Updates in Cardiology and Beyond

Updates in Cardiology and Beyond A Page for Sharing Practice Changing Updates in Cardiology and Beyond

🔴 Beta-Blockers after MI: Toward Personalized Management (NEJM, 2026)Historical benefit: • β-blockers reduced post-MI mo...
15/03/2026

🔴 Beta-Blockers after MI: Toward Personalized Management (NEJM, 2026)

Historical benefit:

• β-blockers reduced post-MI mortality pre-reperfusion via anti-ischemic and anti-arrhythmic effects.

Modern MI context:

• PCI, statins, antiplatelets, and RAAS inhibitors now reduce infarct size and arrhythmic risk.

Contemporary evidence:

• In MI pts with LVEF ≥50%, long-term β-blockers do not reduce death, recurrent MI, or HF.

Guideline implication:

• Routine lifelong β-blockers after uncomplicated MI with preserved EF should be individualized.

Still indicated:

• Reduced EF, HF, arrhythmias, hypertension, or ongoing ischemia remain clear indications.

https://www.nejm.org/doi/full/10.1056/NEJMe2600427

🔴 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of :1. • Replaces pooled cohort...
14/03/2026

🔴 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of

:

1.

• Replaces pooled cohort equations for adults 30–79 years.
• 10-year ASCVD risk categories:
Low:

🔴 The Trial (JAMA, 2026)Low-Dose Rivaroxaban to Prevent Left Ventricular ThrombosisAfter Anterior MI❌ In this multicen...
14/03/2026

🔴 The Trial (JAMA, 2026)

Low-Dose Rivaroxaban to Prevent Left Ventricular ThrombosisAfter Anterior MI

❌ In this multicenter RCT among ptswith anterior STEMI, the addition of low-dose rivaroxaban to DAPT did not demonstratea statistically significant reduction in LV thrombus formation at 1 month but did increase minor bleeding.

• Given the limited power of the study, these findings should be interpreted with caution, as a modest effect cannot be excluded.

https://jamanetwork.com/journals/jamacardiology/article-abstract/2845590

🔴 New Evidence Reshaping Stroke Prevention in (AHA 2025 Highlights)Four major trials are redefining antithrombotic str...
03/03/2026

🔴 New Evidence Reshaping Stroke Prevention in (AHA 2025 Highlights)

Four major trials are redefining antithrombotic strategy in complex AF scenarios:

(Post-Ablation anticoagulation)

• 1,284 high-risk patients ≥1 year after successful AF ablation
• Rivaroxaban vs aspirin
• Follow-up: 3 years
Findings:
• No significant difference in stroke/systemic embolism
• Covert cerebral infarcts similar
• Major/fatal bleeding higher with rivaroxaban (1.6% vs 0.6%)
🔎 Takeaway: In carefully selected patients with low AF burden after ablation, long-term anticoagulation may not provide additional benefit over aspirin — but bleeding risk increases with DOAC. It may be safe to stop blood thinners, even if they have a moderate stroke risk.

(≥1 Year Post-PCI)

• AF patients ≥1 year after DES
• NOAC alone vs NOAC + clopidogrel
Result:
• NOAC monotherapy was noninferior and numerically better for net adverse events.
🔎 Takeaway: Beyond 12 months post-PCI, most AF patients can safely stop antiplatelet therapy and continue oral anticoagulation alone.

(Early Post-PCI Strategy)

• 1 month vs 12 months DOAC + P2Y12 inhibitor
Result:
• Similar ischemic protection
• Less bleeding with 1-month dual therapy
🔎 Takeaway: Shorter dual therapy reduces bleeding without increasing stroke or MI in selected patients.

(LAAC vs Medical Therapy)

• High-risk AF patients
• Left atrial appendage closure vs physician-directed medical therapy
Result:
• Standard medical therapy performed better than LAAC in very high-risk elderly patients.
🔎 Takeaway: LAAC is not superior to optimized anticoagulation in very high bleeding/stroke risk patients. Careful patient selection remains critical.

Overarching Clinical Shift:

✔ Anticoagulation after successful ablation may become individualized, guided by AF burden and bleeding risk rather than risk score alone.

✔ NOAC monotherapy beyond 1 year post-PCI is appropriate for most stable AF patients.

✔ Shorter dual therapy after PCI is increasingly favored, reducing bleeding without compromising ischemic protection.

✔ LAAC is not superior to optimized medical therapy in very high-risk patients, emphasizing careful patient selection.

• Precision, not routine continuation, is becoming the new paradigm in AF stroke prevention.

🔴 The Trial (JAMA, 2026)Catheter Ablation and Oral Anticoagulationfor Secondary Stroke Prevention in Atrial Fibrillati...
03/03/2026

🔴 The Trial (JAMA, 2026)

Catheter Ablation and Oral Anticoagulationfor Secondary Stroke Prevention in Atrial Fibrillation

In patients with atrial fibrillation and a recent stroke history, standard therapy plus catheter ablation did not significantly reduce the risk of the primary composite end point.

The observed event rate was lower than anticipated, suggesting that the study was underpowered to detect clinically meaningful differences.

https://jamanetwork.com/journals/jamaneurology/fullarticle/2845745

ECG Changes in Electrolyte Imbalances
23/02/2026

ECG Changes in Electrolyte Imbalances

🔵 Echo Pearl: The SignDefinition: • The Retro-Aortic Coronary (RAC) sign is echo marker of an anomalous LCx arising fr...
22/02/2026

🔵 Echo Pearl: The Sign

Definition:

• The Retro-Aortic Coronary (RAC) sign is echo marker of an anomalous LCx arising from the Rt coronary sinus or RCA.

Anatomic Course:

• LCx takes a retro-aortic path, passing behind the aortic root into the left AV groove.

Echocardiographic Appearance:

• PLAX: Small circular/tubular echogenic structure posterior to the aortic root.

• A4C: Linear echogenic density along the left AV groove.

Clinical Significance:

• Usually benign but critical to recognize before aortic valve surgery to avoid coronary injury.

Common Pitfall:

• Can be mistaken for annular or aortic calcification.

Next Step:

• Confirm with Coronary CT Angiography (CCTA) if suspected.

Evolution of Risk Stratification in Acute Pulmonary Embolism
22/02/2026

Evolution of Risk Stratification in Acute Pulmonary Embolism

🔴 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guidelinefor the Evaluation and Management of Acute Pulmonary Emboli...
19/02/2026

🔴 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guidelinefor the Evaluation and Management of Acute Pulmonary Embolism in Adults

ACC/AHA First-Ever Guideline For Treatment and Management of Acute PE

https://www.jacc.org/doi/10.1016/j.jacc.2025.11.005

Address

Addis Ababa

Website

Alerts

Be the first to know and let us send you an email when Updates in Cardiology and Beyond posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category