This Week in Cardiology Dec 05 2025 This Week in Cardiology
11 snips
Dec 5, 2025 This week explores the intriguing concept of 'less is more' after PCI, questioning the need for routine complete revascularization. The TARGET-FIRST trial sheds light on early aspirin discontinuation, and the RETREAT-FRAIL study turns a 'negative' trial into a positive take on antihypertensive reduction for frail patients. Fascinating comparisons arise between bleeding risks of apixaban versus aspirin, while experts advocate for AED availability on flights. Finally, updates on Factor XI inhibitors maintain the excitement in cardiology research.
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Short DAPT May Be Sufficient After Low-Risk MI
- TARGET-FIRST shows single-month DAPT followed by P2Y12 monotherapy can match 12-month DAPT for MACE in low-risk MI after complete revascularization.
- This strategy reduced overall bleeding when including clinically relevant bleeding (BARC-2).
Separate Safety From Efficacy In Noninferiority Trials
- Keep safety (bleeding) endpoints separate from efficacy (MACE) when designing non-inferiority trials.
- Use non-inferiority for efficacy and test safety for superiority or report both separately.
Deprescribing Lowers Burden Without Raising Mortality
- RETREAT-FRAIL stepped-down antihypertensive therapy in nursing-home residents reduced pill burden but did not change all-cause mortality.
- In very old, frail patients, competing causes of death limit impact of single preventive interventions on mortality.