Eagle's Eye View: Your Weekly CV Update From ACC.org Aspirin in PCI; Mavacamten in Nonobstructive Cardiomyopathy; Olezarsen and the Treatment of Hypertriglyceridemia
Sep 17, 2025
This week, listeners dive into groundbreaking findings from the recent ESC Congress in Spain. A key discussion revolves around the TARGET-FIRST trial, revealing that P2Y12 monotherapy may be just as effective as dual antiplatelet therapy post-PCI, with fewer bleeding events. The podcast also explores the ODYSSEY-HCM trial, which found that mavacamten offered no clear advantages for nonobstructive hypertrophic cardiomyopathy patients. Finally, the promising results of the ESSENCE-TIMI 73b study show olezarsen significantly reducing triglycerides in at-risk individuals.
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Aspirin May Be Withdrawn Early After PCI
- With modern stent technology, stopping aspirin one month after PCI and continuing P2Y12 monotherapy produced similar one-year ischemic outcomes.
- Continuing DAPT increased bleeding without reducing stent thrombosis in low-risk patients.
Select Low-Risk Patients For Early Aspirin Withdrawal
- Consider early aspirin withdrawal after PCI only for patients judged low risk for stent thrombosis.
- Avoid routine early withdrawal in high-risk patients where stent-thrombosis risk remains substantial.
Mavacamten Not Helpful In Nonobstructive HCM
- Mavacamten failed to improve peak VO2 or quality-of-life measures versus placebo in nonobstructive HCM over 48 weeks.
- The drug's benefit appears confined to obstructive hypertrophic cardiomyopathy for now.