1/ GLP1 agonists in HFpEF? GLP1 agonists, initially touted as a therapy for diabetes, have proven successful for weight loss (SURMOUNT Trial), CV event reduction (SELECT Trial), and now - with beneficial effects in HFpEF and obesity. STEP-HFpEF Trial, NEJM 2023 β₯οΈ
2/ GLP1 agonism in obesity to reduce CV mortality? This trial showed reduction in MI/stroke in prior CVD and high BMI, in the absence of diabetes. A practice-changing trial establishing obesity as a modifiable risk factor for CVD. SELECT Trial, NEJM 2023 β₯οΈ
3/ Catheter ablation in end-stage heart failure? A population not previously studied in this context, having been excluded from prior large trials. This trial showed the importance of sinus rhythm maintenance in this vulnerable population. CASTLE HTx Trial, NEJM 2023 β₯οΈ
4/ Addressing the underlying cause of pulmonary arterial hypertension? Unlike traditional therapies like PDE5 inhibitors which simply vasodilate, sotatercept remodels the pulmonary vascular bed itselfπβ now with demonstrable mortality benefit. STELLAR Trial, NEJM 2023 β₯οΈ
5/ Tricuspid valve repair without open heart surgery? This trial in severe tricuspid regurgitation showed reduced symptoms and regurgitation severity, but without mortality benefit. A beacon of hope for transcatheter intervention in this arena. TRILUMINATE Trial, NEJM 2023 β₯οΈ
6/ Statins for all patients with HIV? This trial was the first large RCT to show primary prevention statin use in HIV patients decreased CV events and prolonged survival. A practice-changing trial that brings CV health to the forefront of HIV therapy. REPRIEVE Trial, NEJM 2023 β₯οΈ
7/ Bempedoic acid for statin intolerant patients? This trial is the first positive outcomes trial for this lipid lowering drug β and the FIRST to show non-statin benefit in primary prevention. CLEAR Outcomes Trial, NEJM 2023 β₯οΈ
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