1. Vrints C, Andreotti F, Koskinas KC et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45: 3415–537. Chronic Coronary Syndromes are a range of clinical presentations or syndromes that arise due to structural and/or functional alterations related to chronic diseases of the coronary arteries and/or microcirculation. These alterations can lead to transient, reversible, myocardial demand vs blood supply mismatch resulting in hypoperfusion (ischaemia), usually (but not always) provoked by exertion, emotion or other stress, and may manifest as angina, other chest discomfort, or dyspnoea, or be asymptomatic. Although stable for long periods, chronic coronary diseases are frequently progressive and may destabilize at any moment with the development of an ACS.
2. Gao XF, Ge Z, Kong XQ, et al. Intravascular ultrasound vs angiography-guided drugcoated balloon angioplasty: the ULTIMATE III trial. JACC Cardiovasc Interv 2024; 17: 1519–28. This study demonstrated that IVUS-guided drug-coated balloon angioplasty is associated with a lower late lumen loss in patients with a de novo coronary lesion compared with angiography guidance.
3. Gao X, Tian N, Kan J, et al. Drug-coated balloon angioplasty of the side branch during provisional stenting: the multicenter randomized DCB-BIF trial. J Am Coll Cardiol 2025;85:1–15. In patients with simple and true coronary bifurcation lesions undergoing provisional stenting, main vessel stenting with a drugcoated balloon for the compromised side branch resulted in a lower 1-year rate of the composite outcome compared with an non-coated balloon intervention for the side branch. The high rates of periprocedural myocardial infarction, which occurred early and did not lead to revascularization, are of unclear clinical significance.
4. Park SJ, Ahn JM, Kang DY, et al. Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, andomized controlled trial. Lancet 2024;403:1753–65. In patients with non-flow-limiting vulnerable coronary plaques, preventive percutaneous coronary intervention reduced major adverse cardiac events arising from high-risk vulnerable plaques, compared with optimal medical therapy alone. Given that PREVENT is the first large trial to show the potential effect of the focal treatment for vulnerable plaques, these findings support consideration to expand indications for percutaneous coronary intervention to include non-flowlimiting, high-risk vulnerable plaques.
5. Møller JE, Engstrøm T, Jensen LO, et al. Microaxial flow pump or standard care in infarct-related cardiogenic shock. N Engl J Med 2024;390: 1382–93. The routine use of a microaxial flow pump with standard care in the treatment of patients with STEMI-related cardiogenic shock led to a lower risk of death from any cause at 180 days than standard care alone. The incidence of a composite of adverse events was higher with the use of the microaxial flow pump.
6. Jørgensen TH, Thyregod HGH, Savontaus M, et al. Transcatheter aortic valve implantation in low-risk tricuspid or bicuspid aortic stenosis: the NOTION-2 trial. Eur Heart J 2024;45:3804–14. Among low-risk patients aged ≤75 years with severe symptomatic aortic stenosis, the rate of the composite of death, stroke, or rehospitalization at 1 year was similar between TAVI and surgery. Transcatheter aortic valve implantation outcomes in young bicuspid AS patients warrant caution and should be further investigated.
7. Lønborg J, Jabbari R, Sabbah M, et al. PCI in patients undergoing transcatheter aortic-valve implantation. N Engl J Med 2025;392:217–27. Among patients with coronary artery disease who were undergoing TAVI, PCI was associated with a lower risk of a composite of death from any cause, myocardial infarction, or urgent revascularization at a median follow-up of 2 years than conservative treatment.
8. Généreux P, Schwartz A, Oldemeyer JB, et al. Transcatheter aortic-valve replacement (TAVR) for asymptomatic severe aortic stenosis. N Engl J Med 2025;392:217–27. Among patients with asymptomatic severe aortic stenosis, a strategy of early TAVR was superior to clinical surveillance in reducing the incidence of death, stroke, or unplanned hospitalization for cardiovascular causes.
9. Baldus S, Doenst T, Pfister R, et al. Transcatheter repair versus mitral-valve surgery for secondary mitral regurgitation. N Engl J Med 2024; 391:1787–98. Among patients with heart failure and secondary mitral regurgitation, transcatheter edge-to-edge repair was noninferior to mitralvalve surgery with respect to a composite of death, rehospitalization for heart failure, stroke, reintervention, or implantation of an assist device in the left ventricle at 1 year.
10. Jaber WA, Gonsalves CF, Stortecky S, et al. Large-bore mechanical thrombectomy versus catheter-directed thrombolysis I n the management of intermediate-risk pulmonary embolism: primary results of the PEERLESS randomized controlled trial. Circulation 2025;151:260–73. PEERLESS met its primary end point in favor of large-bore mechanical thrombectomy Windows compared with catheter-directed thrombolysis in treatment of intermediaterisk pulmonary embolism. Large-bore mechanical thrombectomy had lower rates of clinical deterioration and/or bailout and postprocedural intensive care unit use compared with catheter-directed thrombolysisT, with no difference in mortality or bleeding.
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