the genetically defined FH population.

Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol.

The ORION-10 and ORION-11 phase 3 trials demonstrated that twice-yearly subcutaneous inclisiran reduced LDL cholesterol by approximately 50% with sustained efficacy and an acceptable safety profile. These results confirmed inclisiran as a viable long-acting approach to LDL lowering, offering an alternative to frequent dosing with statins or monoclonal antibodies.

Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients With Heart Failure With and Without Diabetes.

This JAMA DAPA-HF analysis confirmed that dapagliflozin reduced worsening heart failure and cardiovascular death equally in patients with HFrEF with and without type 2 diabetes. The finding strengthened the case for SGLT2 inhibitors as a heart failure therapy independent of glycemic status.

Initial Invasive or Conservative Strategy for Stable Coronary Disease.

The ISCHEMIA trial showed that an initial invasive strategy with revascularization did not reduce cardiovascular death or MI compared with optimal medical therapy alone in patients with stable coronary disease and moderate-to-severe ischemia. The findings reinforced medical therapy as a reasonable first-line approach even in the presence of significant ischemia.

A Community-Based Intervention for Managing Hypertension in Rural South Asia.

This NEJM trial demonstrated that a community-based intervention using trained nonphysician health workers significantly improved blood pressure control in rural South Asian communities. The scalable approach addressed the critical shortage of healthcare professionals in low-resource settings.

Effect of Renal Denervation and Catheter Ablation vs Catheter Ablation Alone on Atrial Fibrillation Recurrence Among Patients With Paroxysmal Atrial Fibrillation and Hypertension

The ERADICATE-AF Randomized Clinical Trial.

The ERADICATE-AF trial showed that adding renal denervation to pulmonary vein isolation significantly reduced AF recurrence in patients with hypertension and paroxysmal AF, demonstrating a synergistic benefit of combining two catheter-based interventions.

Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis

updated 5-year outcomes from the randomised, non-inferiority NOBLE trial.

The 5-year NOBLE update confirmed that CABG remained superior to PCI for the composite endpoint in patients with unprotected left main stenosis, with the difference driven by lower rates of nonprocedural MI and repeat revascularization with surgery.

Lipoprotein(a) Reduction in Persons with Cardiovascular Disease.

This NEJM study demonstrated proof-of-concept that targeted lipoprotein(a) reduction is achievable in patients with established cardiovascular disease using an antisense oligonucleotide. The results validated Lp(a) as a druggable target and paved the way for the large-scale cardiovascular outcomes trials now underway.

Effects of Dapagliflozin on Symptoms, Function, and Quality of Life in Patients With Heart Failure and Reduced Ejection Fraction

Results From the DAPA-HF Trial.

This DAPA-HF analysis showed that dapagliflozin significantly improved heart failure symptoms, physical function, and quality of life in patients with HFrEF within the first few weeks of treatment. The patient-reported outcomes complemented the hard clinical endpoints.

Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age

Insights From DAPA-HF.

This DAPA-HF age subanalysis confirmed that dapagliflozin reduced heart failure events and cardiovascular death consistently across all age groups in patients with HFrEF, including those aged 75 and older. The safety profile was also maintained in elderly patients.

A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve Replacement.

The GALILEO trial demonstrated that rivaroxaban-based antithrombotic therapy after TAVR increased the risk of death or thromboembolic events and bleeding compared with antiplatelet therapy alone. The trial was stopped early for harm, establishing antiplatelet therapy as the preferred post-TAVR strategy in patients without other anticoagulation indications.

Alcohol Abstinence in Drinkers with Atrial Fibrillation.

This randomized trial showed that abstinence from alcohol in regular drinkers with atrial fibrillation significantly reduced AF recurrence and AF burden. The study provided the first high-quality evidence that alcohol cessation is a modifiable lifestyle intervention for AF management.

A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke.

The TST trial demonstrated that targeting LDL cholesterol below 70 mg/dL with statin therapy after ischemic stroke significantly reduced subsequent cardiovascular events compared with a higher target of 90-110 mg/dL. The results extended the 'lower is better' principle to secondary prevention after cerebrovascular events.

Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction.

The COLCOT trial demonstrated that low-dose colchicine (0.5 mg daily) initiated within 30 days of MI significantly reduced the composite of cardiovascular death, cardiac arrest, MI, stroke, or urgent coronary revascularization. This landmark study provided definitive evidence for targeted anti-inflammatory therapy in secondary cardiovascular prevention.

Ticagrelor with or without Aspirin in High-Risk Patients after PCI.

The TWILIGHT trial showed that ticagrelor monotherapy after 3 months of dual antiplatelet therapy significantly reduced clinically relevant bleeding without increasing ischemic events in high-risk patients after PCI. This established P2Y12 inhibitor monotherapy as a safe de-escalation strategy for selected patients.

Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction.

The DAPA-HF trial demonstrated that dapagliflozin reduced the composite of worsening heart failure or cardiovascular death in patients with HFrEF regardless of the presence of diabetes. This transformative result established SGLT2 inhibitors as a fourth pillar of heart failure therapy alongside ACE inhibitors/ARBs, beta-blockers, and mineralocorticoid antagonists.

Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease

The EMPA-HEART CardioLink-6 Randomized Clinical Trial.

The EMPA-HEART trial demonstrated that empagliflozin significantly reduced left ventricular mass index in patients with type 2 diabetes and coronary artery disease, providing the first randomized evidence of direct structural cardiac effects from SGLT2 inhibition.

Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes

a systematic, multinational, large-scale analysis.

This comprehensive multinational analysis compared all first-line antihypertensive drug classes across millions of patients. Thiazide and thiazide-like diuretics showed the most favorable overall effectiveness-to-safety balance, while ACE inhibitors were associated with a higher risk of angioedema and cough compared with ARBs.

Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease

The CLEAR Wisdom Randomized Clinical Trial.

The CLEAR Harmony trial showed that bempedoic acid added to maximally tolerated statin therapy produced additional LDL cholesterol lowering with an acceptable safety profile in patients at high cardiovascular risk. The trial established the tolerability of bempedoic acid in a large, long-term study.

Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease.

The 5-year EXCEL results showed no significant difference between PCI and CABG for the primary composite endpoint in left main coronary disease, though controversy arose over differing results depending on whether periprocedural MI was included. The data fueled the ongoing debate about optimal left main revascularization strategy.

Ticagrelor Alone Versus Dual Antiplatelet Therapy From 1 Month After Drug-Eluting Coronary Stenting.

The TICO trial demonstrated that ticagrelor monotherapy after 3 months of DAPT reduced bleeding without increasing ischemic events compared with continued DAPT at 1 year after DES implantation. The study added to the growing evidence for early P2Y12 inhibitor monotherapy.

Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER)

a phase 2, randomised, double-blind, placebo-controlled trial.

The AMBER trial showed that patiromer, a potassium binder, enabled continued use of spironolactone in patients with resistant hypertension and CKD by preventing hyperkalemia. The results established a practical solution for the clinical dilemma of MRA use in CKD patients.

A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI.

The POPular Genetics trial showed that genotype-guided de-escalation from ticagrelor or prasugrel to clopidogrel in CYP2C19 noncarriers after primary PCI was noninferior for thrombotic events and reduced bleeding. The study established pharmacogenomic-guided antiplatelet selection as a viable personalized medicine approach.

Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction.

The PARAGON-HF trial did not meet its primary endpoint of reduced heart failure hospitalization or cardiovascular death with sacubitril-valsartan versus valsartan in HFpEF. However, prespecified subgroup analysis suggested benefit in patients with lower ejection fractions and in women, informing the expanding indication for ARNI.

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI)

a single-blind randomised controlled trial.

The CONDI-2/ERIC-PPCI trial definitively showed that remote ischemic conditioning applied to the arm before primary PCI for STEMI did not improve clinical outcomes at 12 months. The large, multicenter negative result ended the clinical pursuit of this cardioprotective strategy.

Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes.

The ISAR-REACT 5 trial found that prasugrel was superior to ticagrelor in reducing the composite of death, MI, or stroke in patients with acute coronary syndromes planned for invasive management, with no significant difference in bleeding. This first major head-to-head comparison of newer P2Y12 inhibitors influenced antiplatelet selection in ACS.

Association Between Triglyceride Lowering and Reduction of Cardiovascular Risk Across Multiple Lipid-Lowering Therapeutic Classes

A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials.

This meta-analysis demonstrated that the association between triglyceride lowering and cardiovascular risk reduction depends on concomitant reductions in apolipoprotein B-containing lipoproteins. Triglyceride lowering per se, without apoB reduction, does not reliably reduce cardiovascular events.

Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI)

a randomised, open-label, phase 3b trial.

The ENTRUST-AF PCI trial showed that edoxaban-based dual antithrombotic therapy (edoxaban plus P2Y12 inhibitor) met the noninferiority threshold for bleeding compared with VKA-based triple therapy in AF patients after PCI, adding a fourth DOAC to the evidence supporting aspirin-free strategies.

Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease

10-year follow-up of the multicentre randomised controlled SYNTAX trial.

The SYNTAX 10-year extended follow-up demonstrated that CABG provided superior long-term survival over PCI in patients with three-vessel or left main coronary disease, driven primarily by lower cardiac mortality. This longest-available randomized comparison reinforced CABG as the preferred revascularization strategy for complex coronary disease.

Complete Revascularization with Multivessel PCI for Myocardial Infarction.

The COMPLETE trial showed that routine complete revascularization of nonculprit lesions during the index hospitalization or shortly thereafter reduced cardiovascular death and MI compared with culprit-only PCI in patients with STEMI and multivessel disease. This provided definitive evidence for a strategy of staged complete revascularization after primary PCI.

Ticagrelor in Patients with Stable Coronary Disease and Diabetes.

The THEMIS trial showed that ticagrelor added to aspirin modestly reduced cardiovascular events in patients with stable coronary disease and type 2 diabetes but significantly increased major bleeding. The narrow net clinical benefit limited the clinical adoption of this strategy.

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI)

a phase 3, placebo-controlled, randomised trial.

This THEMIS-PCI subanalysis showed that ticagrelor added to aspirin significantly reduced cardiovascular events in diabetic patients with stable coronary disease and prior PCI, identifying the subgroup with the most favorable risk-benefit profile within the overall neutral THEMIS trial.

Polypill for Cardiovascular Disease Prevention in an Underserved Population.

This NEJM trial demonstrated that a fixed-dose polypill containing atorvastatin, amlodipine, losartan, and hydrochlorothiazide significantly reduced cardiovascular events in an underserved, predominantly minority population without established cardiovascular disease. The results validated the polypill as a practical population-level prevention strategy.

Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease.

The AFIRE trial demonstrated that rivaroxaban monotherapy was superior to rivaroxaban plus an antiplatelet agent in patients with atrial fibrillation and stable coronary artery disease, with significantly less bleeding and no increase in ischemic events. The trial was stopped early due to increased mortality in the combination arm, establishing anticoagulant monotherapy as the standard of care.

Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.

The PIONEER 6 trial established the cardiovascular safety of oral semaglutide in patients with type 2 diabetes at high cardiovascular risk, meeting the noninferiority threshold for MACE versus placebo. This was the first cardiovascular safety trial for an oral GLP-1 receptor agonist.

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran)

a pragmatic, cluster-randomised trial.

The PolyIran trial, a pragmatic cluster-randomized study, demonstrated that a cardiovascular polypill reduced major cardiovascular events in an Iranian population when used for both primary and secondary prevention. The results validated the polypill strategy in a middle-income country setting.

The state of hypertension care in 44 low-income and middle-income countries

a cross-sectional study of nationally representative individual-level data from 1·1 million adults.

This Lancet cross-sectional analysis of 44 low- and middle-income countries identified where patients are lost along the hypertension care continuum, quantifying the massive global treatment gap that accounts for the disproportionate cardiovascular burden in these settings.

Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries

an analysis of 123 nationally representative surveys.

This Lancet analysis of 123 national surveys across 12 high-income countries mapped trends in hypertension awareness, treatment, and control, revealing that despite improvements, substantial gaps in blood pressure management persist even in well-resourced healthcare systems.

Effects of Serelaxin in Patients with Acute Heart Failure.

The RELAX-AHF-2 trial showed that serelaxin (recombinant human relaxin-2) did not reduce cardiovascular death or worsening heart failure in patients with acute heart failure, failing to confirm the promising phase 2 results. The definitive negative outcome closed development of this vasodilator strategy.

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.

The 2018 ACC/AHA/HRS guideline for bradycardia and cardiac conduction delay provided comprehensive updated recommendations for evaluation, pacing indications, and device selection, replacing prior guidelines with contemporary evidence on leadless pacing and physiological pacing strategies.

Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions.

The SPRINT MIND MRI substudy showed that intensive blood pressure control significantly reduced the progression of cerebral white matter lesions compared with standard treatment. The imaging findings provided mechanistic support for the potential neuroprotective effects of aggressive blood pressure management.

Volanesorsen and Triglyceride Levels in Familial Chylomicronemia Syndrome.

This NEJM trial demonstrated that volanesorsen, an antisense oligonucleotide targeting apoC-III, dramatically reduced triglyceride levels in patients with familial chylomicronemia syndrome. As the first targeted therapy for this rare genetic disorder, it addressed a previously unmet therapeutic need.

Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND)

a double-blind, randomised placebo-controlled trial.

The REWIND trial showed that once-weekly dulaglutide reduced the composite of cardiovascular death, nonfatal MI, and nonfatal stroke in patients with type 2 diabetes, including a substantial proportion at primary prevention level. This broadened the evidence for GLP-1 receptor agonists to a lower-risk, more representative diabetes population.

Effect of Alirocumab on Mortality After Acute Coronary Syndromes.

This ODYSSEY OUTCOMES analysis demonstrated that alirocumab reduced all-cause mortality after acute coronary syndrome, particularly in patients with baseline LDL cholesterol ≥100 mg/dL. This was the first PCSK9 inhibitor trial to show a statistically significant mortality reduction.

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.

The 2019 AHA/ACC/HRS focused update on atrial fibrillation management provided new recommendations for anticoagulation including DOACs as first-line therapy, expanded catheter ablation indications, and updated guidance on rhythm versus rate control strategies.

Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention

The SMART-CHOICE Randomized Clinical Trial.

The SMART-CHOICE trial showed that P2Y12 inhibitor monotherapy after 3 months of DAPT was noninferior to continued 12-month DAPT for cardiovascular events after PCI, supporting the de-escalation to single antiplatelet therapy approach.

Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI

The STOPDAPT-2 Randomized Clinical Trial.

The STOPDAPT-2 trial demonstrated that 1 month of DAPT followed by clopidogrel monotherapy was noninferior and even superior to 12-month standard DAPT for net clinical benefit after PCI. The results supported ultra-short DAPT as a viable strategy with contemporary drug-eluting stents.

Systematic Review for the 2018 AHA/ACC Guideline on the Management of Blood Cholesterol

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

JACC publication of the systematic review underlying the 2018 AHA/ACC cholesterol guideline, evaluating the evidence for nonstatin lipid-lowering therapies and their effects on cardiovascular outcomes.

2018 AHA/ACC Guideline on the Management of Blood Cholesterol

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

JACC publication of the full 2018 AHA/ACC blood cholesterol guideline, providing comprehensive recommendations on risk assessment, statin therapy intensity, and nonstatin therapies including ezetimibe and PCSK9 inhibitors for cardiovascular risk reduction.

2018 AHA/ACC Guideline on the Management of Blood Cholesterol

Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

JACC publication of the 2018 AHA/ACC cholesterol guideline executive summary, providing key recommendations including risk enhancers, coronary calcium scoring, and LDL thresholds for PCSK9 inhibitor therapy in a concise format for clinical practice.

Drug-eluting or bare-metal stents for percutaneous coronary intervention

a systematic review and individual patient data meta-analysis of randomised clinical trials.

This Lancet individual patient data meta-analysis provided definitive evidence that new-generation drug-eluting stents are superior to bare-metal stents across all patient subgroups, with reduced target lesion revascularization and no increase in stent thrombosis or mortality. The findings support universal DES use.

Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans.

This NEJM trial compared two dual antihypertensive combinations (amlodipine-hydrochlorothiazide versus perindopril-hydrochlorothiazide) in black African patients with hypertension, providing evidence to guide initial combination therapy in this underrepresented population with high hypertension prevalence.

Systematic Review for the 2018 AHA/ACC Guideline on the Management of Blood Cholesterol

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

This systematic review provided the evidence foundation for the 2018 AHA/ACC cholesterol guideline, evaluating nonstatin therapies including ezetimibe, PCSK9 inhibitors, and bile acid sequestrants for their effects on cardiovascular outcomes beyond statin monotherapy.

2018 AHA/ACC Guideline on the Management of Blood Cholesterol

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

The full 2018 AHA/ACC Guideline on blood cholesterol management redefined the approach to lipid-lowering therapy by integrating risk enhancers, lifetime risk assessment, and coronary artery calcium scoring into treatment decisions. It endorsed PCSK9 inhibitors for secondary prevention when LDL cholesterol remains above threshold despite maximally tolerated statin therapy.

2018 AHA/ACC Guideline on the Management of Blood Cholesterol

Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

The 2018 AHA/ACC cholesterol guideline executive summary introduced risk enhancers, coronary artery calcium scoring for shared decision-making, and LDL-cholesterol thresholds for escalating therapy to PCSK9 inhibitors. The guideline shifted the paradigm from fixed-dose statin therapy toward personalized, risk-based LDL management.

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.

The CREDENCE trial demonstrated that canagliflozin significantly reduced the risk of kidney failure, cardiovascular events, and death in patients with type 2 diabetes and chronic kidney disease. As the first dedicated renal outcomes trial for an SGLT2 inhibitor, it established this drug class as a cornerstone of diabetic nephropathy treatment.

Effects of Icosapent Ethyl on Total Ischemic Events

From REDUCE-IT.

This REDUCE-IT analysis of total ischemic events (not just first events) showed that icosapent ethyl reduced recurrent cardiovascular events by 30%, with a substantial absolute risk reduction. The total event analysis demonstrated even greater benefit than the primary first-event endpoint.

Dapagliflozin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Previous Myocardial Infarction.

This DECLARE-TIMI 58 subanalysis showed that dapagliflozin significantly reduced MACE specifically in patients with type 2 diabetes and prior myocardial infarction, while the broader trial population showed only heart failure benefit. The finding identified the highest-risk subgroup most likely to benefit from SGLT2 inhibition.

Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus.

This DECLARE-TIMI 58 heart failure analysis confirmed that dapagliflozin significantly reduces heart failure hospitalization and cardiovascular death in patients with type 2 diabetes, with the greatest benefit in those with prior heart failure. The results strengthened the heart failure prevention role of SGLT2 inhibitors.

Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients.

The PARTNER 3 trial showed that TAVR with a balloon-expandable valve was superior to surgery for the composite of death, stroke, or rehospitalization at 1 year in patients with severe aortic stenosis at low surgical risk. This landmark result, alongside Evolut Low Risk, established TAVR as a viable alternative to surgery in virtually all aortic stenosis patients.

Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients.

The Evolut Low Risk trial demonstrated that self-expanding TAVR was noninferior to surgical aortic-valve replacement in low-surgical-risk patients with severe aortic stenosis for the composite of death or disabling stroke at 24 months. Together with PARTNER 3, this trial extended TAVR as a treatment option across the full spectrum of surgical risk.

A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report.

The final MOMENTUM 3 report confirmed the long-term superiority of the HeartMate 3 fully magnetically levitated LVAD over the HeartMate II, with sustained reductions in pump thrombosis, stroke, and reoperations. The data cemented HeartMate 3 as the definitive standard in mechanical circulatory support.

Comparison of the Effects of Glucagon-Like Peptide Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors for Prevention of Major Adverse Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus.

This comparative meta-analysis showed that GLP-1 receptor agonists predominantly reduce atherosclerotic events (MI, stroke) while SGLT2 inhibitors primarily reduce heart failure hospitalization and renal outcomes. The distinct benefit profiles support tailored drug selection based on individual patient comorbidities.

Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation.

The AUGUSTUS trial, using a 2×2 factorial design, demonstrated that apixaban was superior to warfarin (less bleeding) and aspirin offered no ischemic benefit over placebo in patients with atrial fibrillation after ACS or PCI. This trial definitively established dual therapy with a DOAC plus a P2Y12 inhibitor as the preferred antithrombotic strategy.

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation.

The RACE 7 ACWAS trial showed that a wait-and-see approach was noninferior to immediate cardioversion for achieving sinus rhythm at 4 weeks in patients with recent-onset symptomatic atrial fibrillation. The results support expectant management as a viable initial strategy in hemodynamically stable patients.

Coronary Angiography after Cardiac Arrest without ST-Segment Elevation.

The COACT trial demonstrated that immediate coronary angiography did not improve 90-day survival compared with delayed angiography in patients resuscitated from cardiac arrest without ST-segment elevation. The findings argued against routine emergent catheterization in this population.

Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients With Hypertension.

This meta-analysis of sham-controlled renal denervation trials confirmed a significant blood pressure reduction with catheter-based renal denervation versus sham procedures. By including only rigorously designed studies, the analysis provided the most definitive evidence for the biological efficacy of renal denervation.