Minor Stroke: When to Use D.A.P.T. vs. Alteplase 10/24/25
Welcome to Cardiology Today â Recorded October 24, 2025. This episode summarizes 5 key cardiology studies on topics like peri-operative complications and low-density lipoprotein cholesterol. Key takeaway: Minor Stroke: When to Use D.A.P.T. vs. Alteplase.
Article Links:
Article 1: Endothelial to mesenchymal transition in cardiovascular diseases: molecular insights and clinical perspectives. (European heart journal)
Article 2: LDL-cholesterol in newborns and children with genetically verified familial hypercholesterolaemia: implications for cholesterol-based screening. (European heart journal)
Article 3: Early outcomes of children with univentricular circulation undergoing Fontan surgery: the EuroFontan registry. (European heart journal)
Article 4: Global Registries and Surveys Programme-Heart Failure (GRASP-HF): Rationale, study design and research implications. (European journal of heart failure)
Article 5: Onset to Treatment Time and Early Neurological Deterioration of Dual Antiplatelet Therapy Versus Alteplase in Minor Stroke. (Journal of the American Heart Association)
Full episode page: https://podcast.explainheart.com/podcast/minor-stroke-when-to-use-d-a-p-t-vs-alteplase-10-24-25/
đ Featured Articles
Article 1: Endothelial to mesenchymal transition in cardiovascular diseases: molecular insights and clinical perspectives.
Journal: European heart journal
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41128016
Summary: Endothelial to Mesenchymal Transition is a crucial process where endothelial cells transform into mesenchymal-like cells, contributing to structures like smooth muscle cells, osteoblasts, fibroblasts, or chondrocytes. This review establishes Endothelial to Mesenchymal Transition’s foundational role in embryonic heart development, particularly in forming cardiac valves from endocardial cushions. More recently, the process has been identified in various adult cardiovascular diseases, highlighting its significance beyond development. Elucidating the molecular mechanisms of Endothelial to Mesenchymal Transition offers potential therapeutic avenues for adult cardiovascular pathologies.
Article 2: LDL-cholesterol in newborns and children with genetically verified familial hypercholesterolaemia: implications for cholesterol-based screening.
Journal: European heart journal
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41127896
Summary: This study investigated the efficacy of cholesterol-based screening for Familial Hypercholesterolaemia in newborns and children using genetically verified cases from a Norwegian national cascade screening program. Researchers collected low-density lipoprotein cholesterol levels from umbilical cord blood in 113 newborns and venous blood in children with confirmed Familial Hypercholesterolaemia between 1998 and 2023. The findings assess the potential of cholesterol-based screening to efficiently identify Familial Hypercholesterolaemia in pediatric populations. This research directly supports the development of universal screening approaches for early detection and management of this genetic condition.
Article 3: Early outcomes of children with univentricular circulation undergoing Fontan surgery: the EuroFontan registry.
Journal: European heart journal
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41127893
Summary: The EuroFontan registry, a multicentre retrospective study across 21 European congenital heart disease and transplant centers, evaluated early outcomes and peri-operative complications in children undergoing Fontan completion for univentricular circulation. This comprehensive study highlights that while the Fontan operation has significantly advanced the management of functional single ventricle physiology, peri-operative complications remain a notable concern. The findings provide critical insights into the real-world challenges and outcomes following this complex cardiac surgery in a large international cohort. This data is invaluable for refining current surgical protocols and improving post-operative care strategies to enhance patient survival and quality of life.
Article 4: Global Registries and Surveys Programme-Heart Failure (GRASP-HF): Rationale, study design and research implications.
Journal: European journal of heart failure
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41126578
Summary: The Global Registries and Surveys Programme-Heart Failure (G.R.A.S.P.-H.F.) is a pan-European, snapshot, observational study designed to evaluate the real-world implementation of evidence-based Heart Failure therapies. This paper details the rationale and study design for G.R.A.S.P.-H.F., aiming to identify existing gaps between guideline recommendations and actual clinical practice. By assessing the uptake of advanced pharmacologic and device-based treatments, the program provides a critical framework for understanding barriers to optimal Heart Failure management. Ultimately, G.R.A.S.P.-H.F. will inform strategies to improve patient outcomes by ensuring more consistent translation of research findings into routine clinical care.
Article 5: Onset to Treatment Time and Early Neurological Deterioration of Dual Antiplatelet Therapy Versus Alteplase in Minor Stroke.
Journal: Journal of the American Heart Association
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41128284
Summary: This prespecified secondary analysis of the ARAMIS trial investigated whether onset-to-treatment time modifies the effect of dual antiplatelet therapy versus intravenous alteplase on early neurological deterioration in acute minor nondisabling ischemic stroke. The ARAMIS trial previously demonstrated that dual antiplatelet therapy is noninferior to alteplase for these patients. This specific analysis, using the as-treated population, aimed to delineate the time-dependent efficacy of these interventions. The findings provide critical guidance for optimizing treatment timing and selection, offering improved strategies to mitigate early neurological deterioration in patients presenting with minor ischemic stroke.
đ Transcript
Today’s date is October 24, 2025. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Endothelial to mesenchymal transition in cardiovascular diseases: molecular insights and clinical perspectives. Endothelial to Mesenchymal Transition is a crucial process where endothelial cells transform into mesenchymal-like cells, contributing to structures like smooth muscle cells, osteoblasts, fibroblasts, or chondrocytes. This review establishes Endothelial to Mesenchymal Transition’s foundational role in embryonic heart development, particularly in forming cardiac valves from endocardial cushions. More recently, the process has been identified in various adult cardiovascular diseases, highlighting its significance beyond development. Elucidating the molecular mechanisms of Endothelial to Mesenchymal Transition offers potential therapeutic avenues for adult cardiovascular pathologies.
Article number two. L.D.L.-cholesterol in newborns and children with genetically verified familial hypercholesterolaemia: implications for cholesterol-based screening. This study investigated the efficacy of cholesterol-based screening for Familial Hypercholesterolaemia in newborns and children using genetically verified cases from a Norwegian national cascade screening program. Researchers collected low-density lipoprotein cholesterol levels from umbilical cord blood in 113 newborns and venous blood in children with confirmed Familial Hypercholesterolaemia between 1998 and 2023. The findings assess the potential of cholesterol-based screening to efficiently identify Familial Hypercholesterolaemia in pediatric populations. This research directly supports the development of universal screening approaches for early detection and management of this genetic condition.
Article number three. Early outcomes of children with univentricular circulation undergoing Fontan surgery: the EuroFontan registry. The EuroFontan registry, a multicentre retrospective study across 21 European congenital heart disease and transplant centers, evaluated early outcomes and peri-operative complications in children undergoing Fontan completion for univentricular circulation. This comprehensive study highlights that while the Fontan operation has significantly advanced the management of functional single ventricle physiology, peri-operative complications remain a notable concern. The findings provide critical insights into the real-world challenges and outcomes following this complex cardiac surgery in a large international cohort. This data is invaluable for refining current surgical protocols and improving post-operative care strategies to enhance patient survival and quality of life.
Article number four. Global Registries and Surveys Programme-Heart Failure (G.R.A.S.P.-H.F.): Rationale, study design and research implications. The Global Registries and Surveys Programme-Heart Failure (G.R.A.S.P.-H.F.) is a pan-European, snapshot, observational study designed to evaluate the real-world implementation of evidence-based Heart Failure therapies. This paper details the rationale and study design for G.R.A.S.P.-H.F., aiming to identify existing gaps between guideline recommendations and actual clinical practice. By assessing the uptake of advanced pharmacologic and device-based treatments, the program provides a critical framework for understanding barriers to optimal Heart Failure management. Ultimately, G.R.A.S.P.-H.F. will inform strategies to improve patient outcomes by ensuring more consistent translation of research findings into routine clinical care.
Article number five. Onset to Treatment Time and Early Neurological Deterioration of Dual Antiplatelet Therapy Versus Alteplase in Minor Stroke. This prespecified secondary analysis of the ARAMIS trial investigated whether onset-to-treatment time modifies the effect of dual antiplatelet therapy versus intravenous alteplase on early neurological deterioration in acute minor nondisabling ischemic stroke. The ARAMIS trial previously demonstrated that dual antiplatelet therapy is noninferior to alteplase for these patients. This specific analysis, using the as-treated population, aimed to delineate the time-dependent efficacy of these interventions. The findings provide critical guidance for optimizing treatment timing and selection, offering improved strategies to mitigate early neurological deterioration in patients presenting with minor ischemic stroke.
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đ Keywords
peri-operative complications, low-density lipoprotein cholesterol, endothelial cells, mesenchymal cells, pediatric cardiology, genetic testing, cardiovascular diseases, minor ischemic stroke, Familial Hypercholesterolaemia, onset-to-treatment time, guideline adherence, clinical practice, real-world data, early neurological deterioration, dual antiplatelet therapy, univentricular circulation, endothelial to mesenchymal transition, alteplase, congenital heart disease, newborn screening, Heart Failure, EuroFontan registry, observational study, Fontan operation, cardiac valves.
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Concise summaries of cardiovascular research for professionals.
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