This Week in Cardiology Feb 13 2026 This Week in Cardiology
Feb 13, 2026
Debate over ticagrelor versus prasugrel in diabetes and PCI outcomes. A new dual‑seal left atrial appendage closure device and its procedural risks. Four‑year pulsed‑field ablation data and how it may change ablation decisions. A nurse‑led lifestyle trial that cut repeat procedures. Discussion about the label "provider" versus doctor and a skeptical look at coffee and dementia research.
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Prasugrel Outperformed Ticagrelor In TUXEDO‑2
- TUXEDO‑2 showed ticagrelor failed non‑inferiority versus prasugrel in diabetics after PCI with higher MACE and bleeding.
- Prasugrel appears superior when stronger antiplatelet therapy is needed, despite ticagrelor's market dominance.
Why Ticagrelor Remains Dominant
- Ticagrelor's persistence likely reflects first‑mover advantage, marketing, guideline embedding, formulary lock‑in, and cognitive biases.
- These nonclinical forces can keep an inferior therapy dominant despite trial evidence.
New LAAO Device Has Promising But Risky Early Data
- The VERITAS single‑arm LAAO study showed high implant success but concerning device‑related thrombus (2.4%) and peri‑device leak (6%).
- Early procedural risks may probabilistically offset uncertain future stroke/bleeding benefit of appendage closure.