Trials that changed cardiology

Beta-blockers · Intravenous atenolol

Early intravenous atenolol in acute myocardial infarction modestly reduced vascular mortality, mainly in the first days.

There is no society video about this trial yet.

Aspirin · Alternate-day aspirin vs placebo

In healthy male physicians, alternate-day aspirin reduced first myocardial infarction, without a conclusive effect on stroke or cardiovascular mortality.

There is no society video about this trial yet.

Thiazide diuretics · Chlorthalidone

In older adults with isolated systolic hypertension, chlorthalidone-based treatment reduced stroke.

There is no society video about this trial yet.

Anticoagulation · Warfarin and aspirin vs placebo

In nonvalvular atrial fibrillation, warfarin and aspirin reduced stroke and systemic embolism compared with placebo.

There is no society video about this trial yet.

Thrombolysis · Accelerated alteplase vs streptokinase

Accelerated alteplase reduced infarction mortality compared with streptokinase.

There is no society video about this trial yet.

Anticoagulation · Warfarin vs aspirin

Warfarin reduced ischemic strokes compared with aspirin, but in patients over 75 the benefit was offset by more hemorrhages.

There is no society video about this trial yet.

Statins · Pravastatin (primary prevention)

Pravastatin reduced coronary events in primary prevention in men with high cholesterol.

There is no society video about this trial yet.

Antiplatelets · Clopidogrel vs aspirin

In patients with prior stroke, myocardial infarction or peripheral artery disease, clopidogrel was modestly more effective than aspirin at preventing ischemic events, with similar safety.

There is no society video about this trial yet.

Statins · Pravastatin vs placebo after MI

After myocardial infarction in patients with average cholesterol, pravastatin reduced coronary death or recurrent infarction compared with placebo.

There is no society video about this trial yet.

Devices · ICD after MI

The implantable defibrillator reduced mortality after infarction with nonsustained ventricular tachycardia and low ejection fraction.

There is no society video about this trial yet.

Anticoagulation · Adjusted-dose warfarin vs fixed low dose plus aspirin

In high-risk atrial fibrillation, adjusted-dose warfarin was clearly superior to fixed low-dose warfarin plus aspirin.

There is no society video about this trial yet.

Secondary-prevention ICD · ICD vs antiarrhythmic drugs

In survivors of near-fatal ventricular arrhythmias, the implantable defibrillator reduced mortality compared with antiarrhythmic drugs, mainly amiodarone.

There is no society video about this trial yet.

Diet · DASH diet

A diet rich in fruits, vegetables and low-fat dairy lowered blood pressure within weeks.

There is no society video about this trial yet.

Anticoagulants · Enoxaparin vs unfractionated heparin

In unstable angina and non-Q-wave myocardial infarction, enoxaparin reduced death, myocardial infarction and recurrent angina compared with unfractionated heparin.

There is no society video about this trial yet.

Calcium channel blockers · Nitrendipine

In older adults with isolated systolic hypertension, nitrendipine-based treatment reduced stroke.

There is no society video about this trial yet.

Statins · Lovastatin vs placebo (primary prevention)

In primary prevention with average cholesterol and low HDL, lovastatin reduced first acute major coronary events compared with placebo.

There is no society video about this trial yet.

Blood pressure targets · Diastolic targets + aspirin

In hypertension, intensive diastolic lowering was safe and benefited diabetic patients; low-dose aspirin reduced major cardiovascular events, mainly myocardial infarction.

There is no society video about this trial yet.

Statins · Pravastatin vs placebo

In patients with prior coronary disease across a broad cholesterol range, pravastatin reduced coronary death, total mortality and cardiovascular events.

There is no society video about this trial yet.

Omega-3 and vitamin E · n-3 PUFA and/or vitamin E after MI

After recent myocardial infarction, omega-3 fatty acids reduced death, reinfarction and stroke, while vitamin E showed no benefit.

There is no society video about this trial yet.

Sudden death prevention · EP-guided therapy (including ICD) vs no antiarrhythmic therapy

In coronary disease with LV dysfunction and inducible nonsustained VT, EP-guided therapy reduced arrhythmic death, a benefit attributable to ICDs rather than drugs.

There is no society video about this trial yet.

Secondary-prevention ICD · ICD vs amiodarone or metoprolol

In cardiac arrest survivors, the ICD was associated with a nonsignificant mortality reduction versus amiodarone or metoprolol; the propafenone arm was stopped for excess mortality.

There is no society video about this trial yet.

Secondary-prevention ICD · ICD vs amiodarone

In patients with serious ventricular arrhythmias or syncope, the ICD showed a nonsignificant reduction in mortality compared with amiodarone.

There is no society video about this trial yet.

ACE inhibitors · Ramipril

Ramipril reduced death, myocardial infarction and stroke in high-risk patients without heart failure.

There is no society video about this trial yet.

Beta-blockers · Carvedilol

Carvedilol reduced mortality even in severe heart failure with reduced ejection fraction.

There is no society video about this trial yet.

Coronary physiology · FFR-guided deferral of PCI

In intermediate coronary stenoses without ischemia by FFR, deferring angioplasty was safe and gave outcomes similar to performing it.

There is no society video about this trial yet.

ACE inhibitors · Perindopril ± indapamide after stroke

After stroke or TIA, perindopril with or without indapamide reduced recurrent stroke.

There is no society video about this trial yet.

Antihypertensive drugs · Chlorthalidone vs amlodipine vs lisinopril

A thiazide-type diuretic was as effective as newer antihypertensives for preventing coronary events, and better for preventing heart failure.

There is no society video about this trial yet.

Primary PCI · Stenting and abciximab

In primary PCI, stenting reduced the need for repeat revascularization compared with balloon angioplasty; abciximab added no clear clinical benefit.

There is no society video about this trial yet.

Dual antiplatelet therapy · Long-term clopidogrel after PCI

After elective PCI, continuing clopidogrel plus aspirin for one year reduced death, myocardial infarction and stroke compared with short-term therapy.

There is no society video about this trial yet.

Statins · Simvastatin vs placebo

In high-risk patients, simvastatin reduced mortality and major vascular events, even among those with baseline LDL cholesterol that was not elevated.

There is no society video about this trial yet.

ARBs · Losartan vs atenolol

In hypertensive patients with left ventricular hypertrophy, losartan reduced cardiovascular events, mainly stroke, compared with atenolol.

There is no society video about this trial yet.

Cardiac resynchronization · CRT vs no biventricular pacing

In moderate-to-severe heart failure with a wide QRS, resynchronization improved symptoms, exercise capacity, quality of life and ejection fraction.

There is no society video about this trial yet.

Statins · Pravastatin vs placebo in the elderly

In older adults at vascular risk, pravastatin reduced coronary events, without benefit on stroke or cognitive function.

There is no society video about this trial yet.

Rhythm vs rate control · Rate control vs rhythm control

In recurrent persistent AF, rate control was not inferior to rhythm control for preventing cardiovascular death and morbidity and proved an appropriate alternative.

There is no society video about this trial yet.

Antihypertensives · ACE inhibitor vs diuretic

In older hypertensive patients, starting with an ACE inhibitor led to better cardiovascular outcomes than diuretics, especially in men, despite similar blood pressure lowering.

There is no society video about this trial yet.

Statins · Atorvastatin vs placebo in hypertension

In hypertensive patients with average or low cholesterol, atorvastatin reduced coronary events and strokes, leading to early termination of the trial.

There is no society video about this trial yet.

Beta-blockers · Carvedilol vs metoprolol tartrate

In heart failure, carvedilol reduced mortality compared with metoprolol tartrate.

There is no society video about this trial yet.

ACE inhibitors · Perindopril vs placebo

In stable coronary disease without heart failure, perindopril reduced cardiovascular death, myocardial infarction and cardiac arrest compared with placebo.

There is no society video about this trial yet.

Antihypertensives · Verapamil-trandolapril vs atenolol-hydrochlorothiazide

In hypertensive patients with coronary disease, a verapamil-trandolapril strategy was as effective as an atenolol-hydrochlorothiazide strategy in preventing cardiovascular events.

There is no society video about this trial yet.

Statins · Atorvastatin in type 2 diabetes

In type 2 diabetes without cardiovascular disease, low-dose atorvastatin reduced major cardiovascular events.

There is no society video about this trial yet.

Cardiac resynchronization · CRT and CRT-D vs optimal medical therapy

In advanced heart failure with a wide QRS, resynchronization reduced death or hospitalization, and adding a defibrillator also reduced all-cause mortality.

There is no society video about this trial yet.

Primary-prevention ICD · ICD + medical therapy vs medical therapy in nonischemic cardiomyopathy

In nonischemic dilated cardiomyopathy, a prophylactic ICD reduced sudden arrhythmic death, with a nonsignificant reduction in all-cause mortality.

There is no society video about this trial yet.

Primary-prevention ICD · Early post-MI ICD vs medical therapy

Prophylactic ICD implantation early after MI in patients with LV dysfunction did not reduce overall mortality: fewer arrhythmic deaths were offset by more nonarrhythmic deaths.

There is no society video about this trial yet.

ACE inhibitors · Trandolapril vs placebo

In stable coronary disease with preserved ventricular function on modern therapy, trandolapril did not reduce cardiovascular events compared with placebo.

There is no society video about this trial yet.

Anticoagulants · Enoxaparin vs unfractionated heparin

In high-risk non-ST-elevation acute coronary syndromes with an early invasive strategy, enoxaparin was noninferior to unfractionated heparin but increased bleeding.

There is no society video about this trial yet.

Antihypertensive drugs · Valsartan vs amlodipine

In high-risk hypertensive patients, valsartan and amlodipine had a similar effect on cardiac events; amlodipine lowered blood pressure faster at first.

There is no society video about this trial yet.

Antihypertensives · Amlodipine ± perindopril vs atenolol ± thiazide

In at-risk hypertensive patients, an amlodipine-perindopril regimen reduced cardiovascular events and total mortality compared with an atenolol-thiazide regimen.

There is no society video about this trial yet.

Devices · Cardiac resynchronization (CRT)

Cardiac resynchronization reduced mortality in heart failure with wide QRS.

There is no society video about this trial yet.

Antiplatelets · Clopidogrel added to aspirin and fibrinolysis

In ST-elevation myocardial infarction treated with fibrinolysis, adding clopidogrel improved infarct-artery patency and reduced ischemic complications without increasing major bleeding.

There is no society video about this trial yet.

Haemodynamic monitoring · Pulmonary artery catheter

In hospitalised advanced heart failure, therapy guided by a pulmonary artery catheter did not improve days alive out of hospital and increased adverse events.

There is no society video about this trial yet.

Fibrates · Fenofibrate vs placebo in diabetes

In type 2 diabetes, fenofibrate did not significantly reduce the primary coronary outcome, although it reduced nonfatal infarctions and revascularizations.

There is no society video about this trial yet.

Statins · High-dose atorvastatin vs simvastatin

After myocardial infarction, high-dose atorvastatin did not significantly reduce the primary coronary outcome versus simvastatin, though it reduced several secondary cardiovascular outcomes.

There is no society video about this trial yet.

Glucose-lowering drugs and CV risk · Pioglitazone vs placebo

In type 2 diabetes with macrovascular disease, pioglitazone missed the broad primary endpoint but reduced death, infarction and stroke, with more heart failure hospitalizations.

There is no society video about this trial yet.

Devices · ICD vs amiodarone

The defibrillator reduced mortality in heart failure with ejection fraction of 35% or less; amiodarone did not.

There is no society video about this trial yet.

Beta-blockers · Nebivolol vs placebo

In elderly patients with heart failure, nebivolol reduced the composite of death or cardiovascular hospitalization compared with placebo and was well tolerated.

There is no society video about this trial yet.

Aspirin · Low-dose aspirin vs placebo

In healthy women, low-dose aspirin did not reduce myocardial infarction or cardiovascular death, lowered ischemic stroke and increased gastrointestinal bleeding.

There is no society video about this trial yet.

AF anticoagulation · Clopidogrel + aspirin vs oral anticoagulation

In AF patients at stroke risk, dual antiplatelet therapy was inferior to oral anticoagulation for preventing vascular events, and the trial was stopped early.

There is no society video about this trial yet.

Anticoagulation · Bivalirudin vs heparin plus GP IIb/IIIa inhibitor

In acute coronary syndromes managed invasively, bivalirudin alone gave similar ischemic protection to heparin plus a GP IIb/IIIa inhibitor with less major bleeding.

There is no society video about this trial yet.

Ablation · Paroxysmal AF

In paroxysmal atrial fibrillation, ablation maintained sinus rhythm better than antiarrhythmic drugs.

There is no society video about this trial yet.

Antiplatelets · Clopidogrel + aspirin vs aspirin

In stable patients with atherothrombotic disease or high risk, adding clopidogrel to aspirin did not significantly reduce myocardial infarction, stroke or cardiovascular death.

There is no society video about this trial yet.

Anticoagulants · Enoxaparin vs unfractionated heparin with fibrinolysis

In ST-elevation myocardial infarction treated with fibrinolysis, enoxaparin reduced death and reinfarction versus unfractionated heparin, at the cost of more major bleeding.

There is no society video about this trial yet.

Statins · Pravastatin + diet vs diet alone

In Japanese adults with hypercholesterolemia and no cardiovascular disease, low-dose pravastatin plus diet reduced coronary heart disease compared with diet alone.

There is no society video about this trial yet.

Statins · Atorvastatin 80 mg vs placebo

After recent stroke or TIA without coronary disease, high-dose atorvastatin reduced strokes and cardiovascular events, with a small increase in hemorrhagic stroke.

There is no society video about this trial yet.

AF anticoagulation · Warfarin vs aspirin in the elderly

In elderly primary-care patients with AF, warfarin reduced stroke and embolism more than aspirin without a clear increase in major bleeding.

There is no society video about this trial yet.

Statins · Rosuvastatin in heart failure

In older adults with ischemic systolic heart failure, rosuvastatin did not reduce the primary outcome.

There is no society video about this trial yet.

Vasopressin antagonists · Tolvaptan vs placebo

In patients hospitalized for heart failure, tolvaptan relieved congestion and corrected hyponatremia but did not change long-term mortality or morbidity.

There is no society video about this trial yet.

CETP inhibitors · Torcetrapib + atorvastatin

Despite markedly raising HDL, torcetrapib increased mortality and cardiovascular events, possibly through off-target effects such as blood pressure elevation.

There is no society video about this trial yet.

VT ablation · Prophylactic substrate ablation + ICD vs ICD alone

In patients with prior MI receiving an ICD, prophylactic substrate ablation reduced appropriate device therapies compared with ICD alone.

There is no society video about this trial yet.

Endothelin antagonists · Intravenous tezosentan vs placebo

In acute heart failure, tezosentan did not improve dyspnea or reduce death or worsening heart failure compared with placebo.

There is no society video about this trial yet.

Rhythm vs rate control · Rhythm vs rate control in heart failure

In patients with AF and heart failure with reduced ejection fraction, drug-based rhythm control did not reduce cardiovascular death compared with rate control.

There is no society video about this trial yet.

Ezetimibe · Familial hypercholesterolemia

In familial hypercholesterolemia, adding ezetimibe to simvastatin lowered LDL further but did not slow carotid wall thickening.

There is no society video about this trial yet.

Omega-3 fatty acids · n-3 PUFA vs placebo

In chronic heart failure, omega-3 fatty acids produced a small but significant reduction in mortality and cardiovascular hospitalizations compared with placebo.

There is no society video about this trial yet.

Antihypertensives · Indapamide ± perindopril in the very elderly

In very elderly hypertensive patients, indapamide-based treatment with optional perindopril reduced stroke, heart failure and total mortality.

There is no society video about this trial yet.

ARBs · Irbesartan (preserved EF)

In heart failure with preserved ejection fraction, irbesartan did not improve outcomes.

There is no society video about this trial yet.

ACE inhibitors & ARBs · Ramipril, telmisartan and their combination

In high vascular-risk patients, telmisartan was non-inferior to ramipril; combining them added no benefit and increased adverse effects.

There is no society video about this trial yet.

Perioperative beta-blockade · Extended-release metoprolol vs placebo

Perioperative metoprolol in noncardiac surgery reduced myocardial infarction but increased total mortality and stroke.

There is no society video about this trial yet.

Cardiac resynchronization · CRT on vs off in NYHA class I-II

In mild or asymptomatic heart failure with a wide QRS, resynchronization did not change the clinical composite score but improved ventricular remodeling and delayed hospitalizations.

There is no society video about this trial yet.

Lipid-lowering therapy · Simvastatin + ezetimibe vs placebo

In mild-to-moderate aortic stenosis, simvastatin plus ezetimibe did not reduce aortic-valve events, although it lowered ischemic events.

There is no society video about this trial yet.

AF anticoagulation · Clopidogrel + aspirin vs aspirin alone

In AF patients unsuitable for anticoagulation, adding clopidogrel to aspirin reduced vascular events, mainly stroke, at the cost of more major bleeding.

There is no society video about this trial yet.

Rate & rhythm control · Dronedarone

In atrial fibrillation, dronedarone reduced cardiovascular hospitalization or death.

There is no society video about this trial yet.

Intravenous iron · Ferric carboxymaltose vs placebo

In heart failure with iron deficiency, with or without anemia, ferric carboxymaltose improved symptoms, functional class and quality of life.

There is no society video about this trial yet.

Cardiac rehabilitation · Exercise training vs usual care

In heart failure with reduced ejection fraction, exercise training was safe and produced only a modest, non-significant reduction in death or hospitalization in the primary analysis.

There is no society video about this trial yet.

Primary-prevention ICD · Early post-MI ICD vs medical therapy

In high-risk patients early after MI, early ICD implantation did not reduce overall mortality, as fewer sudden deaths were offset by more nonsudden deaths.

There is no society video about this trial yet.

Anticoagulation · Dabigatran

Dabigatran was an alternative to warfarin for stroke prevention in atrial fibrillation, with less intracranial bleeding.

There is no society video about this trial yet.

Coronary surgery · Off-pump vs on-pump CABG

Off-pump coronary bypass led to worse one-year composite outcomes and lower graft patency than conventional on-pump surgery.

There is no society video about this trial yet.

Invasive strategy · Early vs delayed invasive intervention in NSTE-ACS

In NSTE-ACS, early invasive intervention did not reduce the primary outcome overall but lowered refractory ischemia and benefited the highest-risk patients.

There is no society video about this trial yet.

Reperfusion strategy · Transfer for early PCI after fibrinolysis vs standard care

In high-risk STEMI treated with fibrinolysis, transfer for routine early PCI reduced ischemic complications without increasing major bleeding.

There is no society video about this trial yet.

Glycemic control in type 2 diabetes · Intensive vs standard glucose control

In veterans with poorly controlled type 2 diabetes, intensive glucose control did not reduce major cardiovascular events, death or microvascular complications.

There is no society video about this trial yet.

Blood pressure control · Intensive (<120) vs standard (<140 mmHg) control

In type 2 diabetes, intensive systolic blood pressure control did not significantly reduce major cardiovascular events versus standard control.

There is no society video about this trial yet.

Fibrates · Fenofibrate added to simvastatin

In high-risk type 2 diabetes, adding fenofibrate to a statin did not reduce cardiovascular events versus statin alone.

There is no society video about this trial yet.

Carotid revascularization · Immediate vs deferred carotid endarterectomy

In asymptomatic carotid stenosis, successful endarterectomy reduces stroke incidence, with benefit persisting through ten years of follow-up.

There is no society video about this trial yet.

Drug-eluting stents · Everolimus vs paclitaxel (2nd generation)

The everolimus-eluting stent had fewer events than the paclitaxel-eluting stent in unselected patients.

There is no society video about this trial yet.

Carotid stenosis · Carotid stenting vs endarterectomy

Carotid stenting and endarterectomy had similar composite outcomes, with more periprocedural stroke after stenting and more myocardial infarction after endarterectomy.

There is no society video about this trial yet.

Carotid stenosis · Carotid stenting vs endarterectomy

In symptomatic carotid stenosis, stenting carried a higher short-term stroke risk than endarterectomy.

There is no society video about this trial yet.

ARBs · Valsartan in impaired glucose tolerance

Valsartan modestly reduced incident diabetes but not cardiovascular events in patients with impaired glucose tolerance.

There is no society video about this trial yet.

PCI after thrombolysis · Immediate transfer for PCI

In STEMI treated with thrombolysis far from a PCI center, immediate transfer for PCI did not improve the primary outcome but reduced death, reinfarction or stroke.

There is no society video about this trial yet.

Devices · CRT-D vs ICD alone

Adding cardiac resynchronization to an ICD reduced mortality and heart failure hospitalization in mild-to-moderate heart failure with wide QRS.

There is no society video about this trial yet.

Anti-obesity drugs · Sibutramine

In obese patients at high cardiovascular risk, sibutramine increased nonfatal cardiovascular events versus placebo despite weight loss.

There is no society video about this trial yet.

Statins · Simvastatin 80 mg vs 20 mg

In myocardial infarction survivors, high-dose simvastatin achieved a modest, nonsignificant reduction in major vascular events, with more myopathy.

There is no society video about this trial yet.

If channel blockers · Ivabradine

Ivabradine reduced heart failure hospitalizations in sinus rhythm with heart rate of 70 bpm or more.

There is no society video about this trial yet.

Renal denervation · Resistant hypertension

In resistant hypertension, renal denervation lowered blood pressure compared with control, in a trial without a sham procedure.

There is no society video about this trial yet.

Ablation · Drug-refractory paroxysmal AF

In paroxysmal atrial fibrillation not controlled by an antiarrhythmic drug, radiofrequency ablation reduced recurrences compared with switching drugs.

There is no society video about this trial yet.

VT ablation · Prophylactic VT ablation before ICD vs ICD alone

In coronary heart disease with stable VT, catheter ablation before ICD implantation prolonged time to VT or VF recurrence compared with ICD alone.

There is no society video about this trial yet.

Other lipid-lowering drugs · Niacin added to statin

In coronary patients with statin-controlled LDL, adding niacin raised HDL but did not reduce cardiovascular events.

There is no society video about this trial yet.

Anticoagulation · Apixaban plus antiplatelet therapy vs placebo after ACS

After high-risk acute coronary syndrome, adding apixaban to antiplatelet therapy increased major bleeding without significantly reducing recurrent ischemic events.

There is no society video about this trial yet.

Anticoagulation · Apixaban vs aspirin

In atrial fibrillation patients unsuitable for vitamin K antagonists, apixaban reduced stroke and systemic embolism versus aspirin without markedly increasing major bleeding.

There is no society video about this trial yet.

Pacing · Atrial (AAIR) vs dual-chamber (DDDR) pacing

In sick sinus syndrome, single-lead atrial pacing did not reduce mortality versus dual-chamber pacing and was associated with more paroxysmal AF and reoperations.

There is no society video about this trial yet.

Diuretics · Furosemide: bolus vs infusion, low vs high dose

In acute heart failure, furosemide administration mode did not alter symptoms, while high dose tended to improve symptoms with transient worsening of renal function.

There is no society video about this trial yet.

Transcatheter mitral repair · MitraClip vs mitral surgery

Percutaneous clip repair was less effective than surgery at reducing mitral regurgitation, though it had a better early safety profile.

There is no society video about this trial yet.

Antiplatelet therapy · High-dose clopidogrel guided by platelet function testing

Increasing clopidogrel dose in patients with high platelet reactivity after PCI did not reduce ischemic events compared with standard dosing.

There is no society video about this trial yet.

Rate & rhythm control · Dronedarone in permanent AF

In permanent atrial fibrillation, dronedarone increased heart failure, stroke and cardiovascular death; the trial was stopped early.

There is no society video about this trial yet.

Left main revascularization · PCI with stents vs CABG

PCI with sirolimus-eluting stents was noninferior to bypass surgery for major events at one year in unprotected left main coronary disease.

There is no society video about this trial yet.

Anticoagulation · Rivaroxaban

Rivaroxaban was non-inferior to warfarin for preventing stroke and embolism in atrial fibrillation.

There is no society video about this trial yet.

Statins · Rosuvastatin vs atorvastatin (IVUS)

High-dose rosuvastatin and atorvastatin produced similar regression of coronary plaque measured by intravascular ultrasound.

There is no society video about this trial yet.

Lipid-lowering · Simvastatin plus ezetimibe in chronic kidney disease

Lowering LDL cholesterol with simvastatin plus ezetimibe reduced major atherosclerotic events in patients with chronic kidney disease.

There is no society video about this trial yet.

Renin inhibitors · Aliskiren

Adding aliskiren to ACE inhibitors or ARBs in type 2 diabetes with cardiorenal risk did not reduce events and increased adverse effects, leading to early termination.

There is no society video about this trial yet.

Ultrafiltration · Cardiorenal syndrome

In decompensated heart failure with worsening renal function, ultrafiltration was inferior to stepped pharmacologic therapy and caused more adverse events.

There is no society video about this trial yet.

Stents · Biolimus-eluting biodegradable polymer stent vs bare-metal stent

In STEMI, biolimus-eluting stents reduced major adverse cardiac events at one year compared with bare-metal stents.

There is no society video about this trial yet.

Surgical revascularization · Off-pump vs on-pump CABG

At one year, off-pump and on-pump CABG showed no significant difference in the composite clinical outcome, with similar quality of life and cognition.

There is no society video about this trial yet.

CETP inhibitors · Dalcetrapib

Dalcetrapib raised HDL cholesterol but did not reduce cardiovascular events after a recent acute coronary syndrome, challenging the HDL-raising hypothesis.

There is no society video about this trial yet.

Steroids in cardiac surgery · Intraoperative dexamethasone vs placebo

High-dose intraoperative dexamethasone did not reduce major adverse events after cardiac surgery, although it shortened ventilation time and hospital stay.

There is no society video about this trial yet.

Infective endocarditis · Early surgery vs conventional treatment

In left-sided endocarditis with large vegetations, early surgery reduced the composite of death and embolic events, mainly by preventing systemic embolism.

There is no society video about this trial yet.

Stents · Everolimus-eluting vs bare-metal stent in STEMI

In STEMI, everolimus-eluting stents did not improve the 1-year combined endpoint versus bare-metal stents, but reduced revascularization and stent thrombosis.

There is no society video about this trial yet.

Mechanical circulatory support · Intra-aortic balloon pump

Intra-aortic balloon pump did not improve 12-month survival in cardiogenic shock after myocardial infarction treated with early revascularization.

There is no society video about this trial yet.

ICD · ICD programming with delayed or high-rate therapy

ICD programming with delayed or high-rate-only detection reduced inappropriate therapies and mortality compared with conventional programming.

There is no society video about this trial yet.

Ablation · First-line ablation

As first-line therapy for paroxysmal AF, ablation did not significantly reduce total AF burden compared with drugs, although there was less AF at the end of follow-up.

There is no society video about this trial yet.

Basal insulin · Insulin glargine vs standard care

In dysglycemic patients at cardiovascular risk, insulin glargine did not change cardiovascular outcomes versus standard care, with more hypoglycemia and weight gain.

There is no society video about this trial yet.

Dual antiplatelet therapy · 24 vs 6 months

After stenting, extending dual antiplatelet therapy from 6 to 24 months did not reduce ischemic events and increased bleeding.

There is no society video about this trial yet.

Vascular access · Radial vs femoral access

In STEMI undergoing PCI, radial access reduced net adverse clinical events, bleeding and cardiac mortality compared with femoral access.

There is no society video about this trial yet.

Antiplatelet therapy · Vorapaxar

Vorapaxar lowered ischemic cardiovascular events in secondary prevention but increased bleeding, including intracranial hemorrhage.

There is no society video about this trial yet.

Antiplatelet therapy · Vorapaxar added to standard therapy vs placebo

In non-ST-elevation acute coronary syndromes, adding vorapaxar did not significantly reduce the primary endpoint and increased major bleeding, including intracranial hemorrhage.

There is no society video about this trial yet.

Anticoagulation · Warfarin vs aspirin in sinus rhythm

In heart failure with reduced EF and sinus rhythm, warfarin and aspirin did not differ in the primary outcome; warfarin reduced stroke at the cost of more bleeding.

There is no society video about this trial yet.

ICD programming · Long vs standard detection interval

In ICD recipients, programming a long detection interval reduced antitachycardia pacing and shocks without increasing syncope or mortality.

There is no society video about this trial yet.

Renin inhibitors · Aliskiren vs placebo after hospitalization

In patients hospitalized for heart failure, adding aliskiren did not reduce post-discharge cardiovascular death or readmissions and increased renal adverse effects and hyperkalemia.

There is no society video about this trial yet.

Cardiac resynchronization · Biventricular vs right ventricular pacing in AV block

In atrioventricular block with systolic dysfunction, biventricular pacing reduced death, urgent heart failure visits and adverse remodeling compared with right ventricular pacing.

There is no society video about this trial yet.

Anticoagulation in primary PCI · Bivalirudin

Started during transport for primary PCI, bivalirudin reduced death or major bleeding versus heparin with optional GP IIb/IIIa inhibitors, with more acute stent thrombosis.

There is no society video about this trial yet.

Coronary surgery · Off-pump vs on-pump CABG in the elderly

In elderly patients, off-pump coronary bypass did not differ from on-pump surgery in death, stroke, infarction, repeat revascularization or new dialysis.

There is no society video about this trial yet.

Diet · Mediterranean diet

A Mediterranean diet with olive oil or nuts reduced cardiovascular events (reanalyzed in 2018).

There is no society video about this trial yet.

Anemia in HF · Darbepoetin alfa

Treating anemia with darbepoetin in systolic heart failure did not improve clinical outcomes and was associated with more stroke.

There is no society video about this trial yet.

PFO closure · Percutaneous PFO closure vs medical therapy

In cryptogenic stroke, PFO closure was not clearly superior to medical therapy in the intention-to-treat population.

There is no society video about this trial yet.

DPP-4 inhibitors · Saxagliptin

Saxagliptin did not change ischemic events in high-risk type 2 diabetes but was associated with more heart failure hospitalizations.

There is no society video about this trial yet.

Pulmonary hypertension · Macitentan

Macitentan, a dual endothelin-receptor antagonist, reduced combined morbidity and mortality versus placebo in patients with pulmonary arterial hypertension.

There is no society video about this trial yet.

Blood pressure targets · Intensive vs standard systolic target after lacunar stroke

After lacunar stroke, a lower systolic target did not significantly reduce recurrent stroke, though it reduced intracerebral hemorrhage and was safe.

There is no society video about this trial yet.

AF ablation · Cryoballoon ablation vs antiarrhythmic drugs

In paroxysmal AF, cryoballoon ablation was more effective than antiarrhythmic drugs for maintaining sinus rhythm with acceptable safety.

There is no society video about this trial yet.

Cardiac arrest · Targeted temperature 33°C vs 36°C

After out-of-hospital cardiac arrest, cooling to 33°C gave no survival or neurologic benefit compared with 36°C.

There is no society video about this trial yet.

RAAS blockade · Losartan plus lisinopril

Combining ACE inhibitor and ARB in diabetic nephropathy did not slow kidney progression and increased hyperkalemia and acute kidney injury, leading to early termination.

There is no society video about this trial yet.

Antithrombotics after PCI · Clopidogrel without aspirin on oral anticoagulant

In anticoagulated patients undergoing PCI, clopidogrel alone reduced bleeding versus triple therapy without increasing thrombotic events.

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Antiplatelet therapy · Extended DAPT (30 vs 12 months) after stenting

Prolonging thienopyridine beyond 12 months after stenting reduced stent thrombosis and major ischemic events but increased bleeding.

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PCSK9 inhibitors · Evolocumab

Evolocumab markedly and durably lowered LDL cholesterol over 52 weeks on top of various background therapies, with good tolerability.

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Anticoagulation in PCI · Heparin vs bivalirudin

In primary PCI, unfractionated heparin reduced major adverse cardiac events compared with bivalirudin, without more bleeding.

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