Tailoring Antiplatelets After P. C. I. for A. C. S. 01/29/26
Welcome to Cardiology Today â Recorded January 29, 2026. This episode summarizes 5 key cardiology studies on topics like P2Y12 inhibitor monotherapy and public reporting. Key takeaway: Tailoring Antiplatelets After P. C. I. for A. C. S..
Article Links:
Article 1: Public Reporting and Case Selection in Congenital Heart Surgery: Signals From a Multicenter Observational Study. (Journal of the American College of Cardiology)
Article 2: Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2. (Journal of the American College of Cardiology)
Article 3: Potent P2Y12 Inhibitor Monotherapy vs DAPT After PCI in Patients With and Without STEMI: The NEO-MINDSET Substudy. (Journal of the American College of Cardiology)
Article 4: Early vs Late Staged PCI After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial. (Journal of the American College of Cardiology)
Article 5: Intracoronary Low-Dose Recombinant Tissue Plasminogen Activator in Primary PCI for ST-Segment Elevation Myocardial Infarction and Large Thrombus Burden: A Randomized Trial. (Journal of the American College of Cardiology)
Full episode page: https://podcast.explainheart.com/podcast/tailoring-antiplatelets-after-p-c-i-for-a-c-s-01-29-26/
đ Featured Articles
Article 1: Public Reporting and Case Selection in Congenital Heart Surgery: Signals From a Multicenter Observational Study.
Journal: Journal of the American College of Cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41603821
Summary: This study investigated the association between public reporting and potential risk avoidance in congenital heart surgery. Researchers evaluated changes in case selection and hospital performance, using predicted probability of mortality as a measure of case-mix complexity. The work addressed the critical need to understand both changes in case selection and patient outcomes after public reporting, particularly concerning the potential for risk avoidance in complex surgical fields.
Article 2: Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2.
Journal: Journal of the American College of Cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41603507
Summary: C. I. Effectiveness in Stable C. A. D.: Secondary Analysis of O. R. B. I. T. A. -2. The O. R. B. I. T. A. -2 trial demonstrated the efficacy of percutaneous coronary intervention in patients with stable angina and coronary artery disease, even without background antianginal medication. This secondary analysis specifically examined whether this percutaneous coronary intervention effect is consistent across different age groups. It focused on the interaction between age and both symptom relief and stenosis improvement, addressing a knowledge gap regarding treatment consistency across demographics.
Article 3: Potent P2Y12 Inhibitor Monotherapy vs DAPT After PCI in Patients With and Without STEMI: The NEO-MINDSET Substudy.
Journal: Journal of the American College of Cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41384891
Summary: A. P. T. After P. C. I. in Patients With and Without S. T. E. M. I.: The N. E. O. -M. I. N. D. S. E. T. Substudy. This prespecified analysis from the N. E. O. -M. I. N. D. S. E. T. trial evaluated whether treatment effects of early aspirin discontinuation differ between S. T. -segment elevation myocardial infarction and non-S. T. -segment elevation acute coronary syndrome. The study compared potent P2Y12 inhibitor monotherapy with dual antiplatelet therapy after percutaneous coronary intervention. This research addressed how acute coronary syndrome presentation influences optimal antiplatelet strategies post-percutaneous coronary intervention.
Article 4: Early vs Late Staged PCI After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial.
Journal: Journal of the American College of Cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41295935
Summary: C. I. After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial. This randomized trial investigated the optimal timing for staged percutaneous coronary intervention after subintimal tracking and re-entry for chronic total occlusions. The study compared an earlier timeframe of five to seven weeks versus a later timeframe of twelve to fourteen weeks for staged stenting. This research addressed a crucial clinical question regarding the management of complex chronic total occlusion percutaneous coronary intervention.
Article 5: Intracoronary Low-Dose Recombinant Tissue Plasminogen Activator in Primary PCI for ST-Segment Elevation Myocardial Infarction and Large Thrombus Burden: A Randomized Trial.
Journal: Journal of the American College of Cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41194755
Summary: C. I. for S. T. -Segment Elevation Myocardial Infarction and Large Thrombus Burden: A Randomized Trial. This randomized trial evaluated the effect of targeted, intracoronary low-dose recombinant tissue plasminogen activator (alteplase) in patients with S. T. -segment elevation myocardial infarction undergoing primary percutaneous coronary intervention and exhibiting a large thrombus burden. The study investigated whether this strategy improves microvascular obstruction without increasing systemic bleeding risk. This research addressed the clinical challenge of distal embolization and reduced myocardial tissue perfusion, which affects about half of S. T. E. M. I. patients receiving primary percutaneous coronary intervention.
đ Transcript
Today’s date is January 29, 2026. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Public Reporting and Case Selection in Congenital Heart Surgery: Signals From a Multicenter Observational Study. This study investigated the association between public reporting and potential risk avoidance in congenital heart surgery. Researchers evaluated changes in case selection and hospital performance, using predicted probability of mortality as a measure of case-mix complexity. The work addressed the critical need to understand both changes in case selection and patient outcomes after public reporting, particularly concerning the potential for risk avoidance in complex surgical fields.
Article number two. Association Between Age and P. C. I. Effectiveness in Stable C. A. D.: Secondary Analysis of O. R. B. I. T. A. -2. The O. R. B. I. T. A. -2 trial demonstrated the efficacy of percutaneous coronary intervention in patients with stable angina and coronary artery disease, even without background antianginal medication. This secondary analysis specifically examined whether this percutaneous coronary intervention effect is consistent across different age groups. It focused on the interaction between age and both symptom relief and stenosis improvement, addressing a knowledge gap regarding treatment consistency across demographics.
Article number three. Potent P2Y12 Inhibitor Monotherapy vs D. A. P. T. After P. C. I. in Patients With and Without S. T. E. M. I.: The N. E. O. -M. I. N. D. S. E. T. Substudy. This prespecified analysis from the N. E. O. -M. I. N. D. S. E. T. trial evaluated whether treatment effects of early aspirin discontinuation differ between S. T. -segment elevation myocardial infarction and non-S. T. -segment elevation acute coronary syndrome. The study compared potent P2Y12 inhibitor monotherapy with dual antiplatelet therapy after percutaneous coronary intervention. This research addressed how acute coronary syndrome presentation influences optimal antiplatelet strategies post-percutaneous coronary intervention.
Article number four. Early vs Late Staged P. C. I. After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial. This randomized trial investigated the optimal timing for staged percutaneous coronary intervention after subintimal tracking and re-entry for chronic total occlusions. The study compared an earlier timeframe of five to seven weeks versus a later timeframe of twelve to fourteen weeks for staged stenting. This research addressed a crucial clinical question regarding the management of complex chronic total occlusion percutaneous coronary intervention.
Article number five. Intracoronary Low-Dose Recombinant Tissue Plasminogen Activator in Primary P. C. I. for S. T. -Segment Elevation Myocardial Infarction and Large Thrombus Burden: A Randomized Trial. This randomized trial evaluated the effect of targeted, intracoronary low-dose recombinant tissue plasminogen activator (alteplase) in patients with S. T. -segment elevation myocardial infarction undergoing primary percutaneous coronary intervention and exhibiting a large thrombus burden. The study investigated whether this strategy improves microvascular obstruction without increasing systemic bleeding risk. This research addressed the clinical challenge of distal embolization and reduced myocardial tissue perfusion, which affects about half of S. T. E. M. I. patients receiving primary percutaneous coronary intervention.
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đ Keywords
P2Y12 inhibitor monotherapy, public reporting, hospital performance, dual antiplatelet therapy, recombinant tissue plasminogen activator, staged stenting, non-S. T. -segment elevation acute coronary syndrome, S. T. -segment elevation myocardial infarction, age, chronic total occlusion, alteplase, subintimal tracking and re-entry, stable angina, case mix complexity, primary percutaneous coronary intervention, coronary artery disease, microvascular obstruction, revascularization timing, percutaneous coronary intervention, risk avoidance, O. R. B. I. T. A. -2 trial, congenital heart surgery.
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