Cardio Trial Files: PCI vs. CABG on Major Bleeding in LMCAD, Single Pill Combination for HTN, and PCI + TAVI in CAD
Major Bleeding and Mortality After Revascularization of Left Main Disease
Giustino G et al. JACC (December 2024)
Bottom Line: This study, a randomized controlled trial with a 5-year follow-up, compared the rates and outcomes of major bleeding (MB) after left main coronary artery disease (LMCAD) revascularization using percutaneous coronary intervention (PCI) with dual antiplatelet therapy or coronary artery bypass grafting (CABG). The sample size included 1,905 patients with unprotected LMCAD. The primary outcome was 5-year rates of MB, which were significantly lower in the PCI group (7.9%) compared to the CABG group (14.8%). MB events within 5 years were associated with a higher subsequent risk of all-cause mortality. The conclusion was that CABG resulted in higher rates of MB, but postdischarge MB was more frequent after PCI. MB after both procedures was associated with increased cardiovascular and noncardiovascular mortality within 5 years.
Efficacy and Safety of a Novel Low-Dose Triple Single-Pill Combination Compared With Placebo for Initial Treatment of Hypertension
Rodgers A et al. JACC (December 2024)
Bottom Line: This international, randomized, double-blind, placebo-controlled, parallel-group trial enrolled 295 adults with hypertension receiving 0 to 1 BP-lowering drugs. After a 2-week placebo run-in, participants were randomized to receive either GMRx2 ¼ dose or GMRx2 ½ dose, or placebo. The primary outcome was the difference in change in home SBP from randomization to week 4. Both doses showed statistically significant reductions in home SBP compared to placebo, with good tolerability and no significant differences in adverse events.
PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation
Lønborg J et al. NEJM (August 2024)
Bottom Line: This international clinical trial randomly assigned 455 patients with severe symptomatic aortic stenosis and at least one coronary-artery stenosis to undergo PCI with TAVI or receive conservative treatment with TAVI. The primary outcome was a major adverse cardiac event at 2 years, and the results showed that PCI was associated with a lower risk of this outcome compared to conservative treatment. Safety outcomes, including bleeding events and procedural complications, were also assessed. The conclusion was that PCI with TAVI may be a beneficial treatment option for patients with severe aortic stenosis and coronary artery disease.
Cardio Trial Files Issue #CRD-2025-02
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