TCTMD’s Top 10 Most Popular Stories for September 2024

Many of our most-read stories this month were spillovers from the European Society of Cardiology (ESC) Congress 2024, with a mix of drug and device trials as well as guidelines making the list. Conspicuous outliers included a story about cheaper tirzepatide and our coverage of a meta-analysis making the case for prophylactic left atrial appendage (LAA) closure in patients undergoing cardiac surgery—even if they don’t have atrial fibrillation.

1. ESC RESHAPE-HF2 Is a Win for MitraClip in FMR—Not Everyone’s On Board

A flurry of papers, including a meta-analysis of the three RCTs, reflect big interest and even larger, unanswered questions.

2. ESC New ESC Guidelines on BP and Hypertension Shift Treatment Targets Lower

The recommendations, based on STEP, CRHCP, and ESPRIT data, are now more in line with US guidance.

3. Cheaper Version of Tirzepatide for Weight Loss Now Available, Lilly Says

The manufacturer is selling single-dose vials of the drug via its online pharmacy at around $400 to $500 for a 4-week supply.

4. ESC FINEARTS-HF: Benefit of Finerenone Extends to HFmrEF and HFpEF Patients

There was no reduction in CV death, but HF doctors are happy to gain another agent for use in patients with mildly reduced or preserved ejection fraction.

5. ESC NOTION-3: PCI Before TAVI Lowers MACE Risks in Patients With Significant CAD

There was a reduction in MACE with PCI before TAVI, but that doesn’t mean revascularization should be the norm, say experts.

6. ESC SENIOR-RITA Offers Rare Insights Into Best Care for Older NSTEMI Patients

No impact was seen on mortality between the invasive and medical arms, but other endpoints may mean more to patients.

7. LAAO During Cardiac Surgery May Help, Even in AF’s Absence

While awaiting more definitive RCTs, it would be reasonable to exclude the LAA in some of these patients, one expert says.

8. ESC SHAM-PVI: Catheter Ablation Improves Objective Measure of AF Burden

Though there are limitations, the sham-controlled trial shows “no clinically relevant placebo effect,” a researcher says.

9. ESC MitraClip vs Surgery for Severe FMR? MATTERHORN Claims Noninferiority

Critics were quick to point out that this small, short-term trial—mostly in patients with preserved EF—had no medical arm.

10. ESC Edoxaban Monotherapy Wins for AF and Stable Coronary Disease: EPIC-CAD

The results reinforce existing guidelines that advise pulling back on antithrombotic therapy in the chronic phase.

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You can delve deeper into our coverage of the ESC Congress by visiting our conference page, by watching our Beyond the Data video interviews with host Mamas Mamas, BMBCh, DPhil, or by tuning into the September edition of the Heart Sounds podcast.