April’s most-read cardiology news reflects the vibrancy and complexity of the field—drawing from major late-breaking trials, expert debates, and clinical pearls from the 2025 American College of Cardiology (ACC) Scientific Sessions in Chicago. This month’s top 10 spans topics from cerebral embolic protection in TAVI to the ongoing PCI vs. CABG debate, and fresh insights into managing ischemia with nonobstructive coronary arteries (INOCA).
Here’s what captivated clinicians this month:
1. BHF PROTECT-TAVI Trial Dims Hope for Embolic Protection in TAVI
The British Heart Foundation-funded trial dealt another blow to cerebral embolic protection during transcatheter aortic valve implantation (TAVI). Despite expert disappointment, the door may not be fully closed yet on embolic filters.
2. ACC WARRIOR Trial: No Clear Strategy Yet for INOCA
The trial focused on patients with ischemia with nonobstructive coronary arteries (INOCA), showing no reduction in cardiovascular events with intensive therapy. COVID-19 disruptions limited definitive conclusions.
3. OPINION: The Cath Lab Attire Debate—Time to Update Dress Codes?
Discussion around sterile attire in the cath lab—like bouffant caps and beard covers—questions whether tradition is trumping evidence. Are the current infection-control measures overdone?
4. RIVAWAR Trial: Rivaroxaban Stands Up to Warfarin for LV Thrombus Post-MI
In patients with left ventricular thrombus after myocardial infarction, rivaroxaban proved comparable to warfarin in efficacy and safety, offering clinicians a modern anticoagulation option.
5. Final FAME 3 Results: PCI Matches CABG at 5 Years
Fractional flow reserve (FFR) and drug-eluting stents (DES) may have helped percutaneous coronary intervention (PCI) catch up with coronary artery bypass grafting (CABG) in multivessel disease patients.
6. ACC SOUL: Oral Semaglutide Impresses in High-Risk Diabetes
The trial showed oral semaglutide outperformed standard care in high-risk type 2 diabetes patients. For those reluctant to use injectables, this could be a game changer.
7. COMPARE-TAVI 1-Year Results: Myval Shows Strong Performance
The Myval valve stood its ground against industry leader Edwards Sapien in intermediate-risk TAVI patients. Room remains for new players in the growing TAVI space.
8. Mavacamten Falls Short in Nonobstructive HCM Phase III Trial
Despite early hope, mavacamten didn’t improve outcomes in patients with nonobstructive hypertrophic cardiomyopathy (HCM). Experts now stress it’s a distinct entity from obstructive HCM.
9. TRILUMINATE: TEER Lowers HF Hospitalizations at 2 Years
The tricuspid edge-to-edge repair (TEER) approach not only improved quality of life at 1 year, but also significantly cut heart failure hospitalizations by year 2.
10. Evolut Low-Risk 5-Year Data: TAVI Keeps Pace with Surgery
The 5-year follow-up from the Evolut Low Risk Trial reaffirmed that TAVI remains a strong option, even among low-risk surgical candidates.
Final Thoughts
April’s cardiology highlights underscore how rapidly practice evolves—both through rigorous clinical trials and the nuance of real-world experience. Whether you're a clinician, researcher, or student, staying informed on these trends is key to delivering the best care.
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