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No incremental effect on CHD/nfMI at 10y f/u (1.6% ARD at 4.8y & at 10y) HR 0.59 at 4.8y vs 0.79 at 10y! Why did a 40% reduction in nfMI at 4.8y not translate into a mortality benefit at 10y? Something about those pesky little MIs!

Are the medical device approval standards in the United States lax? JACC Cardiovasc Interv. 2025 Feb 10;18(3):380-384. doi: 10.1016/j.jcin.2024.08.037. JACC Cardiovasc Interv. 2025 Feb 10;18(3):385-387. doi: 10.1016/j.jcin.2024.10.044

Snake oil salesmen of the 21st century! Here they come. endpts.com/rfk-jr-convene…

Warrior trial PEP result 👇 Is this a NULL trial or a NEGATIVE trial? Trial powered for HR 0.80 which was excluded by 95% CI How many null or negative PRAGMATIC trials before we seriously consider/scrutinize the utility of such trials?

API-CAP NI margin of HR of 2! Really!! Is the 41% loss of efficacy acceptable given no benefit in terms of major bleeding which is a more stringent criterion for clinically relevant bleeding even though the latter was the prespecified bleeding endpoint?

PROTECT-TAVI Another pragmatic trial bites the dust! However, the study hypothesis was rather shaky to begin with and the results are not terribly surprising.

No 'additive' cardioprotective effect of GLP-1RA on background use of SGLT2i in HARMONY, AMPLITUDE-O and most recently SOUL. Cardioprotective effects of GLP-1RA are 'independent' of SGLT2i ahajournals.org/doi/epdf/10.11… 10.1016/j.jacc.2023.05.048

Do you agree with the 55% who voted to give beta blocker post-MI? x.com/nejm/status/19…

Are claims that time has come for “…routine & preferred strategy for asymptomatic AS patients to shift from watchful waiting to prompt AVR...” justified? doi.org 10.1001/jamacardio.2024.5648

For the 8 out of 38 who voted Yes, here is something to ponder. 👇 jacc.org/doi/abs/10.101… Feel free to recalibrate your views if you must! x.com/kaulcsmc/statu…

cardiovascularbusiness.com/topics/clinica…

"TRISCEND II investigators assert that magnitude & durability of health status benefit (HSB), emergence of HSB over first 6m, & relationship between TR severity & HSB provide circumstantial evidence of true biological effect." Does it r/o placebo effect? eurointervention.pcronline.com/article/unblin…

abbott.mediaroom.com/2025-05-27-Abb… How many devices are approved by the FDA based on small (n<110), open-label, single-arm, non-randomized trial?

On the basis of current evidence, what is the appropriate action regarding routine early use of beta blocker post-MI which is endorsed as Class 1 LoE A recommendation by 2025 ACS guideline?

ACS Guidelines for shortening DAPT to mitigate bleeding risk 2023 ESC/EACTs: Class 2b LoE B for aspirin or P2Y12 monotherapy after 1m 2025 ACC/AHA: Class 1 LoE A for ticagrelor monotherapy after 1m Which guidelines are more faithful to the evidence?

61% voted to downgrade or retire beta-blocker recommendation and 39% to wait for additional evidence from ongoing trials 👇 x.com/kaulcsmc/statu… For deeper dive into current evidentiary support (or lack thereof) 👇 jacc.org/doi/10.1016/j.… JACC Journals John Mandrola, MD Andrew Foy

Close Call with 56% voting for European guidelines being more faithful to the evidence. Our perspective is more aligned with the European guideline which give a weak recommendation for abbreviated DAPT to mitigate bleeding. 👇🏻 jacc.org/doi/10.1016/j.… JACC Journals jay brophy