As we close another impactful year in cardiovascular medicine, we at touchCARDIO are pleased to share our 2025 year in review, highlighting the developments, discussions and innovations that we feel have shaped the field. From advances in rhythm management and imaging to emerging approaches in heart-failure care and prevention and an increased adoption of artificial intelligence (AI), 2025 has been defined by rapid progress and thoughtful clinical evolution.
We’ve gathered brief reflections from both expert voices from members of our editorial board and our inaugural touchCARDIO Future Leaders. Their perspectives spotlight major clinical advances from 2025, pivotal trial results, evolving interventional standards and new frameworks for cardiovascular risk assessment and prevention. Together, they offer expert reflections on shifting practice paradigms and emerging technologies that are shaping the future of cardiology.
We hope this curated collection inspires reflection, conversation and renewed energy as we look ahead to another year of discovery and progress in cardiac care in 2026.
Bryan Kluck
Editorial Board
Interventional Cardiologist, Allentown and Harrisburg, PA, USA
“The recently published CREST-2 trial sets up to be the next great shift in the treatment of carotid artery disease. This carefully designed and rigorously conducted trial compared, separately, carotid artery stenting (CAS) along with medical therapy and carotid endarterectomy (CE) along with medical therapy, each to medical therapy alone in asymptomatic patients. The results demonstrated that CAS added to medical therapy was statistically superior to medical therapy alone, whereas CE added to medical therapy was not. Well over a decade ago, CAS disrupted the well-established place of CE driven by the Asymptomatic Carotid Atherosclerosis Study (ACAS) and the North American Symptomatic Carotid Endarterectomy Trial (NASCET). CAS operators faced stiff opposition from surgeons, but slowly they were able to carve a role for CAS based on trials including the first Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) trial. That said, insurance coverage, guideline committees as well as many CAS sceptics placed CAS as, at best, equivalent to CE. At worst, second tier.
CREST-2 demonstrates clear superiority in treating asymptomatic carotid stenosis, by far the largest population of carotid disease patients considered for treatment. I would argue that societies and guideline committees need to promptly revise guidelines to stay ahead of the confusion that will be engendered by this new data. Further, given the slow uptake of CAS for the last decade, the number of skilled operators has considerably declined. Specialty societies, perhaps in collaboration with industry would be well advised to let this be a call to arms, resurrecting the formerly robust training programs such that a work force is available to enact this paradigm shift.”
Jose L Merino
Editorial Board
Chief of the Arrhythmia and Robotic Electrophysiology Unit, La Paz University Hospital, and Professor of Cardiology, Universidad Autónoma de Madrid, Madrid, Spain
“2025 has been a transformative year where theoretical promises finally became clinical practice. The defining highlight has been the consolidation of pulsed field ablation (PFA) as a new standard of care, fundamentally changing our workflow for atrial fibrillation. Parallel to this, we saw the formalization of conduction system pacing (CSP) via the new European Society of Cardiology (ESC)/European Heart Rhythm Association (EHRA) consensus. Yet, 2025 wasn’t just about interventions; the release of the EHRA Practical Compendium on Antiarrhythmic Drugs has been a crucial milestone. By introducing the ‘ABC’ framework and modernizing the classical drug classifications, this document has provided a long-overdue contemporary standard for medical therapy. We are closing the year with a toolkit that allows us to integrate advanced ablation, physiological pacing, and optimized pharmacotherapy more effectively than ever before.”
William Boden
Editorial Board
Veterans Association New England Healthcare System, Boston University School of Medicine, Boston, MA, USA
“Enhancing Global Cardiovascular Risk Reduction
In optimally reducing cardiovascular risk through primary prevention, it is imperative to quantify the estimated lifetime risk associated with cardiovascular risk factors. A landmark publication assessed the impact of the presence or absence of five classic risk factors (hypertension, hyperlipidaemia, body weight [underweight versus overweight or obesity], diabetes, and smoking at age 50 years) on lifetime risk of cardiovascular disease.
Using harmonized individual-level data from 2,078,948 participants across 133 cohorts, 39 countries, and 6 continents, the authors observed that the lifetime risk of cardiovascular disease was 24% (95% confidence interval [CI], 21–30) among women and 38% (95% CI, 30–45) among men in whom all five risk factors were present. Comparing participants with none versus all five risk factors, the estimated number of additional life-years free of cardiovascular disease was 13.3 (95% CI, 11.2–15.7) for women and 10.6 (95% CI, 9.2–12.9) for men, while the estimated number of additional life-years free of death was 14.5 (95% CI, 9.1–15.3) for women and 11.8 (95% CI, 10.1–13.6) for men. Regional heterogeneity was observed in the magnitude of lifetime difference among the various cardiovascular risk factors, particularly for hypertension, which was the leading global contributor to cardiovascular disease. Modifying the presence of hypertension was related to the most additional life-years free of cardiovascular disease. This study enhances our current knowledge because of the improved generalizability of findings, the use of large and geographically diverse data, and the individual, patient-level data showing that modification of one or more risk factors such as hypertension during a critical midlife decade was associated with additional lifetime years without cardiovascular disease.
Inflammation, High-sensitivity C-reactive Protein, and Lipoprotein(a) as Additional Modifiers of 30-year Outcomes
Beyond low-density lipoprotein cholesterol (LDL-C) alone, the presence of elevated levels of high-sensitivity C-reactive protein (hs-CRP) and lipoprotein(a) contribute significantly to 5-year and 10-year predictions of cardiovascular risk and represent distinct therapeutic pathways for additional pharmacological intervention. While women have a lower prevalence of obstructive coronary artery disease than men, they have the same or higher risk of developing a first major adverse cardiac event (MACE), including myocardial infarction (MI), stroke, coronary revascularization, or cardiovascular death during long-term follow-up.
In a prospective cohort analysis of 27,939 initially healthy US women (mean age 54.7 years) enrolled in the Women’s Health Study between 1992 and 1995, a single combined measure of hs-CRP, LDL-C, and lipoprotein (a) level provided strong cardiovascular risk prediction over a subsequent 30-year follow-up period. A total of 3,662 MACE events occurred (13.1%) during a subsequent 30-year follow-up. Importantly, each biomarker provided incremental information to the other two biomarkers, such that the combination of all 3 provided the greatest magnitude of spread and prediction of long-term risk. Covariable-adjusted hazard ratios for the composite primary MACE endpoint comparing the top with the bottom quintiles were 1.70 (95% CI, 1.52–1.90) for hs-CRP, 1.36 (95% CI, 1.23–1.52) for LDL-C, and 1.33 (95% CI, 1.21–1.47) for lipoprotein(a). The 30-year risk rose with each quintile of hs-CRP and LDL-C levels but was increased for lipoprotein(a) predominantly at the highest quintile. These data amplify how important a single combined measure of hs-CRP, LDL-C and lipoprotein(a) levels among initially healthy US women predicted long-term incident cardiovascular events, and highlight additional modifiers of cardiovascular risk that can extend therapeutic strategies to prevent cardiovascular events beyond traditional risk factors.”
Barry Uretsky
Editorial Board
University of Arkansas for Medical Sciences, Little Rock, AR, USA
“There have been several important randomized clinical trials published in 2025 that have incrementally improved cardiovascular treatment, including for those on glucagon-like peptide-1 (GLP-1) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, as well as drug therapy after stenting, just to name a few. However, the most important development is in increased awareness and use of AI in cardiovascular disease diagnosis and treatment. An example is use of AI to interpret echocardiograms, similar to the development of the computerized ECG interpretation 40 years ago. Use of the computerized ECG algorithm has not eliminated the human reader, but has made the interpretative process more efficient. The growth of AI in cardiology will continue exponentially in the next several years, and as such, this seems to be the most impactful development in the last year (by the way, when I asked an AI platform the same question as to the most important cardiovascular development in 2025, it agreed that AI was the most important one!).”
Sheldon Goldberg
Editorial Board
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
“As physicians caring for patients with cardiovascular disease in 2025, we have at our fingertips breakthrough technologies that show promise in improving the quality and duration of life. The revolutionary advances in non-invasive imaging and minimally invasive intervention allow for earlier detection and improved outcomes. For example, coronary computed tomography angiography (CCTA) can now be used to non-invasively assess stenosis severity, physiologic significance and lesion composition. Information from CCTA even allows for more accurate planning of percutaneous coronary intervention (PCI) procedures before we step into the catheterization suite. The power of AI, properly harnessed, will provide greater sophistication in everything from more rapid and accurate image interpretation to improved detection of acute myocardial infarction and thereby more appropriate selection of patients for urgent reperfusion therapy.
However, these advances are happening against a background of increasing social isolation and corporate influence on our daily routines. As a result, we are seeing more depression and burnout among physicians at a time when scientific breakthroughs are giving us more tools than ever. The challenge ahead will be to reverse this trend, return to our roots and rededicate ourselves to the proposition that helping others by providing compassionate science-based care improves measurable benefit not only to our patients, but to ourselves.”
George W Vetrovec
Editorial Board
The Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
“2025 provided significant science in interventional cardiology. The area that has struck me as most exciting and provocative for evolving therapeutic opportunities.is the potential to identify ‘at-risk’ plaques before plaque rupture leading to acute coronary syndromes. Significant data is coming quickly, looking at best diagnostic and potential therapeutic management. While the optimum imaging modalities remain in evolution, standard intravascular technologies, as well as non-invasive imaging utilizing magnetic resonance imaging (MRI) or computed tomography (CT) coronary angiography, supported by AI interpretation, are currently providing valuable information. More studies and refinement in assessing the results of such imaging studies are needed, but from a risk assessment modality, early identification of plaque rupture risk represents a major opportunity to be ahead of heart attack risk, rather than rapid revascularization once the event has occurred. Remaining is how to best treat the identified, high-risk plaque. Intensive lipid therapy and perhaps anti-inflammatory treatment, currently colchicine with unclear benefit, will likely play an important role in management.
Beyond medications, the potential to prophylactically treat plaques with stents and/or drug-eluting balloons is an interesting consideration requiring continued studies to identify which patients are most likely to benefit beyond medications. Many questions remain to be answered, but the prospects for preventing a myocardial infarction. rather than playing catch up as we do now, this is a hot area for research and opportunities to provide better care.”
Salik Iqbal
2025 Future Leader
Inselspital, University of Bern, Bern, Switzerland
“Key development that changed cardiology in 2025
In 2025, there were certain landmark achievements in cardiology, especially in cardiac electrophysiology. PFA achieved safety and efficacy in both, paroxysmal (single shot champion trial) and persistent atrial fibrillation (AF; ADVANTAGE AF) for AF ablation. These data, together with large registries such as MANIFEST-17K, reinforce how PFA is emerging as a new standard for AF substrate treatment in 2025 and will replace thermal ablation (radio frequency and cryoablation) in future once long-term data is available.
Exciting developments to watch in 2025 and beyond
Looking ahead, the next frontier is the first explorations of PFA for ventricular tachycardia (VT) substrate modification. The Ventricular Catheter Ablation Study (VCAS) shows promising results. If early-phase trials confirm safety and durable lesion formation in VT, we may be on the cusp of another major leap in cardiology and cardiac electrophysiology.”
Monika Sanghavi
2025 Future Leader
University of Pennsylvania, Philadelphia, PA, USA
“As a preventive cardiologist at heart, I believe the 2025 hypertension guidelines deserve a highlight. They mark a paradigm shift in how we conceptualize and manage elevated blood pressure. Rather than relying on rigid treatment thresholds, the new framework emphasizes comprehensive cardiovascular risk management, mirroring the evolution of lipid management. Hypertension is no longer viewed as a binary condition that “turns on” at a specific number, but as a continuum of risk that should be addressed in the context of an individual’s overall risk profile. This approach has the potential to fundamentally change practice by enabling earlier intervention, more personalized treatment, and meaningful reductions in long-term cardiovascular risk.”
Cite: A year in review: Expert voices on the developments that defined 2025. touchCARDIO. 16 December 2025.
Editor: Heather Hall, Managing Editor.
Disclosures: This article was created by the touchCARDIO team utilizing AI as an editorial tool (ChatGPT (GPT-5.1) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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