This Week in Cardiology Dec 19 2025 This Week in Cardiology
Dec 19, 2025
Explore the paradox of predicting first myocardial infarctions with risk scores that often fail in low-risk populations. Delve into the CELEBRATE trial, showcasing a new subcutaneous GP IIb/IIIa inhibitor, and the intriguing yet fragile results it produced. Review the SURPASS CVOT trial comparing diabetes treatments and the unexpected effects on all-cause mortality. Finally, uncover the troubling story of andexanet alfa, revealing the flaws in its early adoption and the lessons that emerge from evidence-based practice.
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The MI Paradox Of Risk Scores
- Risk scores identify groups but miss many individuals who have first MIs, creating an MI paradox.
- Large numbers of low-risk people produce a high absolute number of first MIs despite low individual risk.
Most First MIs Come From Low-Risk Pools
- Many first MIs occur in people with minimal symptoms or no prior high-risk features.
- Similar paradox appears in sudden cardiac death and in larger cohorts showing no modifiable risk factors in many cases.
Prioritize Healthy Living And Emergency Access
- Recommend healthy living and tell patients not to ignore symptoms as a pragmatic prevention strategy.
- Ensure policy supports capable, well-staffed cath labs to provide timely STEMI care.