
This Week in Cardiology Nov 21 2025 This Week in Cardiology
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Nov 21, 2025 This week, the discussion dives into groundbreaking findings from the CREST-2 trial, revealing new insights into treating carotid artery disease. The ongoing battle between prasugrel and ticagrelor continues, with recent evidence suggesting prasugrel holds an edge for high-risk diabetic patients. Plus, there's an intriguing look at coffee consumption's relationship with atrial fibrillation—could that morning cup actually lower your risk? Tune in for a blend of clinical updates and listener feedback that keeps healthcare professionals engaged!
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Complete Revascularization Results Are Nuanced
- Patient-level meta-analyses can give a persuasive but potentially biased picture depending on included trials and sensitivity analyses.
- John Mandrola argues the complete revascularization benefit may be driven by trials with non-STEMI or periprocedural MI counting issues, so results remain unconvincing to him.
Apply Clinical Judgment Over Trial Averages
- Use clinical judgment and do not generalize trial averages to every patient, especially when trials exclude non-randomizable cases.
- The onus is on clinicians to prove why doing more (like additional PCI) benefits a specific patient before proceeding.
Drug Class Versus Individual Agent Effects Are Unclear
- Class effects versus individual drug effects remain uncertain; trial context and patient selection may explain differing outcomes.
- Mandrola cites bucindolol and BEST to illustrate how patient fragility and trial populations can drive apparent drug failures.
