1. Tarantini G, Honton B, Paradies V, et al. Early discontinuation of aspirin after PCI in low-risk acute myocardial infarction. N Engl J Med 2025;393:2083–94. Among low-risk patients with acute myocardial infarction who had undergone early complete revascularization and had completed 1 month of dual antiplatelet therapy without complications, P2Y12-inhibitor monotherapy was noninferior to continued dual antiplatelet therapy with respect to the occurrence of adverse cardiovascular and cere- brovascular events and resulted in a lower incidence of bleeding events.
2. Guimarães PO, Franken M, Tavares CAM, et al. Early withdrawal of aspirin after PCI in acute coronary syndromes. N Engl J Med 2025;393:2095–106. Among patients who had undergone successful PCI for acute coronary syndromes, potent P2Y12 inhibitor monotherapy was not found to be noninferior to dual antiplatelet therapy with respect to a composite of death or ischemic events at 12 months.
3. Gould KL, Johnson NP, Roby AE, et al. Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial. Eur Heart J 2025;46:3273–86. Erratum in: Eur Heart J. 2025 Sep 2;46(33):3286 . The randomized CENTURY trial demonstrates that comprehensive integrated lifestyle modification and medical management towards goals with revascularization reserved for severely reduced CFC, significantly reduced risk factor scores, death, death or MI, and revascularization.
4. Fearon WF, Zimmermann FM, Ding VY, et al. Outcomes after fractional flow reserve-guided percutaneous coronary intervention versus coronary artery bypass grafting (FAME 3): 5-year follow-up of a multicentre, open-label, randomised trial. Lancet 2025;405:1481–90. This prespecified 5-year follow-up of FAME 3 shows no significant differences in the composite outcome of death, stroke, or myocardial infarction in 1.500 patients with three-vessel CAD not involving the left main coronary artery, although rates of myocardial infarction and repeat revascularisation remained higher with PCI. In addition, this final analysis of the trial showed no longterm accrual of benefit after CABG on a composite outcome of death, stroke, or myocardial infarction, which contradicts previous studies.
5. Ali ZA, Shin D, Vijayvergiya R. et al. Optical coherence tomography -vs angiographyguided coronary stent implantation in calcified lesions: the ILUMIEN IV trial. Eur Heart J 2025;46:3201–10. In the ILUMIEN IV trial, OCT-guided PCI in patients with angiographically determined moderately or severely calcified lesions reduced the 2-year rate of target vessel failure compared with angiography-guided PCI, an effect that was not seen in patients with lesions with no or mild angiographic calcium.
6. Kim MC, Ahn JH, Hyun DY, et al. Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION-STEMI): a multicentre, non- inferiority, open-label, randomised trial. Lancet 2025;406:1032–43. Among patients with STEMI and multivessel disease, immediate complete revascularisation was not shown to be noninferior to staged complete revascularisation during the index admission in terms of incidence of a composite of death from any cause, non-fatal myocardial infarction, or any unplanned revascularisation at 1 year. This finding might inform future clinical guidelines on the role and optimal use of immediate complete revascularisation during the index admission.
7. Nijveldt R, Maeng M, Beijnink CWH, et al. Immediate or deferred nonculprit-lesion PCI in myocardial infarction. N Engl J Med, 10.1056/NEJMoa2512918. Among patients with STEMI who have undergone successful primary PCI, immediate iFR-guided PCI was not superior to deferred cardiac stress MRI–guided PCI of nonculprit coronary-artery lesions with respect to death from any cause, recurrent myocardial infarction, or hospitalization for heart failure at 3 years.
8. Spaulding C, Krackhardt F, Bogaerts K, et al. Comparing a strategy of sirolimuseluting balloon treatment to drug-eluting stent implantation in de novo coronary lesions in all-comers: design and rationale of the SELUTION DeNovo Trial. Am Heart J 2023;258:77–84. (1-year results presented TCT 2025). SELUTION DeNovo trial is an open-label, multi-center international randomized trial comparing a strategy of PCI with sirolimuseluting balloon and provisional DES to a strategy of PCI with systematic DES on target vessel failure at one and five years. Non-inferiority will be tested at one and five years. If non-inferiority is met at five years, superiority will be tested.
9. Tchetche D, Pibarot P, Bax JJ, et al. Transcatheter vs. surgical aortic valve replacement in women: the RHEIA trial. Eur Heart J 2025;46:2079–88. Among women with severe aortic stenosis, the incidence of the composite of death, stroke, or rehospitalization at 1 year was lower with TAVI than with surgery.
10. Praz F, Borger MA, Lanz J, et al. ESC/ EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2025;46: 4635–736. This is an update to: European Heart Journal, Volume 43, Issue 7, 14 February 2022, Pages 561–632, https://doi.org/10. 1093/eurheartj/ehab395.
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