
This Week in Cardiology Nov 21 2025 This Week in Cardiology
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Nov 21, 2025 This week, the discussion dives into groundbreaking findings from the CREST-2 trial, revealing new insights into treating carotid artery disease. The ongoing battle between prasugrel and ticagrelor continues, with recent evidence suggesting prasugrel holds an edge for high-risk diabetic patients. Plus, there's an intriguing look at coffee consumption's relationship with atrial fibrillation—could that morning cup actually lower your risk? Tune in for a blend of clinical updates and listener feedback that keeps healthcare professionals engaged!
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Drug Class Versus Individual Agent Effects Are Unclear
- Class effects versus individual drug effects remain uncertain; trial context and patient selection may explain differing outcomes.
- Mandrola cites bucindolol and BEST to illustrate how patient fragility and trial populations can drive apparent drug failures.
Focus On Absolute Benefit And Targeting
- When interpreting lipid-lowering or novel therapy trials, consider absolute benefit and time-to-event delays, not just relative risk.
- Target therapies to patients with high atherosclerotic burden rather than broadly applying them.
CREST-2 Shifts Asymptomatic Carotid Care
- CREST-2 shows minimal absolute benefit from revascularization for asymptomatic carotid stenosis when best medical therapy is used.
- Mandrola views the data as closing the chapter on routine carotid endarterectomy and argues to prioritize aggressive medical therapy first.
