This Week in Cardiology Oct 31 2025 This Week in Cardiology
12 snips
Oct 31, 2025 Delve into the latest in cardiology as topics range from optimizing treatments for stable coronary artery disease to the long-term outcomes of aortic stenosis management. Discover the implications of recent trials, including the debate on complete versus culprit-only revascularization strategies during STEMI and their clinical significance. Learn how functional testing stacks up against anatomical assessments for chest pain evaluation and why managing risk factors could enhance outcomes for atrial fibrillation patients post-ablation.
AI Snips
Chapters
Transcript
Episode notes
Question Routine Complete Revascularization
- Routine preventive PCI of stable non-culprit lesions at STEMI does not clearly improve death, MI, or heart-failure outcomes.
- The iMODERN trial showed similar 3-year event rates despite far fewer deferred PCIs guided by stress imaging.
iMODERN Shows Deferred Strategy Spares PCIs
- iMODERN randomized immediate IFR-guided PCI versus deferred stress-CMR–guided PCI after STEMI and found no difference in death, MI, or heart-failure hospitalization.
- Deferred imaging led to roughly 80% fewer non-culprit PCIs without worse clinical outcomes.
Trial Limitations Cloud Complete PCI Benefits
- Trials supporting immediate complete revascularization have limitations like small size, biased endpoints, or adjudication problems.
- Periprocedural MI definitions and early trial terminations complicate interpretation of benefit signals.