TCTMD’s Top 10 Most Popular Stories for November 2023

All but three of our top 10 stories this month stemmed from the American Heart Association (AHA) 2023 meeting in Philadelphia, with the ORBITA-2 trial topping the list. A breadth of subspecialties are reflected among the other most popular, ranging from acute MI care to cardiometabolic disease and prevention. Rounding out the list are the US Food and Drug Administration’s approval of renal denervation, the stopping of the OCEANIC-AF trial of the factor IXa inhibitor asundexian for stroke prevention, and a PCR London Valves session cautioning against direct comparisons between the recent trials of low-risk TAVI versus SAVR.

1. AHA Placebo-Controlled ORBITA-2 Shows PCI Eases Symptoms in Stable Angina

In patients not taking antianginal meds, PCI clearly alleviated some—but not all—symptoms. What does that mean in practice?

2. AHA DAPA-MI: Cardiometabolic Endpoints ‘Win’ With Dapagliflozin After Acute MI

The trial had to switch out its hard primary endpoints for a win-ratio analysis: the result was a “soft positive,” one observer said.

3. AHA Full SELECT Results Affirm CV Risk Reduction With Semaglutide in Nondiabetics

Obesity specialists and cardiologists hailed the results as a turning point with the potential for a “huge population impact.”

4. AHA MINT Hints at Benefits of Liberal Transfusions in Acute MI With Anemia

The primary endpoint was missed in MINT, but most study findings suggest a restrictive transfusion strategy has little to add.

5. FDA Approves Paradise Renal Denervation System: What Comes Next?

This marks the culmination of more than a decade of work, but there are still questions about where the field goes from here.

6. AHA ARTESiA: Apixaban Lowers Stroke Risk in Subclinical AF

With an increase in major bleeding, too, there’s a question about whether the benefit is worth the risk.

7. AHA AZALEA-TIMI 71: Bleeds Plunge With Abelacimab vs Rivaroxaban in AF, but Stroke Impact Unclear

Stroke was an exploratory endpoint and with few of those events, the PI says it’s impossible to draw any strong conclusions.

8. Asundexian’s Lack of Efficacy Sinks OCEANIC-AF

Bayer says the phase III trial was stopped early because the novel Factor XIa inhibitor was inferior to apixaban for stroke risk.

9. PCR London Valves Looking for a Winner Between Long-term TAVI Trials? Don’t, Experts Urge

Directly comparing PARTNER 3 and Evolut Low Risk results is like “discussing reincarnation,” one prominent statistician warns.

10. AHA Inflammation More Powerful Than LDL as CV Risk Predictor in Statin-Free Patients

Lowering LDL is still key, says Paul Ridker, but a new analysis of CLEAR Outcomes is another reminder that hs-CRP also matters.

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Find anything you might have missed from the VIVA 2023, AHA 2023 and PCR London Valves meetings on our conference page. We also have video interviews with the ORBITA-2 and DAPA-MI investigators.