Revascularization for patients with ischaemic left ventricular (LV) systolic dysfunction takes one of two forms - percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG), both of which have positives and negatives. STICH, published in 2011, analysed the role of CABG in patients with LV systolic dysfunction and looked at improvement of clinical outcomes in 1,212 patients from 22 countries across the world, optimised to either optimal medical therapy or optimal medical therapy plus CABG. REVIVED-BCIS2 in 2022 looked at 700 patients in the UK with a similar patient population of 35% ejection fraction or less, randomized to PCI or optimal medical therapy. This interview dives into their analysis of the results from these exciting trials and investigation into the discrepancies between the outcomes.

The challenges of improving risk prediction in atrial fibrillation were brought to the forefront through recent research on multiple biomarkers. This work explores how various biomarkers are linked to different outcomes and their potential to refine risk prediction. Early findings suggest that no single pathway is responsible for the observed outcomes, underscoring the need for larger, more comprehensive studies. Such studies must include a wide range of biomarkers and phenotypic associations to accurately determine and predict the diverse outcomes in patients with atrial fibrillation.

touchCARDIO spoke with Dr Mike Gibson, Harvard Medical School, Boston, MA, USA to discuss the results of his trial investigating the relationship between apolipoprotein A-I infusions and cardiovascular outcomes, presented at ESC 2024. He explains that while high-density lipoprotein (HDL) is generally associated with good outcomes, not all HDL is equally effective at removing cholesterol from plaque, a process known as cholesterol efflux, which is crucial for better outcomes after a heart attack.

touchCARDIO spoke with Dr Ganesan Karthikeyan All India Institute of Medical Sciences (AIIMS), New Delhi, India to get the results from the SAFE-PVT trial, presented at ESC 2024. SAFE-PVT was created to look at the difference in outcomes between surgery and fibrinolytic therapy to treat left-sided mechanical valve thrombosis, a condition that, while rare in developed countries, continues to affect patients in low- and middle-income countries where there are additional challenges in maintaining anticoagulation. This study looked to discern the differences in outcomes between surgery, the most common option in developed countries and also most recommended in Western guidelines, and fibrinolytic therapy with a low-dose, slow-infusion tPA regimen.