MedShr

30/03/2026

ACC.26 CHAMPION-AF Trial shows LAAO non-inferior to DOACs in non-valvular AF

CHAMPION-AF rewrites the playbook on atrial fibrillation management. In 3,000 patients suitable for long-term blood thinners, left atrial appendage closure proved noninferior for preventing stroke, CV death, and systemic embolism - while nearly halving bleeding risk at 3 years. Published simultaneously in NEJM, this trial opens the door to shared decision-making for a much broader AF population.



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30/03/2026

𝐓𝐫𝐞𝐧𝐝𝐢𝐧𝐠 𝐨𝐧 𝐌𝐞𝐝𝐒𝐡𝐫: 35M with RUQ pain & a liver MRI showing peripheral nodular enhancement with centripetal fill-in. Can you identify the hepatic lesion?

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A 35-y-o-with RUQ pain. late image of enhanced T1-weighted MR image of the liver shown-DX? on MedShr

30/03/2026

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐃𝐚𝐲: A 4-month-old infant with scaly erythematous plaques across the trunk. What are your differentials and management plan?

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Rash in 4 month old girl on MedShr

30/03/2026

Do you agree with the working diagnosis for this patient with chest pain and orthopnoea? Share your thoughts on MedShr: https://medshr.it/rZbQ8yUClBb

Very unusual explanation for orthopnea and chest pain on MedShr

29/03/2026

ACC.26 IMPEDENCE-HFpEF - CardioSet Lung Impedence guided management reduces HFpEF hospitalisation

IMPEDANCE-HFpEF: a randomized trial testing whether non-invasive lung impedance monitoring can guide diuretic therapy in HFpEF — and the results are remarkable. In 150 patients followed for a mean of 38 months, lung impedance–guided management reduced HF hospitalizations by 81% (HR 0.19; P

29/03/2026

ACC.26: FAST III - vFFR is non inferior to invasive FFR

FAST III establishes vFFR as a noninferior alternative to invasive FFR for guiding coronary revascularization: in 2,235 patients across 37 European centres, vFFR-guided treatment produced identical 1-year outcomes to wire-based FFR (7.5% vs 7.5%; risk difference -0.02 pp; 95% CI -2.25 to 2.21; P=0.004 for noninferiority). Study-vessel failure was also similar at 4.0% vs 4.6%. No pressure wire. No adenosine. Published simultaneously in NEJM.



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29/03/2026

ACC.26: PRO-TAVI - PCI can safely be deferred until after TAVI

PRO-TAVI: the first RCT to show that PCI can safely be deferred in TAVI patients with concomitant coronary artery disease. In 466 elderly patients across 12 Dutch centres, a TAVI-first strategy was noninferior to routine pre-TAVI revascularization for the composite of death, MI, stroke, or major bleeding at 1 year (24.1% vs 25.8%; rate difference −1.7 pp; P

29/03/2026

ACC.26: TRI-FR - TEER gives long terms improves in outcomes

TRI-FR extended follow-up: the first RCT to show transcatheter tricuspid repair delivers long-term outcome benefit. At a median follow-up of ~35 months, T-TEER added to medical therapy reduced the composite of first HF hospitalization, tricuspid surgery, or CV death by 44% (HR 0.56; 95% CI 0.36–0.88; P=0.0109) and halved recurrent HF hospitalizations (rate ratio 0.52; P=0.0073). Benefit emerged beyond year 1 — reframing severe TR from a passive marker to a treatable driver of right-sided heart failure.



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29/03/2026

ACC.26: ALL RISE - Cathworks FFRangio is non-inferior to invasive FFR

ALL-RISE delivers landmark evidence for wire-free coronary physiology: in 1,930 patients across 59 international sites, a treatment strategy guided by angiography-derived FFR was noninferior to pressure wire–guided physiology for 1-year MACE (6.9% vs 7.1%; HR 0.98; 95% CI 0.70–1.39; P=0.0008 for noninferiority). Assessment was faster (6 vs 8 min), with shorter procedure times, less fluoroscopy, and lower contrast volume. Published simultaneously in NEJM.

29/03/2026

ACC.26 ORBITA CTO - placebo controlled trial shows CTO PCI improves symptoms

ORBITA-CTO delivers landmark evidence: in the first randomized, double-blind, placebo-controlled trial of CTO PCI, recanalization significantly improved the angina symptom score (OR 4.38; 95% CrI 1.57–12.69; Pr[Benefit] = 99.6%). Patients undergoing CTO PCI experienced 30.6 additional angina-free days over 6 months, with consistent improvements across SAQ domains and CCS class. Blinding was rigorously maintained. Published simultaneously in JACC.



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29/03/2026

CHIP-BCIS3 delivers a sobering result: in 300 patients with severe LV dysfunction undergoing complex PCI, routine elective mechanical circulatory support did not reduce the primary hierarchical composite outcome (win ratio 0.85; P=0.30). Cardiovascular death was significantly higher in the pump group — 26.7% vs 14.5% (HR 1.91; P=0.018). The first randomized trial of elective pump-supported high-risk PCI challenges current practice. Published simultaneously in the NEJM.



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