Two Neutral IVUS Trials in Complex PCI—And One Positive—Spark Debate
Three recent randomized trials compared intravascular ultrasound (IVUS) with angiography for guiding complex percutaneous coronary interventions (PCI). Only DKCRUSH VIII, which focused on true bifurcation lesions, demonstrated a 60% relative reduction in 1‑year target‑vessel failure. The European OPTIMAL and IVUS‑CHIP studies, despite enrolling high‑risk left‑main and mixed complex lesions, showed neutral outcomes. Experts attribute the discrepancy to operator experience and the extent to which IVUS findings altered procedural technique, sparking debate over its routine use despite class 1A guideline recommendations.
Olezarsen Doesn’t Lower Plaque Volume: Essence-TIMI 73b
Olezarsen, an antisense drug targeting APOC3, dramatically lowered triglycerides (‑64 %) and remnant cholesterol (‑72 %) in the Phase III Essence‑TIMI 73b trial, yet a 12‑month coronary CTA subanalysis showed no significant reduction in non‑calcified plaque volume versus placebo. The study involved 468 patients...
Evolution of Pharmacotherapy in STEMI
The podcast examines how STEMI pharmacotherapy has transformed over the past 46 years, moving from routine fibrinolysis to routine primary PCI with potent antiplatelet regimens. It highlights the recent approval of zalunfiban, a fast‑acting glycoprotein IIb/IIIa inhibitor, for administration at first medical...
TCTMD’s Top 10 Most Popular Stories for March 2026
March 2026’s most‑read TCTMD stories were dominated by ACC conference data and new dyslipidemia guidelines emphasizing earlier, intensive LDL lowering and routine CAC and Lp(a) screening. Large trials showed that Impella mechanical circulatory support did not improve outcomes in anterior...
SCOUT-HCM: Mavacamten Can Benefit Teens With Obstructive HCM, Too
The phase III SCOUT‑HCM trial showed that mavacamten (Camzyos) significantly reduced left ventricular outflow tract (LVOT) gradients in adolescents with obstructive hypertrophic cardiomyopathy (HCM) compared with placebo. Forty‑four patients aged 12‑17 were randomized to weight‑based doses of 2 or 5 mg daily, achieving a...
Transcatheter ViV a Solid Option for Failed Mitral Bioprostheses: SURViV
The SURViV randomized trial compared transcatheter mitral valve‑in‑valve (ViV) with redo surgical replacement in 150 patients with failed bioprosthetic mitral valves, many of whom had rheumatic disease. At one year, ViV showed a markedly lower all‑cause mortality (5.3% vs 20.8%)...
SPIRIT-HF: Spironolactone’s Benefit Still Uncertain in HF With Preserved, Mildly Reduced EF
The SPIRIT‑HF trial, designed to test spironolactone in heart‑failure patients with preserved or mildly reduced ejection fraction, enrolled only 730 of the planned 1,564 participants and therefore lacked statistical power. Over two years, the composite of cardiovascular death or total...
Barbershop Effort Falls Short for Hypertension Prevention in Black Men
A community health worker‑led, barbershop‑based program aimed at preventing hypertension in Black men was evaluated in a cluster‑randomized trial across 22 barbershops involving 430 participants. The primary endpoint—change in systolic blood pressure over 12 months—showed no significant reduction in either...
Very Low LDL Levels Best in Secondary Prevention: Ez-PAVE
New randomized data from the Ez‑PAVE trial in South Korea show that lowering LDL cholesterol to below 55 mg/dL in patients with established atherosclerotic cardiovascular disease reduces major cardiovascular events by 33% compared with a target of less than 70 mg/dL. The...
KARDINAL: Monthly Tonlamarsen May Not Enhance BP Lowering in Resistant Hypertension
The phase II KARDINAL trial evaluated monthly versus single‑dose tonlamarsen, an angiotensinogen‑targeted nucleic‑acid therapy, in patients with resistant hypertension on multiple drugs. While monthly injections achieved a 67% reduction in plasma AGT compared with 23% after a single dose, both regimens...
HI-PEITHO: Catheter-Directed Therapy Bests Anticoagulation in Intermediate-Risk PE
The HI‑PEITHO trial showed that ultrasound‑facilitated, catheter‑directed fibrinolysis combined with heparin cuts the 7‑day composite risk of PE‑related death, cardiorespiratory decompensation or collapse by 61% versus anticoagulation alone. In 544 intermediate‑risk pulmonary embolism patients, the number needed to treat was...
Mechanical Circulatory Support Doesn’t Reduce Infarct Size in STEMI
The STEMI Door‑to‑Unload trial showed that using the Impella CP device 30 minutes before primary PCI in anterior STEMI patients without cardiogenic shock did not reduce infarct size compared with PCI alone, and it increased major bleeding and vascular complications. The study...
US Societies Lay Out Requirements for Transcatheter Tricuspid Valve Procedures
Major cardiovascular societies, led by the ACC and AHA, released a consensus document outlining requirements for establishing and maintaining transcatheter tricuspid valve intervention (TTVI) programs in the United States. The guidance sets minimum institutional volumes—such as at least 50 open‑heart...
March 2026 Dispatch for the CV Team
The March 2026 CV Dispatch highlights a range of new findings, from a Chinese cohort linking elevated blood pressure at embryo transfer to lower live‑birth rates, to the PROMISE trial showing women experience similar major cardiovascular events despite lower plaque...
Top Cardiology News for March 2026
During the March 2026 episode of TCTMD’s Heart Sounds, experts highlighted several emerging cardiology developments. Updated lipid‑lowering guidelines emphasize earlier statin initiation and novel agents for high‑risk patients. New echocardiographic surveillance protocols for aortic stenosis aim to detect disease progression before...
Epicardial Fat Shows Promise as a Clinical Risk Factor for CAD
Researchers analyzing 773 patients in the PARADIGM registry found that larger epicardial adipose tissue (EAT) volumes measured by coronary CT angiography were strongly associated with both any plaque progression and rapid plaque progression over an eight‑year follow‑up. While high EAT...
Two Conduction-System Pacing RCTs Give Conflicting Results
Two randomized trials comparing conduction‑system pacing (CSP) with traditional biventricular (BiV) cardiac resynchronization therapy produced opposite results. The Chinese HeartSync‑LBBP study found that left‑bundle branch pacing reduced the composite of death or heart‑failure hospitalization and improved ventricular remodeling, while the...
TAVR-MET: Early Signs Point to Less Postprocedural Valve Dysfunction With Tirzepatide
Patients with obesity undergoing transcatheter aortic valve replacement (TAVR) who received tirzepatide before and after the procedure experienced significantly lower rates of subclinical leaflet thrombosis (HALT) and paravalvular leak. In the randomized TAVR‑MET trial of 260 patients, tirzepatide reduced HALT...
Echocardiographic Surveillance of AS Doesn’t Measure Up to Guidelines
A real‑world study of 20,571 California patients with aortic stenosis found that echocardiographic surveillance aligned with 2020 ACC/AHA guidelines markedly improves outcomes. Guideline‑concordant monitoring occurred in 74% of mild cases but fell below 50% for severe disease, the group at...
No Major Progress on Making CV Care More Affordable: JACC Stats
The latest JACC statistics issue reveals that the long‑standing decline in cardiovascular mortality has stalled, while total spending on cardiovascular care has more than tripled since 2000. Analysis of privately insured working‑age adults shows inflation‑adjusted healthcare expenditures rose from $4,813...
Rox Heart Radio: On the Cusp of ACC 2026
Incoming ACC President Roxana Mehran discusses the upcoming 2026 ACC meeting in New Orleans on the Rox Heart Radio podcast. She outlines her vision for the organization, emphasizing data‑driven leadership, patient‑centered outcomes, and broader member engagement. The episode highlights strategic...
Ultraprocessed Food Again Linked to Higher CVD Risk: MESA
A new analysis of the Multi‑Ethnic Study of Atherosclerosis (MESA) links each additional daily serving of ultra‑processed food to a 5.1% rise in incident cardiovascular disease (CVD). Participants in the highest consumption quintile faced a 66% higher CVD risk compared...
CARPOOL Radial Access as Good as Femoral in PAD Procedures
The CARPOOL observational study compared radial‑to‑peripheral (R2P) and femoral access for peripheral artery disease (PAD) interventions and found comparable 30‑day major adverse limb event (MALE) rates. While radial access achieved a technical success of 87.2% versus 94.9% for femoral, it...
Stress May Augment Impact of Adverse Pregnancy Outcomes on CV Health
Researchers found that women who experienced an adverse pregnancy outcome (APO) and reported high psychosocial stress had significantly higher diastolic blood pressure 2–7 years postpartum, whereas stress alone did not affect blood pressure in uncomplicated pregnancies. The analysis of 3,322...
SOLVE-TAVI: Patient Sex, for the Most Part, Doesn’t Sway Outcomes by Valve Type
The five‑year SOLVE‑TAVI trial shows that self‑expanding and balloon‑expandable transcatheter aortic valves deliver comparable long‑term efficacy and durability in both men and women with severe aortic stenosis. Stroke incidence was markedly lower in women receiving the self‑expanding valve (0.9% vs...
Suspended Lead Suit Brings Radiation Exposure Down to Zero for Many Structural Imagers
Interventional echocardiographers using Biotronik’s Zero‑Gravity suspended lead suits during left atrial appendage occlusion (LAAO) procedures experienced dramatically lower radiation, with undetectable levels in 60% of cases. In a JAMA Network Open study of 125 LAAO cases, median dose dropped from...
Novel Strategies Can Enable Fair Access to Heart Transplantation
The 2018 heart‑allocation reform removed rigid donor service areas, shifting the primary barrier to transplantation from geography to a center’s ability to deploy modern donor‑utilization tools. Advanced preservation technologies and donation‑after‑circulatory‑death (DCD) protocols have expanded the donor pool, but adoption...
Oral Anticoagulation Alone Best for Stable CAD Patients With AF: Meta-Analysis
A meta‑analysis of six randomized trials involving 5,924 stable CAD patients with atrial fibrillation found that oral anticoagulant (OAC) monotherapy reduced cardiovascular mortality by 31% and major bleeding by 54% compared with OAC plus a single antiplatelet. The benefit persisted...
Pediatric and Congenital Heart Disease Series: In-Vivo Assessment of Novel Cardiac Valve Prostheses
On March 12, 2026, TCTMD’s Heart Valve Matters podcast featured Ami Bhatt and John Carney discussing the role of in‑vivo assessments in shaping next‑generation cardiac valve prostheses for children with congenital heart disease. The hosts highlighted how animal studies and...
AGENT IDE Midterm Results Still Give DCB an Edge for In-Stent Restenosis
Three‑year follow‑up of the AGENT IDE trial shows the Agent paclitaxel‑coated balloon (DCB) outperforms uncoated balloon angioplasty in treating in‑stent restenosis (ISR), with target‑lesion failure (TLF) rates of 32.7% versus 40.9% (hazard ratio 0.72). The advantage is driven mainly by...
Large Variability in Use of Invasive Strategy for Type 1 NSTEMI: NCDR
An analysis of 287,275 type 1 NSTEMI patients from the NCDR Chest Pain‑MI Registry (2019‑2024) found that 87.1% underwent invasive coronary angiography, yet substantial site‑level variability persisted, ranging from 57.3% to 100% use. Paradoxically, the sickest, older, and minority patients were...
3. Barbara Casadei, MD, DPhil, on Taking Risks and Shifting Focus
Renowned cardiologist Barbara Casadei, MD, DPhil, discusses her recent appointment as Editor‑in‑Chief of JAMA Cardiology on the Hearts & Minds podcast. She reflects on how taking calculated risks has shaped her career trajectory and informs her new editorial vision. Casadei...
Good News for Intravascular Imaging Continues at 5 Years: RENOVATE-COMPLEX-PCI
The RENOVATE‑COMPLEX‑PCI trial’s 5‑year follow‑up confirms that intravascular imaging guidance markedly lowers target‑lesion failure and cardiac death compared with angiography alone, especially in chronic total occlusions and long diffuse lesions. Across 1,639 patients, target‑lesion failure occurred in 10.5% of the...
Digital Data May Sway Intensive BP Treatment in the Elderly
Physicians are more likely to choose intensive blood‑pressure targets for elderly patients when digital health data—home BP readings and wearable mobility metrics—are available. A discrete choice experiment with 197 Australian doctors showed an odds ratio of 2.7 for intensive treatment...
Should Moderate FMR Should Be Treated With M-TEER? Experts Duke It Out
At THT 2026, leading cardiologists debated whether transcatheter edge‑to‑edge repair (M‑TEER) should be used for patients with heart failure and moderate functional mitral regurgitation (FMR). Dr. Stefan Anker argued that current European guidelines and data from the RESHAPE‑HF2 trial support considering...
Many PE Teams Embraced Mechanical Thrombectomy Early On: PERT Registry
Mechanical thrombectomy use for acute pulmonary embolism rose 18% annually from 2016 to 2024, overtaking catheter‑directed thrombolysis by 2021. The shift began before landmark trials such as STORM‑PE and PEERLESS, reflecting clinician confidence despite limited randomized data. Analysis of 2,958...
Advanced HF in Finland: Costs, Survival Diverge for Elective vs Urgent LVAD
A Finnish observational study of 78 advanced heart‑failure patients found that 24‑month survival and costs are comparable for elective left ventricular assist device (LVAD) implantation and heart transplantation. In contrast, urgent LVAD placement after ECMO support resulted in markedly lower...
Baroreflex Activation for Advanced HF Yields Positive Results: Postmarketing Data
Baroreflex activation therapy (BAT) using the Barostim implant demonstrated sustained improvements in left‑ventricular ejection fraction and NYHA functional class in the real‑world REBALANCE registry of 435 advanced HFrEF patients. Six‑month data showed LVEF rising from 26.8 % to 29.9 % and 34 %...
Optimal BP After HeartMate 3 LVAD May Be Higher Than Previously Thought
A pooled analysis of the MOMENTUM 3 and ARIES‑HM3 trials involving 1,983 HeartMate 3 LVAD recipients identified an optimal early mean arterial pressure (MAP) of 85‑100 mm Hg, with 85‑95 mm Hg appearing ideal. Patients who spent more time within this range during the first 90...
The CorCMR Trial
The CorCMR Trial, discussed by Colin Berry and C. Michael Gibson, investigates the utility of stress cardiac magnetic resonance (CMR) imaging for patients presenting with angina but no obstructive coronary artery disease (CAD). The study compares stress CMR‑derived perfusion data...
AI-Enabled Virtual HF Care May Help Boost GDMT, Stabilize Weight
A non‑randomized study of the ISHI Health AI‑enabled virtual heart‑failure platform showed significant gains in guideline‑directed medical therapy (GDMT) and improved weight stability among 747 patients across six community cardiology practices. The system collected remote biometric data, generated risk‑graded alerts,...
AF Common, Worsens Prognosis After Stem Cell Transplant for Multiple Myeloma
A retrospective study of 801 multiple myeloma patients undergoing autologous stem cell transplantation found that 8.7% developed atrial fibrillation post‑procedure. Age over 65, prior paroxysmal AF, and obesity were independent risk factors, with a median onset of 13 days. Post‑transplant...
Holding Out Hope for HF Shunts, Even After an FDA Panel’s Doubts
The FDA Circulatory System Devices Panel rejected the V‑Wave interatrial shunt, citing a neutral primary endpoint in the RELIEVE‑HF trial despite promising subgroup results in HFrEF patients. The trial showed no overall reduction in mortality, hospitalizations, or quality‑of‑life measures, and...
Worsening CAC Tied to Cognitive Decline in Midlife: CARDIA
A new analysis of the CARDIA cohort shows that progression of coronary artery calcium (CAC) over roughly a decade is linked to measurable declines in processing speed and global cognition among middle‑aged adults. The relationship holds regardless of baseline CAC...
AI in Cardiovascular Imaging and Interventions: Boon or Bane?
At the 2026 EAPCI Summit, experts highlighted AI’s expanding role in cardiovascular interventions, from mortality risk modeling to intravascular imaging analysis. A University of Galway study identified gamma‑glutamyl transferase as a strong 10‑year mortality predictor in the SYNTAX cohort, validated...
Transfer Delays Tied to Worse Acute Stroke Intervention Results
A new Lancet Neurology study of 22,410 ischemic‑stroke patients shows that door‑in‑door‑out (DIDO) times exceeding the 90‑minute guideline are tied to poorer functional outcomes and lower rates of endovascular therapy. Patients with DIDO intervals of 91‑180 minutes, 181‑270 minutes, and...
Rox Heart Radio: Why AI?
Rox Heart Radio released a new episode titled “Why AI?” featuring host Roxana Mehran in conversation with cardiology researchers Ami Bhatt and Rohan Khera. The trio explores how artificial intelligence is poised to reshape cardiovascular care, from imaging interpretation to risk prediction....
When Nudges Aren’t Enough: Study Ponders AS Referral System Changes
A Canadian study of 343 patients with moderate or severe aortic stenosis found that automated prompts in echocardiography reports and EMRs only modestly improved specialist referrals. About 60% of severe AS patients and just over 20% of moderate cases were...
Adult Survivors of Childhood Cancer May Do Well With Simple Strategy for CV Risk
A randomized trial of 347 adult survivors of childhood cancer found that early cardiovascular (CV) risk screening alone was as effective as screening plus one‑on‑one counseling. Both groups showed improvements in blood pressure and lipid measures, with the counseling arm...
Loberamisal Scores a Rare Win for Stroke Neuroprotection
The phase III LAIS trial showed that loberamisal, a novel neuroprotectant, raised the proportion of acute ischemic‑stroke patients achieving an excellent functional outcome (mRS 0‑1) to 69.7% versus 56.4% with placebo when given within 48 hours of symptom onset. The study enrolled 997...
