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Provides first targeted option for symptomatic nonobstructive HCM; extends myosin inhibition beyond obstructive disease.

For the first time, we have shown clinically meaningful improvements in symptoms and exercise capacity with a treatment that targets the cause of the disease.
Supports DOAC use in intermediate-risk AF; extends randomized evidence beyond high-risk populations.

The key impact on clinical practice is that the level of evidence about this population was actually very low, and this is the first [randomized controlled trial] to support that DOAC therapy can give benefit to this patient population.
Neither default policy reduces ischemic events more than the other in ACS after PCI; confirms comparable real-world effectiveness and safety.

The implementation gap that exists between carefully controlled randomized trials and routine clinical practice is real and should always be considered by physicians and policymakers.
Supports statin initiation for CV prevention in adults ≥70 without CVD; confirms event reduction in primary prevention but leaves disability-free survival benefit open.

The risk of heart attack and stroke is a concern for older people and knowing there is an effective measure for lowering that risk will be a huge reassurance to older people and their families. We hope to see updated guidelines to help clinicians make use of these new findings.
Prasugrel monotherapy is not noninferior to DAPT after STEMI PCI; challenges early aspirin omission and reinforces dual therapy for ischemic protection.

“These findings do not support prasugrel monotherapy at the time of primary PCI for STEMI. It appears that DAPT is needed for at least the first month but the optimum duration of DAPT remains to be determined.”
Milvexian adds no ischemic benefit after ACS; safety supports continued evaluation in ongoing atrial fibrillation and stroke prevention trials.

“Why is this important in terms of safety? Because milvexian is currently being evaluated in two other large trials: one in atrial fibrillation and one in secondary stroke prevention.”
May support switching to clopidogrel monotherapy after 12 months to reduce bleeding; extends randomized evidence on DAPT de-escalation in high-ischemic-risk patients.

Extended DAPT provided greater protection against major ischemic events, including death, whereas clopidogrel monotherapy reduced major or clinically relevant bleeding. It seems that no single strategy is best for every patient, but rather, long-term antiplatelet therapy should be individualized ...
Evolocumab before PCI improves LDL-C targets without reducing 1-year events; challenges acute pleiotropic benefit assumptions and leaves optimal timing open.

[T]he trial shows that for patients with MI, the benefits from LDL-C lowering are a marathon, not a sprint, and that a rapid LDL-C reduction at 7 days with a PCSK9 monoclonal antibody will take years to translate into meaningful clinical benefits.
Awaiting this RCT's results on adaptive digital outreach for statin adherence in ASCVD; may extend digital health strategies if positive.

The principal contribution of ADHERE-ASCVD may not be the modest improvement in statin adherence, but the demonstration that important clinical questions can be tested rapidly and rigorously within existing health system infrastructure.
Supports response-tailored shorter antibiotics in left-sided IE with noninferior safety; extends RCT evidence but requires relapse monitoring.

We estimate that around half of the patients that we see in our clinics with left-sided infective endocarditis could be eligible for tailored reduced-duration antibiotic therapy. Shorter courses of antibiotics may also improve patients' quality of life by reducing the physical and psychological t...