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As a clinician, preventing hemodynamic deterioration in the intermediate-high-risk group is meaningful. If these findings are replicated and reflected in future guideline updates, there may be a shift from reactive management towards a more proactive reperfusion strategy in carefully selected intermediate-risk pulmonary embolism patients.

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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.

Boyoung Joung

5w

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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.

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“Despite major advances in pharmacologic and device-based therapies, pulmonary hypertension remains one of the strongest predictors of hospitalization, right ventricular failure, and death in patients with left heart disease and heart failure.”

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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.

Jörg Hausleiter

5w

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Among these high-risk patients, transcatheter tricuspid valve repair on top of medical therapy resulted not only in quality-of-life improvements but also in meaningful and sustained reductions in hard clinical outcomes, which has not been demonstrated before with the intervention.

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Importantly, this was not because coronary access was impaired after TAVI. Rather, once the valve had been treated, the clinical decision about whether PCI was still necessary sometimes changed.

Dr. Rolf Wachter

Professor of Clinical and Interventional Cardiology · Leipzig University

4w

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Our data show that most of the improvement reported by patients does not appear to be attributable to catheter ablation itself, but rather to factors such as a placebo effect or adjustments to their medication. Current guidelines recommend catheter ablation primarily to prevent the recurrence of atrial fibrillation and improve quality of life. However, our study shows that the effect of the ablation itself does not adequately explain the improvement in quality of life.

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“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.”

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“Once a heart attack has been ruled out, routine heart scans may not be required. Implementation of these trial findings could reduce healthcare costs and simplify care for patients without compromising future outcomes.”