This Week in Cardiology Dec 19 2025 This Week in Cardiology
Dec 19, 2025
Explore the paradox of predicting first myocardial infarctions with risk scores that often fail in low-risk populations. Delve into the CELEBRATE trial, showcasing a new subcutaneous GP IIb/IIIa inhibitor, and the intriguing yet fragile results it produced. Review the SURPASS CVOT trial comparing diabetes treatments and the unexpected effects on all-cause mortality. Finally, uncover the troubling story of andexanet alfa, revealing the flaws in its early adoption and the lessons that emerge from evidence-based practice.
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Prioritize Healthy Living And Emergency Access
- Recommend healthy living and tell patients not to ignore symptoms as a pragmatic prevention strategy.
- Ensure policy supports capable, well-staffed cath labs to provide timely STEMI care.
New SubQ GP IIb/IIIa Agent And Trial Design
- Zalunfoban is a subcutaneous GP IIb/IIIa inhibitor achieving rapid but short platelet inhibition aimed for first medical contact in STEMI.
- The CELEBRATE trial used a hierarchical ordinal endpoint and showed a modest adjusted benefit driven by softer outcomes.
CELEBRATE's Benefit Is Fragile And Soft-Endpoint Driven
- CELEBRATE showed a fragile 21% odds reduction (OR 0.79; p=0.03) with no clear mortality or stroke benefit.
- The composite benefit was driven by heart-failure hospitalizations, troponin measures, and event-free survival rather than hard endpoints.