Cardiology Trials

 Patients having PCI for acute MI who had completed one month of DAPT with aspirin and ticagrelor without ischemic or bleeding events were randomly assigned to either continue that regimen or switch to aspirin plus clopidogrel for the next 11 months in this study. According to the findings of this trial, among patients undergoing PCI for AMI who had completed 1 month of DAPT with aspirin and ticagrelor without incident, switching to aspirin + clopidogrel for the next 11 months met criteria for noninferiority and superiority compared to continuing with aspirin + ticagrelor. This was mostly due to a decrease in significant bleeding, although ischemia episodes were also reduced quantitatively with a de-escalation technique. De-escalation was carried out without the need for genotype testing or reload. These are intriguing findings that are both therapeutically meaningful and cost-effective. The only limitation is that this trial only involved East Asian patients, therefore its applica...

 The trial's purpose was to compare full revascularization guided by fractional flow reserve (FFR) vs angiography in patients with ST-segment elevation myocardial infarction (STEMI) who underwent PCI of their culprit artery. Design of the Study Patients with non-culprit multivessel coronary disease who underwent initial PCI for STEMI were randomized to FFR-guided revascularization (n = 590) or angiography-guided revascularization (n = 581). The total number of enrollees was 1,171. The duration of the follow-up was 12 months. The average patient age was 63 years. 15% of the population was female. Type 2 diabetes:  18% of the population. Criteria for inclusion: STEMI patients with multivessel non-culprit coronary disease Criteria for exclusion: Single-vessel coronary artery disease Instability of the heart Previously performed coronary artery bypass grafting Calcification of the coronary arteries Chronic complete occlusion Important Findings: At 12 months, the primary outcome of...

 In terms of net adverse clinical events, the MASTER DAPT trial found that shortened antiplatelet medication was not inferior to regular antiplatelet therapy. Description: The trial's purpose was to compare shortened antiplatelet therapy to standard antiplatelet therapy in patients who had percutaneous coronary intervention (PCI) using a biodegradable-polymer sirolimus-eluting stent. Design of the Study:  Participants with symptomatic coronary artery disease who had PCI during the previous 30-44 days were randomly assigned to one of two groups: shortened therapy (n = 2,295) or standard therapy (n = 2,284). Among people who do not require oral anticoagulation: Participants in the abbreviated therapy group promptly discontinued dual antiplatelet therapy (DAPT) and continued single antiplatelet therapy. Participants in the conventional therapy group received DAPT for 5 months before switching to mono antiplatelet medication. Those with an indication for oral anticoagulation inclu...

The LAAOS III trial found that surgical left atrial appendage closure during cardiac surgery was effective when used in conjunction with anticoagulation. Description: The study compared surgical left atrial appendage occlusion to no occlusion in patients with atrial fibrillation who were undergoing open-heart surgery for another reason. Design of the Study: Patients with atrial fibrillation and a high risk of stroke were randomized to surgical left atrial appendage occlusion (n = 2,379) or no left atrial appendage occlusion (n = 2,391) during open-heart surgery for another reason. The total number of students enrolled: 4,770. Follow-up time: 3.8 years. The average patient: 71 years old. 32 percent of the population was female. Diabetes: 32 percent of the population. Criteria for inclusion: People who are having heart surgery with cardiopulmonary bypass. People who have atrial fibrillation and CHA2DS2-Vasc more than 2. Criteria for exclusion: Off-pump surgery  Implantation of a mech...

 The ATLANTIS trial showed that full-dose apixaban is not superior to standard of care (vitamin K antagonist if an indication for OAC; antiplatelets if no indication) among patients undergoing TAVR despite a reduction in valve leaflet thrombosis (compared with antiplatelet therapy ). 

 Among patients with advanced heart failure with reduced ejection fraction (HFrEF), the combination of sacubitril and valsartan was not found to be superior to valsartan in terms of lowering NT-proBNP, and it did not enhance any of the other clinical outcomes studied. The multicenter trial assigned 335 HFrEF patients to one of two treatment groups: sacubitril/valsartan (n=167) or valsartan (n=168). The patients were followed for 24 weeks. EF was less than 20% at baseline, systolic blood pressure was approximately 113 mm Hg, estimated glomerular filtration rate was 63.6 mL/min/1.73m2 in the combination arm and 65.7 mL/min/1.73m2 in the valsartan arm, and NT-proBNP levels were 1,931 pg/ml and 1,818 pg/ml in the respective arms, respectively. The majority of the patients (60 percent) were Caucasian, 60 years old, and almost one-third were female. Because of the significant risk of poor results in this susceptible demographic during the COVID-19 pandemic, the experiment was terminated ...