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1/.2-year follow-up results of TRILUMINATE trial of T-TEER for severe TR were published in Circulation. Are the results informative and credible?

Close Call with 56% voting for European guidelines being more faithful to the evidence. Our perspective is more aligned with the European guideline which give a weak recommendation for abbreviated DAPT to mitigate bleeding. 👇🏻. @JACCJournals @brophyj.

61% voted to downgrade or retire beta-blocker recommendation and 39% to wait for additional evidence from ongoing trials.👇.For deeper dive into current evidentiary support (or lack thereof).👇.@JACCJournals @drjohnm @AndrewFoy82.

ACS Guidelines for shortening DAPT to mitigate bleeding risk. 2023 ESC/EACTs: Class 2b LoE B for aspirin or P2Y12 monotherapy after 1m. 2025 ACC/AHA: Class 1 LoE A for ticagrelor monotherapy after 1m. Which guidelines are more faithful to the evidence?.

On the basis of current evidence, what is the appropriate action regarding routine early use of beta blocker post-MI which is endorsed as Class 1 LoE A recommendation by 2025 ACS guideline?.

How many devices are approved by the FDA based on small (n<110), open-label, single-arm, non-randomized trial?.

"TRISCEND II investigators assert that magnitude & durability of health status benefit (HSB), emergence of HSB over first 6m, & relationship between TR severity & HSB provide circumstantial evidence of true biological effect." .Does it r/o placebo effect?.

For the 8 out of 38 who voted Yes, here is something to ponder. 👇.Feel free to recalibrate your views if you must!.

Are claims that time has come for “…routine & preferred strategy for asymptomatic AS patients to shift from watchful waiting to prompt AVR. ” justified?.10.1001/jamacardio.2024.5648.

Do you agree with the 55% who voted to give beta blocker post-MI?.

No 'additive' cardioprotective effect of GLP-1RA on background use of SGLT2i in HARMONY, AMPLITUDE-O and most recently SOUL. Cardioprotective effects of GLP-1RA are 'independent' of SGLT2i . 10.1016/j.jacc.2023.05.048

PROTECT-TAVI.Another pragmatic trial bites the dust!.However, the study hypothesis was rather shaky to begin with and the results are not terribly surprising.

API-CAP.NI margin of HR of 2! Really!!.Is the 41% loss of efficacy acceptable given no benefit in terms of major bleeding which is a more stringent criterion for clinically relevant bleeding even though the latter was the prespecified bleeding endpoint?

Warrior trial PEP result 👇.Is this a NULL trial or a NEGATIVE trial?.Trial powered for HR 0.80 which was excluded by 95% CI.How many null or negative PRAGMATIC trials before we seriously consider/scrutinize the utility of such trials?

Snake oil salesmen of the 21st century! Here they come.

Are the medical device approval standards in the United States lax?. JACC Cardiovasc Interv. 2025 Feb 10;18(3):380-384. doi: 10.1016/j.jcin.2024.08.037. JACC Cardiovasc Interv. 2025 Feb 10;18(3):385-387. doi: 10.1016/j.jcin.2024.10.044.

No incremental effect on CHD/nfMI at 10y f/u (1.6% ARD at 4.8y & at 10y) HR 0.59 at 4.8y vs 0.79 at 10y!.Why did a 40% reduction in nfMI at 4.8y not translate into a mortality benefit at 10y?.Something about those pesky little MIs!

IPD MA.Incident TB: 8 vs 21, RD 0.41, 0.18-0.92, p=0.03. Are the trials poolable?.Should treatment decision be made on a sum total of 29 primary outcome events?.Is a meta-analytic P value of 0.03 sufficiently robust?.