[{"name":"HEART FAILURE","subSubjects":[{"name":"Isosorbide\/hydralazine","topics":[{"id":"79","name":"V-HeFT","year":"1986","p":"In patients with HFrEF in the era before beta blockers and ACEi,","i":"isosorbide and hydralazine","c":"led to a trend towards reduced mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/3520315","subSubjectId":"32"},{"id":"81","name":"V-HeFT II","year":"1991","p":"In patients with HFrEF,","i":"enalapril","c":"reduced mortality","o":"when compared to isosorbide and hydralazine","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/2057035","subSubjectId":"32"},{"id":"82","name":"A-HeFT","year":"2004","p":"In self-identified black patients with HFrEF and NYHA III-IV symptoms,","i":"isosorbide and hydralazine","c":"reduced mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15533851","subSubjectId":"32"}]},{"name":"Atrial fibrillation","topics":[{"id":"85","name":"AF-CHF","year":"2008","p":"In patients with HFrEF and comorbid atrial fibrillation,","i":"rhythm control","c":"led to no decrease in cardiovascular mortality","o":"when compared to rate control.","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/18565859","subSubjectId":"33"},{"id":"86","name":"AATAC","year":"2016","p":"In patients with HFrEF and persistent atrial fibrillation for whom a rhythm control was chosen,","i":"afib ablation","c":"improved survival","o":"when compared to medical management","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/27029350","subSubjectId":"33"},{"id":"88","name":"CASTLE-AF","year":"2018","p":"In patients with symptomatic (NYHA II-IV) HFrEF (EF<35%) and comorbid atrial fibrillation,","i":"catheter ablation","c":"improved survival and led to a greater improvement in ejection fraction","o":"when compared to pharmacological rate or rhythm 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syndrome,","i":"routine ultrafiltration","c":"led to greater adverse effects and worsening renal function","o":"when compared to pharmacological diuresis alone","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1210357","subSubjectId":"35"},{"id":"224","name":"ADVOR","year":"2022","p":"In patients with acute decompensated heart failure,","i":"IV acetazolamide added to standard loop diuretic","c":"led to faster resolution of volume overload","o":"when compared to loop diuretic alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/36027559\/","subSubjectId":"35"},{"id":"262","name":"B-CONVINCED","year":"2009","p":"In patients with acute decompensated HFrEF (EF<40%),","i":"continuation of outpatient beta blocker therapy","c":"led to no difference in mortality, hospital stay length, or symptoms, but did increase beta blocker prescription at discharge","o":"when compared to holding outpatient beta 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enalapril","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30415601\/","subSubjectId":"37"}]},{"name":"HFpEF","topics":[{"id":"140","name":"CHARM-Preserved","year":"2003","p":"In patients with HFpEF (EF>40%),","i":"candesartan","c":"reduced hospital admissions but had no effect on mortality","o":"when compared to placebo.","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/13678871\/","subSubjectId":"38"},{"id":"142","name":"RELAX","year":"2013","p":"In patients with HFpEF (EF>50% and NYHA Class II-IV),","i":"sildenafil","c":"had no effect on exercise capacity (VO2 max)","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23478662\/","subSubjectId":"38"},{"id":"144","name":"TOPCAT","year":"2014","p":"In patients with HFpEF (EF>45%),","i":"spironolactone","c":"led to no increased survival but did have a small reduction in hospital admissions","o":"when compared to 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Note: a criticism of this study is that a low dose of rosuvastatin (10mg daily) was used","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17984166\/","subSubjectId":"41"},{"id":"161","name":"STICH","year":"2011","p":"In patients with ischemic cardiomyopathy (EF<35%),","i":"CABG","c":"led to a mortality benefit at 10 years","o":"when compared to optimal medical therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/21463150\/","subSubjectId":"41"},{"id":"232","name":"REVIVED-BCIS2","year":"2022","p":"In patients with ischemic cardiomyopathy (EF<35%) and viable myocardium,","i":"PCI","c":"led to no difference in ejection fraction, hospitalization, or mortality at 2 years","o":"when compared to optimal medical therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/36027563\/","subSubjectId":"41"}]},{"name":"Ivabradine","topics":[{"id":"162","name":"SHIFT","year":"2010","p":"In patients with HFrEF (EF<35%) and NYHA Class II-III symptoms with HR > 70 bpm despite optimum medical therapy,","i":"the addition of ivabradine","c":"reduced the composite of heart failure mortality and hospitalization at 2 years","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/20801500\/","subSubjectId":"42"}]},{"name":"Digoxin","topics":[{"id":"163","name":"DIG","year":"1997","p":"In patients with HFrEF (EF<45%),","i":"digoxin","c":"had no effect on mortality but decreased hospital admissions","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/9036306\/","subSubjectId":"43"},{"id":"270","name":"DIGIT-HF","year":"2025","p":"In patients with HFrEF (EF<40%),","i":"digitoxin (a cardiac glycoside inhibitor like digoxin, but with hepatic clearance)","c":"decreased the composite of death and heart failure hospitalization","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/40879434\/","subSubjectId":"43"}]},{"name":"Vasopressin","topics":[{"id":"164","name":"EVEREST-Outcomes","year":"2007","p":"In patients with HFrEF,","i":"tolvaptan","c":"had no effect on mortality","o":"when compared to placebo.","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17384437\/","subSubjectId":"44"}]},{"name":"SGLT-2 Inhibition","topics":[{"id":"165","name":"DAPA-HF","year":"2019","p":"In patients with HFrEF (EF<40%) with or without diabetes,","i":"dapagliflozin","c":"reduced cardiovascular deaths and heart failure hospitalizations","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/31535829\/","subSubjectId":"45"},{"id":"175","name":"EMPEROR-Reduced","year":"2020","p":"In patients with HFrEF (EF<40%) with or without diabetes,","i":"empagliflozin","c":"reduced cardiovascular deaths and heart failure hospitalizations","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/32865377\/","subSubjectId":"45"},{"id":"218","name":"EMPULSE","year":"2022","p":"In patients hospitalized with acute decompensated heart failure (regardless of ejection fraction)","i":"inpatient initiation of empagliflozin","c":"decreased the composite of death, future heart failure hospitalization, and symptom worsening","o":"when compared to placebo","note":"","link":"https:\/\/www.nature.com\/articles\/s41591-021-01659-1","subSubjectId":"45"},{"id":"243","name":"SOLOIST-WHF","year":"2021","p":"In patients with diabetes and recently worsening heart failure (regardless of ejection fraction)","i":"sotagliflozin (SGLT2 and SGLT1 inhibitor)","c":"decreased the composite of CV death and heart failure hospitalization","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2030183","subSubjectId":"45"}]},{"name":"Device Therapy (ICD\/CRT)","topics":[{"id":"143","name":"MUSTT","year":"1999","p":"In patients with ischemic cardiomyopathy (EF<40%) and non-sustained ventricular tachycardia,","i":"ICD implantation protocalized after an EP study","c":"decreased mortality","o":"when compared to patients not receiving an EP study","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/10601507\/","subSubjectId":"46"},{"id":"146","name":"MADIT-II","year":"2002","p":"In patients with HFrEF (EF<30%) and myocardial infarction > 40 days prior,","i":"ICD implantation","c":"reduced mortality","o":"when compared to optimal medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/11907286\/","subSubjectId":"46"},{"id":"148","name":"SCD-HeFT","year":"2005","p":"In patients with HFrEF (EF<35%) and NYHA II or III symptoms,","i":"ICD implantation","c":"decreased mortality","o":"when compared to amiodarone or placebo. Note: prior to this trial, MADIT-II showed a survival benefit only post myocardial infarction","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15659722\/","subSubjectId":"46"},{"id":"151","name":"DEFINITE","year":"2004","p":"In patients with HFrEF (EF<35%) and nonischemic with NYHA class III-IV symptoms,","i":"ICD implantation","c":"led to a non-significant trend towards increased survival","o":"when compared to optimum medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15152060\/","subSubjectId":"46"},{"id":"152","name":"DINAMIT","year":"2004","p":"In patients with HFrEF (EF<35%) after an acute myocardial infarction (6-40 days prior) and with autonomic dysfunction,","i":"ICD implantation","c":"decreased death from arrhythmia but did not decrease all-cause mortality when added to optimum medical therapy, when","o":"compared to patients receiving optimum medical therapy alone. Note: due to this trial, guidelines are to implant an ICD after 40 days post myocardial infarction if a low EF is sustained","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15590950\/","subSubjectId":"46"},{"id":"155","name":"MADIT-CRT","year":"2009","p":"In patients with HFrEF (EF<30% and QRS>130ms and none-mild symptoms (NYHA class I-II),","i":"ICD implantation with cardiac resynchronization therapy","c":"decreased mortality and heart failure events","o":"when compared to ICD implantation alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19723701\/","subSubjectId":"46"},{"id":"158","name":"RAFT","year":"2010","p":"In patients with HFrEF (EF<30% and QRS>130ms and mild-moderate symptoms (NYHA class II-III),","i":"ICD implantation with cardiac resynchronization therapy","c":"decreased mortality","o":"when compared to ICD implantation alone (though with greater adverse effects)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/21073365\/","subSubjectId":"46"},{"id":"239","name":"LBBP-RESYNC","year":"2022","p":"In patients with HFrEF (EF<40%) and LBBB undergoing cardiac resynchronization therapy,","i":"left bundle branch pacing","c":"led to greater ejection fraction and symptom improvement","o":"when compared to traditional biventricular pacing (simultaneous pacing of RV septum and coronary sinus)","note":"","link":"https:\/\/www.jacc.org\/doi\/abs\/10.1016\/j.jacc.2022.07.019","subSubjectId":"46"}]},{"name":"Advanced therapies","topics":[{"id":"137","name":"REMATCH","year":"2001","p":"In patients with advanced heart failure (NYHA Class IV),","i":"left ventricular assist device implantation","c":"decreased all-cause mortality","o":"when compared to optimum medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/11794191\/","subSubjectId":"47"},{"id":"139","name":"INTrEPID","year":"2007","p":"In patients with heart failure with inotrope dependence and deemed not suitable for heart transplant,","i":"left ventricular assist device implanation","c":"decreased all-cause mortality","o":"when compared to patients without mechanical support","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17707178\/","subSubjectId":"47"},{"id":"141","name":"HEARTMATE II","year":"2009","p":"In patients with advanced heart failure,","i":"continuous flow devices","c":"improved survival","o":"when compared to pulsatile devices. Note: devices used in the previous REMATCH and INTrEPID trials were pulsatile devices","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19920051\/","subSubjectId":"47"}]},{"name":"Anemia","topics":[{"id":"134","name":"RED-HF","year":"2013","p":"In patients with HFrEF and mild-moderate anemia,","i":"darbapoeitin administration to a goal hemoglobin > 13g\/dL","c":"had no effect on all-cause mortality or hospitalization","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23473338\/","subSubjectId":"48"},{"id":"135","name":"IRONOUT-HF","year":"2017","p":"In patients symptomatic HFrEF (EF<40%, NYHA Class II-IV) and iron-deficiency anemia,","i":"oral iron supplementation","c":"did not increase exercise capacity (VO2)","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28510680\/","subSubjectId":"48"}]}]},{"name":"VALVULAR 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regurgitation (i.e. from annular dilation in HFrEF),","i":"transcatheter mitral valve repair","c":"led to no difference in mortality or hospitalization at 1 year","o":"when compared to optimal medical management alone","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1805374","subSubjectId":"50"},{"id":"266","name":"RESHAPE-HF2","year":"2024","p":"In patients with moderate-severe functional mitral regurgitation and heart failure,","i":"trancatheter mitral valve repair","c":"decreased the composite of CV death and hospitalization","o":"when compared to optimal medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/39216092\/","subSubjectId":"50"}]},{"name":"Aortic Stenosis","topics":[{"id":"87","name":"PARTNER B","year":"2010","p":"In patients with severe aortic stenosis and deemed poor surgical candidates,","i":"transcatheter aortic valve replacement (TAVR)","c":"increased survival but at expense of more strokes","o":"when compared to medical 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patients with severe aortic stenosis and deemed low-risk surgical candidates,","i":"transcatheter aortic valve replacement (TAVR)","c":"decreased rates of all-cause mortality, stroke, and rehospitalization when","o":"compared to surgical aortic valve replacement (SAVR)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30883058\/","subSubjectId":"51"},{"id":"179","name":"RECOVERY","year":"2020","p":"In patients with asymptomatic but \"very severe\" aortic stenosis (valve area < 0.75 cm2 and either jet velocity > 4.5m\/s or gradient > 50 mmHg),","i":"early valve surgery","c":"reduced cardiovascular and all-cause mortality","o":"when compared to conservative management alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/31733181\/","subSubjectId":"51"},{"id":"191","name":"SURTAVI","year":"2018","p":"In patients with severe aortic stenosis and deemed intermediate-risk surgical candidates,","i":"transcatheter aortic valve replacement (TAVR)","c":"led to a similar mortality benefit","o":"when compared to patients receiving surgical aortic valve replacement (SAVR)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28304219\/","subSubjectId":"51"},{"id":"268","name":"EARLY TAVR","year":"2024","p":"In patients with asymptomatic severe aortic stenosis,","i":"TAVR","c":"reduced the composite of death, stroke, and unplanned hospitalization at over 3 year followup","o":"when compared to routine clinical surveillance","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/39466903\/","subSubjectId":"51"}]},{"name":"Tricuspid Regurgitation","topics":[{"id":"235","name":"TRILUMINATE","year":"2023","p":"In patients with symptomatic severe tricuspid regurgitation,","i":"transcatheter tricuspid valve repair with a TriClip","c":"decreased regurgitation severity and subjective symptoms but had no effect on mortality or hospitalization","o":"when compared to no intervention","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/36876753\/","subSubjectId":"96"}]}]},{"name":"ACUTE CORONARY SYNDROME","subSubjects":[{"name":"PCI","topics":[{"id":"97","name":"FRISC-II","year":"1999","p":"In patients with UA\/NSTEMI and intermediate-high risk,","i":"an early invasive strategy (PCI within 48hrs)","c":"improved survival","o":"when compared to optimum medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/10475181\/","subSubjectId":"5"},{"id":"100","name":"SHOCK","year":"1999","p":"In patients with acute MI complicated by cardiogenic shock,","i":"early revascularization","c":"improved survival at 6 months","o":"when compared to initial medical therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/10460813\/","subSubjectId":"5"},{"id":"102","name":"TACTICS-TIMI 18","year":"2001","p":"In patients with UA\/NSTEMI,","i":"an early invasive strategy (PCI and GPIIb\/IIIa inhibition with tirofiban)","c":"decreased cardiovascular events (but with benefit mainly in TIMI score > 2)","o":"when compared to a selectively invasive strategy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/11419424\/","subSubjectId":"5"},{"id":"104","name":"TIMACS","year":"2009","p":"In patients with UA\/NSTEMI,","i":"early intervention (<24hrs)","c":"led to no difference in mortality or cardiovascular events","o":"when compared to delayed intervention (>36hrs), except in patients at high risk (GRACE > 140)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19458363\/","subSubjectId":"5"},{"id":"106","name":"OAT","year":"2006","p":"In patients with subacute MI (3-28 days prior) and clinically stable,","i":"the addition of PCI to optimum medical therapy","c":"led to no survival benefit","o":"when compared to optimum medical therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17105759\/","subSubjectId":"5"},{"id":"107","name":"DANAMI-3 PRIMULTI","year":"2015","p":"In patients with STEMI who were found to have multivessel disease,","i":"complete revascularization","c":"led to decreased MACE (major adverse cardiac events)","o":"when compared to revascularization of the culprit lesion alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/26347918\/","subSubjectId":"5"},{"id":"108","name":"CvLPRIT","year":"2015","p":"In patients with STEMI who were found to have multivessel disease,","i":"complete revascularization","c":"led to decreased MACE (major adverse cardiac events)","o":"when compared to revascularization of the culprit lesion alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25766941\/","subSubjectId":"5"},{"id":"109","name":"NORSTENT","year":"2016","p":"In patients with unstable angina or stable angina who were undergoing PCI,","i":"2nd generation drug eluting stents","c":"led to decreased need for revascularization (presumably due to decreased restenosis) but also a slight reduction in in-stent thrombosis (unexpected)","o":"when compared to contemporary bare metal stent","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/27572953\/","subSubjectId":"5"},{"id":"110","name":"AIDA","year":"2017","p":"In patients with unstable angina or stable angina who were undergoing PCI,","i":"resorbable scaffolds","c":"were associated with a 2.6% increase in thrombosis\/MI","o":"when compared to drug eluting stents","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28402237\/","subSubjectId":"5"},{"id":"111","name":"Compare-Acute","year":"2017","p":"In patients with STEMI who were found to have multivessel disease,","i":"treating all vessels with an FFR-guided approach (see FAME trial)","c":"led to decreased cardiovascular events","o":"when compared to treating only the infarct-related artery alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28745981\/","subSubjectId":"5"},{"id":"112","name":"CULPRIT-SHOCK","year":"2017","p":"In patients with MI complicated by cardiogenic shock,","i":"culprit-lesion only PCI (with or without intervention in other arteries as a staged procedure)","c":"increased survival","o":"when compared to treating all vessels. Note: this is in contrast to CvPRIT, DANAMI-3 PRIMULTI, and Compare-Acute: suggestive that if shock, culprit-lesion only approach is preferred","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/29083953\/","subSubjectId":"5"},{"id":"219","name":"TRANSIENT","year":"2019","p":"In patients with transient STEMI (ST elevation resolution upon hospital admission),","i":"emergent PCI","c":"showed no reduction in infarct size, heart failure incidence, or cardiovascular mortality","o":"when compared to delayed PCI (within 24-48 hours)","note":"","link":"https:\/\/academic.oup.com\/eurheartj\/article\/40\/3\/283\/5145843?login=true#129797169","subSubjectId":"5"}]},{"name":"Aspirin","topics":[{"id":"113","name":"VA Cooperative Study","year":"1983","p":"In patients with unstable angina,","i":"aspirin","c":"reduced mortality and MI at 12 weeks","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/6135989\/","subSubjectId":"6"},{"id":"166","name":"ISIS-2","year":"1988","p":"In patients with acute MI,","i":"aspirin by itself, streptokinase by itself, as well as aspirin and streptokinase together","c":"decreased mortality at 5 weeks","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/2899772\/","subSubjectId":"6"}]},{"name":"P2Y12 Inhibition","topics":[{"id":"114","name":"CAPRIE","year":"1996","p":"In patients with recent MI, stroke, or symptomatic peripheral artery disease,","i":"clopidogrel as a secondary prevention monotherapy","c":"decreased cardiovascular events","o":"when compared to aspirin","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/8918275\/","subSubjectId":"52"},{"id":"115","name":"CURE","year":"2001","p":"In patients with UA\/NSTEMI,","i":"dual antiplatelet therapy with clopidogrel and aspirin","c":"reduced cardiovascular mortality, non-fatal MI, and stroke but increased the rate of major bleeding at 9 months","o":"when compared to aspirin alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/11519503\/","subSubjectId":"52"},{"id":"116","name":"PLATO","year":"2009","p":"In patients with ACS,","i":"ticagrelor as a part of dual antiplatelet therapy with aspirin","c":"reduced cardiovascular mortality without increased bleeding, but with greater adverse effects (bradycardia\/dyspnea) at 12 months","o":"when compared to clopidogrel as a part of dual antiplatelet therapy. Note: bradycardia\/dyspnea may be due to the molecular similarity between ticagrelor and adenosine","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19717846\/","subSubjectId":"52"},{"id":"117","name":"TRITON-TIMI 38","year":"2007","p":"In patients with ACS and scheduled PCI,","i":"prasugrel","c":"reduced cardiovascular mortality, non-fatal MI, and non-fatal stroke but at the expense of increased bleeding","o":"when compared to clopidogrel","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17982182\/","subSubjectId":"52"},{"id":"118","name":"CHAMPION PHOENIX","year":"2013","p":"In patients undergoing PCI (either for ACS or stable angina),","i":"cangrelor","c":"reduced ischemic events","o":"when compared to clopidogrel. Note: cangrelor is a P2Y12 inhibitor (like clopidogrel, ticagrelor, prasugrel) but with quick on-off capability","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23473369\/","subSubjectId":"52"},{"id":"168","name":"ISAR-REACT 5","year":"2019","p":"In patients with ACS with planned coronary angiography,","i":"prasugrel","c":"reduced the composite of death, nonfatal MI, and stroke, with similar incidence of bleeding,","o":"when compared to ticagrelor","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/31475799\/","subSubjectId":"52"},{"id":"249","name":"ACCOAST","year":"2013","p":"In patients with NSTEMI,","i":"pretreatment with prasugrel before angiography","c":"increased bleeding without a difference in ischemic events at 30 days","o":"when compared to prasugrel loading after angiography","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23991622\/","subSubjectId":"52"},{"id":"260","name":"ULTIMATE-DAPT","year":"2024","p":"In patients receiving PCI for acute coronary syndrome,","i":"1 month of ticagrelor and aspirin followed by 11 months of ticagrelor monotherapy","c":"decreased bleeding without difference in composite CV mortality and ischemic events","o":"when compared to traditional 12 months of ticagrelor and aspirin","note":"","link":"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)00473-2\/abstract","subSubjectId":"52"},{"id":"271","name":"TACSI","year":"2025","p":"In patients receiving CABG for acute coronary syndrome,","i":"DAPT with aspirin and ticagrelor","c":"led to no difference in CV events but did increase major bleeding","o":"when compared to aspirin alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/40888737\/","subSubjectId":"52"}]},{"name":"Anticoagulation","topics":[{"id":"119","name":"ESSENCE","year":"1997","p":"In patients with UA\/NSTEMI,","i":"enoxaparin","c":"reduced the composite of death, MI, or recurrent angina at 14 days","o":"when compared to unfractionated heparin","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/9250846\/","subSubjectId":"53"},{"id":"120","name":"OASIS-5","year":"2006","p":"In patients with NSTEMI,","i":"fondaparinux","c":"led to no significant increase in mortality, MI, or refractory ischemia","o":"when compared to enoxaparin. Note: subgroup analysis in PCI showed a higher rate of catheter-related thrombus in the fondaparinux arm","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/16537663\/","subSubjectId":"53"},{"id":"121","name":"ATLAS ACS-2 TIMI 51","year":"2012","p":"In patients with recent ACS,","i":"the addition of rivaroxaban to dual antiplatelet therapy","c":"decreased cardiovascular mortality and MI\/stroke, but increased nonfatal bleeding (eg, intracerebral hemorrhage)","o":"when compared to dual antiplatelet therapy alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/22077192\/","subSubjectId":"53"}]},{"name":"tPA","topics":[{"id":"122","name":"GUSTO","year":"1993","p":"In patients with ACS,","i":"rapidly administered tPA","c":"decreased mortality at 30 days","o":"when compared to streptokinase or slowly-administered tPA and streptokinase","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/8204123\/","subSubjectId":"54"}]},{"name":"Statin","topics":[{"id":"123","name":"MIRACL","year":"2001","p":"In patients with UA\/NSTEMI,","i":"the early initiation of atorvastatin (within 4 days of hospitalization)","c":"reduced the composite of death, nonfatal MI, cardiac arrest, and rehospitalization","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/11277825\/","subSubjectId":"55"},{"id":"124","name":"PROVE IT-TIMI 22","year":"2004","p":"In patients with recent ACS,","i":"high intensity atorvastatin","c":"reduced cardiovascular events","o":"when compared to moderate intensity pravastatin","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15007110\/","subSubjectId":"55"}]},{"name":"Ezetimibe","topics":[{"id":"125","name":"IMPROVE-IT","year":"2015","p":"In patients with recent ACS,","i":"the addition of ezetimibe to statin therapy","c":"reduced cardiovascular mortality but not all-cause mortality","o":"when compared to statin therapy alone. Note: a criticism of this trial is that only a moderate intensity statin was used","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/26039521\/","subSubjectId":"56"}]},{"name":"Beta Blocker","topics":[{"id":"126","name":"COMMIT","year":"2005","p":"In patients with acute MI not undergoing PCI,","i":"intravenous metoprolol followed by high dose metoprolol succinate","c":"did not reduce mortality, reinfarction, or cardiac arrest, but did increase the rate of cardiogenic shock","o":"when compared to placebo. Note: a criticism of this trial is that quite aggressive doses of metoprolol were used","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/16271643\/","subSubjectId":"57"},{"id":"257","name":"BHAT","year":"1982","p":"In patients with acute myocardial infarction 5-21 days prior,","i":"propranolol","c":"reduced both all-cause and CV mortality","o":"when compared to placebo","note":"","link":"https:\/\/jamanetwork.com\/journals\/jama\/article-abstract\/370103","subSubjectId":"57"},{"id":"258","name":"REDUCE-AMI","year":"2024","p":"In patients with acute MI undergoing coronary angiography and found to have normal ejection fraction,","i":"longterm beta blockade","c":"did not reduce mortality or new MI","o":"when compared to no beta blockade","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/38587241\/","subSubjectId":"57"}]},{"name":"ACEi\/ARB","topics":[{"id":"127","name":"SAVE","year":"1992","p":"In patients with acute MI complicated by left ventricular dysfunction,","i":"captopril","c":"decreased mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/1386652\/","subSubjectId":"58"},{"id":"128","name":"GISSI-3","year":"1994","p":"In patients with acute MI and no HFrEF,","i":"lisinopril given within 24 hours","c":"reduced mortality at 6 weeks","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/7910229\/","subSubjectId":"58"},{"id":"129","name":"VALIANT","year":"2003","p":"In patients with recent ACS complicated by systolic dysfunction,","i":"valsartan","c":"led to a similar mortality reduction","o":"when compared to captopril","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/12921816\/","subSubjectId":"58"}]},{"name":"Antiarrhythmics","topics":[{"id":"130","name":"CAST-I","year":"1991","p":"In patients with recent MI and increased ventricular ectopy,","i":"flecainide or encainide (class 1C antiarrhythmics)","c":"suppressed ventricular ectopy, but increased mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/1900101\/","subSubjectId":"59"},{"id":"131","name":"CAST-II","year":"1992","p":"In patients with recent MI,","i":"moricizine (class 1C antiarrhythmic since removed from market)","c":"increased mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/1377359\/","subSubjectId":"59"}]},{"name":"Thrombus Aspiration","topics":[{"id":"171","name":"TASTE","year":"2013","p":"In patients with STEMI,","i":"thrombus aspiration prior to PCI","c":"led to no difference in 30-day mortality","o":"when compared to PCI alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23991656\/","subSubjectId":"74"},{"id":"172","name":"TOTAL","year":"2015","p":"In patients with STEMI,","i":"routine manual thrombectomy prior to PCI","c":"led to no difference in the composite of cardiovascular death, recurrent MI, cardiogenic shock, and NYHA IV heart failure within 180 days, but was associated with increased stroke at 30 days","o":"when compared to PCI alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25853743\/","subSubjectId":"74"}]},{"name":"Etc","topics":[{"id":"173","name":"IABP-SHOCK II","year":"2012","p":"In patients with acute MI complicated by cardiogenic shock,","i":"intraaortic balloon pump use","c":"did not decrease mortality at 30 days","o":"when compared to non-use","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/22920912\/","subSubjectId":"75"},{"id":"174","name":"CANTOS","year":"2017","p":"In patients with recent MI and with CRP elevation,","i":"canakimumab (an antibody against IL-2)","c":"reduced CV events but increased nonfatal infection","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28845751\/","subSubjectId":"75"},{"id":"186","name":"COLCOT","year":"2019","p":"In patients with recent MI (within 30 days),","i":"colchicine at a low dose (0.5 mg qday)","c":"decreased the composite of death from cardiovascular causes, resuscitated cardiac arrest, recurrent MI, stroke, or urgent hospitalization for angina","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/31733140\/","subSubjectId":"75"},{"id":"259","name":"DanGer Shock","year":"2024","p":"In patients with STEMI complicated by cardiogenic shock,","i":"mechanical circulatory support with a microaxial flow pump (Impella CP)","c":"decreased mortality but increased major bleeding and limb ischemia","o":"when compared to standard care alone","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/38587239\/","subSubjectId":"75"}]}]},{"name":"CORONARY ARTERY DISEASE\/\nHYPERLIPIDEMIA","subSubjects":[{"name":"PCI","topics":[{"id":"31","name":"COURAGE","year":"2007","p":"In patients with stable CAD,","i":"the addition of PCI to optimum medical therapy","c":"led to no increase in survival or decrease in MI","o":"when compared to optimum medical therapy alone. Note: FAME and FAME 2 later show that this may not hold true when using FFR","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/17387127\/","subSubjectId":"24"},{"id":"32","name":"FAME","year":"2009","p":"In patients with stable CAD receiving PCI,","i":"FFR-guided PCI (<0.8)","c":"led to a decrease in mortality\/MI\/revascularization","o":"when compared to angiography-guided PCI. Note: FFR = distal pressure of diseased coronary artery \/ aortic pressure. A threshold of 0.8 was used in this study","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19144937\/","subSubjectId":"24"},{"id":"33","name":"FAME 2","year":"2012","p":"In patients with stable CAD and FFR < 0.8,","i":"PCI","c":"reduced the composite of mortality, MI, and revascularization","o":"when compared to OMT alone. Note: this outcome is in contrast to that of COURAGE, wherein an FFR-guided approach was not used","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/22924638\/","subSubjectId":"24"},{"id":"34","name":"IFR-SWEDEHEART","year":"2017","p":"In patients with CAD (stable or unstable) undergoing PCI,","i":"an iFR-guided approach","c":"led to no difference in mortality or CV events","o":"when compared to an FFR-guided approach. Note: IFR, or instantaenous wave free ratio refers to the pressure gradient across a lesion during the portion of diastole when resistance low. Unlike FFR, IFR does not require adenosine administration","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28317438\/","subSubjectId":"24"},{"id":"35","name":"ORBITA","year":"2018","p":"In patients with stable angina despite medical therapy,","i":"the addition of PCI to anti-anginal medications","c":"led to no change in exercise capacity","o":"when compared to anti-anginal medications and sham PCI. Note: a criticism that PCI was angiography-guided, not pressure guided (iFR\/FFR)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/29103656\/","subSubjectId":"24"},{"id":"169","name":"ISCHEMIA","year":"2020","p":"In patients with stable CAD,","i":"an early invasive strategy (angiography\/PCI and medical therapy)","c":"did not reduce cardiovascular events or mortality","o":"when compared to a conservative strategy (initial medical therapy followed by angiography\/PCI if medical therapy failed)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/32227755\/","subSubjectId":"24"},{"id":"251","name":"ORBITA-2","year":"2023","p":"In patients with stable angina on none-minimal medical therapy,","i":"PCI","c":"improved symptoms","o":"when compared to a sham procedure","note":"","link":"https:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa2310610","subSubjectId":"24"},{"id":"261","name":"PREVENT","year":"2024","p":"In patients undergoing angiography found to have non-flow limiting (FFR>0.8) but vulnerable plaque,","i":"preventative PCI","c":"reduced composite CV death and ischemic events","o":"when compared to optimal medical therapy alone","note":"","link":"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)00413-6\/abstract","subSubjectId":"24"}]},{"name":"Niacin","topics":[{"id":"28","name":"HPS2-Thrive","year":"2014","p":"In patients with atherosclerotic disease (prior MI, CVD, PAD),","i":"niacin","c":"led to no decrease in cardiovascular events (and was also poorly tolerated)","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25014686\/","subSubjectId":"22"},{"id":"269","name":"AIM-HIGH","year":"2011","p":"In patients with atherosclerotic disease (CAD, CVD, PAD) and LDL cholesterol < 70 mg\/dL on statin,","i":"niacin","c":"improved HDL cholesterol and triglyceride levels but led to no difference in CV events","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa1107579","subSubjectId":"22"}]},{"name":"Ezetimibe","topics":[{"id":"26","name":"ENHANCE","year":"2008","p":"In patients with familial hypercholesterolemia,","i":"the addition of ezetimibe to simvastatin","c":"led to no significant difference in coronary artery intimal thickness, but with significant LDL\/triglyceride\/CRP reduction","o":"when compared to simvastatin and placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/18376000\/","subSubjectId":"20"}]},{"name":"Statin","topics":[{"id":"19","name":"4S","year":"1994","p":"In patients with CAD (prior MI or current angina) with hyperlipidemia,","i":"simvastatin","c":"decreased all-cause mortality and CAD-related mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/7968073\/","subSubjectId":"7"},{"id":"20","name":"WOSCOPS","year":"1995","p":"In men with hyperlipidemia,","i":"pravastatin","c":"reduced MI and CAD-related mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/7566020\/","subSubjectId":"7"},{"id":"21","name":"TNT","year":"2005","p":"In patients with stable CAD and hyperlipidemia,","i":"atorvastatin 80 mg daily","c":"led to lower cardiovascular mortality and events","o":"when compared to atorvastatin 10 mg daily","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/15755765\/","subSubjectId":"7"},{"id":"22","name":"JUPITER","year":"2008","p":"In patients with normal LDL but high CRP,","i":"rosuvastatin","c":"decreased cardiovascular events","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/18997196\/","subSubjectId":"7"},{"id":"23","name":"Stopping Statins at the End of Life","year":"2015","p":"In patients with a life expectancy < 1 yr,","i":"stopping statin","c":"led to no difference in 60 day mortality and improved quality of life","o":"when compared to continuation of statin therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25798575\/","subSubjectId":"7"},{"id":"236","name":"SAMSON","year":"2021","p":"In patients who stopped statin use due to adverse effects,","i":"statin reinitation with atorvastatin","c":"led to no difference in side effect recurrence rate nor symptom severity","o":"when compared to reinitation with placebo","note":"","link":"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2021.07.022","subSubjectId":"7"},{"id":"240","name":"REPRIEVE","year":"2023","p":"In patients with HIV and no known cardiovascular disease,","i":"pitavastatin","c":"reduced the composite of cardiovascular events and mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/37486775\/","subSubjectId":"7"}]},{"name":"PCSK9 inhibition","topics":[{"id":"24","name":"ODYSSEY LONG TERM","year":"2015","p":"In high risk patients (heterozygote familial hypercholesterolemia, CAD, or CAD-equivalent),","i":"the addition of alirocumab to a high intensity statin","c":"further reduced LDLc by 62% and reduced CV events","o":"when compared to statin and placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25773378\/","subSubjectId":"8"},{"id":"25","name":"FOURIER","year":"2017","p":"In patients with clinical atherosclerotic disease (prior MI, stroke, or symptomatic PAD) and LDLc >70 mg\/dL despite mod-high statin,","i":"the addition of evolocumab","c":"reduced CV events but not mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28304224\/","subSubjectId":"8"},{"id":"274","name":"VESALIUS-CV","year":"2025","p":"In patients with CAD (eg coronary artery calcification) or diabetes without a prior vascular event,","i":"evolocumab","c":"reduced CV events","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/41211925\/","subSubjectId":"8"}]},{"name":"Omega-3","topics":[{"id":"29","name":"ORIGIN n-3 Fatty Acids","year":"2012","p":"In patients with diabetes or prediabetes,","i":"fish oil","c":"led to no decrease in cardiovascular mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/22686415\/","subSubjectId":"23"},{"id":"30","name":"REDUCE-IT","year":"2019","p":"In patients with CAD or diabetes and another risk factor, and already on statin with residual hypertriglyceridemia (135-499 mg\/dL),","i":"the addition of icosapent ethyl","c":"reduced cardiovascular events and cardiovascular death at 4.9 years","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30415628\/","subSubjectId":"23"},{"id":"178","name":"EVAPORATE","year":"2020","p":"In patients with CAD and already on statin with residual hypertriglyceridemia (135-499 mg\/dL)","i":"the addition of icosapent ethyl","c":"reduced low-attenuation plaque volume on CT","o":"when compared to placebo","note":"","link":"https:\/\/academic.oup.com\/eurheartj\/advance-article\/doi\/10.1093\/eurheartj\/ehaa652\/5898836","subSubjectId":"23"}]},{"name":"Fibrate","topics":[{"id":"27","name":"ACCORD Lipid","year":"2010","p":"In patients with diabetes,","i":"adding a fibrate to simvastatin","c":"led to no significant reduction in cardiovascular events","o":"when compared to placebo and simvastatin","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/20228404\/","subSubjectId":"21"},{"id":"238","name":"PROMINENT","year":"2022","p":"In patients with diabetes and hypertriglyceridemia (200-499 mg\/dL)","i":"pemafibrate","c":"lowered triglyceride levels but had no effect on cardiovascular events","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/36342113\/","subSubjectId":"21"}]},{"name":"CABG","topics":[{"id":"36","name":"BARI-2D","year":"2009","p":"In patients with stable CAD and diabetes,","i":"revascularization with CABG or PCI and optimum medical therapy","c":"reduced CV events","o":"when compared to optimum medical therapy alone. Note: no difference in events was found between CABG and optimum medical therapy vs PCI and optimum medical therapy (in contrast to the FREEDOM trial)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19502645\/","subSubjectId":"25"},{"id":"37","name":"SYNTAX","year":"2009","p":"In patients with 3-vessel coronary artery disease or left main disease,","i":"CABG","c":"led to a reduction in cardiovascular events at 1 year","o":"when compared to PCI","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/19228612\/","subSubjectId":"25"},{"id":"38","name":"FREEDOM","year":"2012","p":"In patients with diabetes and multivessel CAD,","i":"CABG","c":"improved survivial but was with a modest increase in strokes","o":"when compared to PCI","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23121323\/","subSubjectId":"25"},{"id":"39","name":"BEST","year":"2015","p":"In patients with multivessel CAD receiving revascularization,","i":"CABG","c":"improved survival","o":"when compared to PCI","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25774645\/","subSubjectId":"25"},{"id":"40","name":"EXCEL","year":"2016","p":"In patients with left main CAD and low-intermediate complexity (SYNTAX score 32 or less),","i":"PCI","c":"was without a significant difference in composite outcome of death, MI, or stroke","o":"when compared to CABG","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/27797291\/","subSubjectId":"25"},{"id":"264","name":"NOBLE","year":"2016","p":"In patients with left main coronary artery disease,","i":"PCI","c":"led to increased mortality and myocardial infarction","o":"when compared to CABG","note":"","link":"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(16)32052-9\/abstract","subSubjectId":"25"}]},{"name":"Anti-platelet","topics":[{"id":"41","name":"DAPT","year":"2014","p":"In patients who receive PCI with a drug-eluting stent,","i":"30 months of dual antiplatelet therapy","c":"decreased cardiovascular events but increased bleeding, and also unexpectedly increased mortality (from malignancy)","o":"when compared to 12 months of therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25399658\/","subSubjectId":"26"},{"id":"42","name":"PEGASUS-TIMI 54","year":"2015","p":"In patients with MI 1-3 years prior,","i":"aspirin and ticagrelor","c":"decreased CV mortality and CV events, but increased rates of bleeding","o":"when compared to aspirin   placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25773268\/","subSubjectId":"26"},{"id":"212","name":"COMPASS","year":"2017","p":"In patients with stable coronary or peripheral artery disease,","i":"aspirin and low dose rivaroxaban (2.5 mg bid)","c":"decreased the composite of cardiovascular death, MI, and stroke, but with increased major bleeding","o":"when compared to aspirin alone","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1709118","subSubjectId":"26"},{"id":"256","name":"AFIRE","year":"2019","p":"In patients with stable CAD (>1 year post-revascularization or without intervention) and comorbid atrial fibrillation,","i":"rivaroxaban monotherapy","c":"decreased bleeding without a difference in cardiovascular events","o":"when compared to rivaroxaban and an antiplatelet","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1904143","subSubjectId":"26"}]},{"name":"Triple Therapy","topics":[{"id":"43","name":"WOEST","year":"2013","p":"In patients who receive PCI and are already getting anticoagulation for another indication,","i":"clopidogrel alone (double therapy)","c":"led to less bleeding and was without a difference in thrombotic events","o":"when compared to clopidogrel and aspirin (triple therapy)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23415013\/","subSubjectId":"27"},{"id":"44","name":"ISAR-TRIPLE","year":"2015","p":"In patients who receive a drug eluting stent and are already getting anticoagulation for another indication,","i":"dual antiplatelet therapy and anticoagulation for 6 months","c":"led to no difference in cardiovascular events or bleeding","o":"when compared to dual antiplatelet therapy and anticoagulation for 6 weeks, followed by aspirin and anticoagulation","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/25908066\/","subSubjectId":"27"},{"id":"45","name":"PIONEER AF-PCI","year":"2016","p":"In patients who receive a drug eluting stent and have atrial fibrillation,","i":"rivaroxaban combined with single or dual antiplatelet therapy","c":"reduced bleeding","o":"when compared to warfarin with dual antiplatelet therapy","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/27959713\/","subSubjectId":"27"},{"id":"46","name":"RE-DUAL","year":"2017","p":"In patients who receive a drug eluting stent and have atrial fibrillation,","i":"dual therapy with dabigatran and a thienopyridine (clopidogrel, ticagrelor)","c":"decreased bleeding and was with similar thrombosis risk","o":"when compared to triple therapy (warfarin, thienopyridine, and aspirin)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/28844193\/","subSubjectId":"27"},{"id":"248","name":"AUGUSTUS","year":"2019","p":"In patients with atrial fibrillation who had recent ACS or PCI,","i":"double therapy with apixaban and P2Y12 inhibition","c":"decreased bleeding and was with similar thrombosis risk","o":"when compared to double therapy with warfarin and P2Y12 inhibition or triple therapy (addition of aspirin)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30883055\/","subSubjectId":"27"}]},{"name":"ACEi","topics":[{"id":"47","name":"HOPE","year":"2000","p":"In patients with multiple cardiovascular risk factors but no heart failure,","i":"ramipril","c":"reduced CV mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/10639539\/","subSubjectId":"28"},{"id":"48","name":"EUROPA","year":"2003","p":"In patients with stable CAD but no heart failure,","i":"perindopril (an ACEi)","c":"reduced cardiovascular mortality","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/13678872\/","subSubjectId":"28"}]},{"name":"Colchicine","topics":[{"id":"49","name":"LoDoCo","year":"2013","p":"In patients with stable CAD,","i":"the addition of colchicine to aspirin and statin","c":"decreased the risk of cardiovascular events","o":"when compared to patients not receiving colchicine. Note: this trial was not placebo controlled","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23265346\/","subSubjectId":"29"},{"id":"176","name":"LoDoCo2","year":"2020","p":"In patients with chronic CAD,","i":"colchicine","c":"decreased the composite of cardiovascular death, myocardial infarction, and ischemic stroke, with however a nonsignificant trend towards increased noncardiovascular mortality","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2021372","subSubjectId":"29"}]},{"name":"Diet","topics":[{"id":"50","name":"PREDIMED","year":"2013","p":"In patients at high risk for cardiovascular disease,","i":"a mediterranean diet","c":"reduced cardiovascular death and events","o":"when compared to a low fat diet. Note: this study was retracted and republished in 2018, where a similar conclusion was found but with the inability to confirm randomization","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/23432189\/","subSubjectId":"30"}]},{"name":"PPI","topics":[{"id":"51","name":"COGENT","year":"2010","p":"In patients with CAD on aspirin and clopidogrel,","i":"omeprazole","c":"had no effect on CV events but lowered the incidence of upper gastrointestinal bleeding by 87%","o":"when compared to not receiving omeprazole","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/20925534\/","subSubjectId":"31"}]},{"name":"Stress testing\/Cardiac CT","topics":[{"id":"230","name":"DISCHARGE","year":"2022","p":"In patients with stable chest pain and intermediate risk of CAD,","i":"noninvasive imaging with coronary CT angiography","c":"was noninferior in preventing CV death, MI, and stroke, and was with a lower risk of procedural adverse effects","o":"when compared to invasive coronary angiography","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/35240010\/","subSubjectId":"94"},{"id":"228","name":"PROMISE","year":"2015","p":"In patients with stable chest pain undergoing noninvasive ischemic testing,","i":"anatomic testing with coronary CTA","c":"led to no difference in death or cardiovascular events","o":"when compared to functional testing (stress echo, ekg, or nuclear testing)","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1415516","subSubjectId":"94"},{"id":"229","name":"SCOT-HEART","year":"2018","p":"In patients with stable chest pain,","i":"the addition of coronary CTA to standard care","c":"reduced the composite of CV death and MI, without increasing the rate of invasive angiography","o":"when compared to standard care alone","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1805971","subSubjectId":"94"},{"id":"252","name":"POST-PCI","year":"2022","p":"In high-risk patients who underwent recent PCI,","i":"routine cardiac stress testing","c":"led to no difference in the composite of death, MI, and hospitalization at 2 years followup","o":"when compared to standard care alone","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2208335","subSubjectId":"94"}]},{"name":"Bempedoic Acid","topics":[{"id":"231","name":"CLEAR Outcomes","year":"2023","p":"In statin-intolerant patients indicated for statin (with CAD or with high CAD risk)","i":"bempedoic acid","c":"reduced major adverse cardiovascular events","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2215024","subSubjectId":"95"}]},{"name":"GLP1 Agonist","topics":[{"id":"250","name":"SELECT","year":"2023","p":"In nondiabetic patients with cardiovascular disease and BMI>27,","i":"GLP1 agonism with semaglutide","c":"decreased cardiovascular mortality and events at 40 months","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa2307563","subSubjectId":"98"},{"id":"253","name":"LEADER","year":"2016","p":"In patients with diabetes and high cardiovascular risk,","i":"GLP1 agonism with liraglutide","c":"decreased cardiovascular events and mortality","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1603827","subSubjectId":"98"},{"id":"254","name":"SUSTAIN-6","year":"2016","p":"In patients with diabetes and high cardiovascular risk,","i":"GLP1 agonism with semaglutide","c":"decreased the composite of CV death, MI, and stroke","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1607141","subSubjectId":"98"}]}]},{"name":"ATRIAL FIBRILLATION","subSubjects":[{"name":"Rate\/Rhythm","topics":[{"id":"52","name":"AFFIRM","year":"2002","p":"In patients with nonvalvular atrial fibrillation,","i":"rate control","c":"led to a trend towards increased survival with a lower risk of adverse events","o":"when compared to rhythm control","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/12466506\/","subSubjectId":"9"},{"id":"53","name":"RACE II","year":"2010","p":"In patients with permanent atrial fibrillation for whom a rate control strategy is chosen,","i":"lenient control (<110 bpm)","c":"was noninferior in terms of preventing cardiovascular events","o":"when compared to strict control (<80 bpm)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/20231232\/","subSubjectId":"9"},{"id":"183","name":"EAST-AFNET 4","year":"2020","p":"In patients with early atrial fibrillation (diagnosed within 1 year)","i":"early rhythm control (via antiarrhythmic drugs or afib ablation)","c":"led to a decreased composite of cardiovascular death, stroke, or hospitalization","o":"when compared to usual care (rate control with rhythm control for symptoms 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atrial fibrillation at high risk of embolic events,","i":"percutaneous left atrial appendage closure","c":"led to no difference in stroke, systemic embolism, bleeding, or CV death","o":"when compared to anticoagulation with DOAC","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/32586585\/","subSubjectId":"67"}]},{"name":"Caffeine","topics":[{"id":"273","name":"DECAF","year":"2025","p":"In coffee drinking patients with persistent atrial fibrillation undergoing cardioversion,","i":"continued coffee drinking","c":"reduced afib recurrence","o":"when compared to abstinence from coffee intake","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/41206802\/","subSubjectId":"99"}]}]},{"name":"MISCELLANEOUS","subSubjects":[{"name":"Arthritis","topics":[{"id":"67","name":"PRECISION","year":"2016","p":"In patients with rheumatoid arthritis or osteoarthritis who require daily NSAIDs and are at elevated cardiovascular risk,","i":"celecoxib","c":"was noninferior in terms of cardiovascular death 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patients > 70 years of age without cardiovascular disease or dementia,","i":"100mg daily aspirin","c":"did not decrease mortality but did increase the risk of major hemorrhage","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30221596\/","subSubjectId":"71"},{"id":"75","name":"ASCEND","year":"2018","p":"In patients > 40 years of age with diabetes (A1c < 8) but without cardiovascular disease,","i":"100mg daily aspirin","c":"decreased vascular events but also increased risk of bleeding","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/30146931\/","subSubjectId":"71"},{"id":"76","name":"ARRIVE","year":"2018","p":"In patients (men > 55 years old or women > 60 years old) with moderate cardiovascular risk but without history of cardiovascular disease or diabetes,","i":"100mg daily aspirin","c":"did not decrease cardiovascular events but did increase the risk of major bleeding","o":"when compared to 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diuretic),","i":"renal artery denervation","c":"led to no difference in blood pressure at 6 months","o":"when compared to sham control","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/24678939\/","subSubjectId":"72"},{"id":"214","name":"ASCOT","year":"2005","p":"In patients with hypertension,","i":"an amlodipine-based regimen (with addition of ACE inhibitor as necessary)","c":"decreased cardiovascular events","o":"when compared to an atenolol-based regimen (with addition of thiazide diuretic as necessary)","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/16154016\/","subSubjectId":"72"},{"id":"222","name":"CHAP","year":"2022","p":"In pregnant patients with chronic hypertension,","i":"strict blood pressure control to < 140\/90","c":"led to a lower incidence of severe preeclampsia, preterm birth, or fetal death, and was without detriment to fetal growth","o":"when compared to standard treatment of target < 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regimen","note":"","link":"https:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa1808312","subSubjectId":"73"}]},{"name":"Pulmonary Hypertension","topics":[{"id":"205","name":"SERAPHIN","year":"2013","p":"In patients with symptomatic pulmonary arterial hypertension,","i":"macitentan (endothelin receptor antagonist)","c":"reduced the composite of mortality and disease progression","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1213917","subSubjectId":"92"},{"id":"204","name":"TRIUMPH","year":"2010","p":"In patients with symptomatic pulmonary arterial hypertension despite treatment with bosentan or sildenafil,","i":"the addition of inhaled treprostinil (prostacyclin analogue)","c":"improved exercise capacity and quality of life,","o":"but without decrease in disease progression when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/20430262\/","subSubjectId":"92"},{"id":"206","name":"PATENT","year":"2013","p":"In patients with symptomatic pulmonary arterial hypertension,","i":"riociguat (cyclic-GMP stimulator in the nitric oxide pathway)","c":"improved exercise capacity and decreased disease progression","o":"when compared to placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1209655","subSubjectId":"92"},{"id":"207","name":"AMBITION","year":"2015","p":"In patients with pulmonary arterial hypertension with class II or III symptoms and without prior treatment,","i":"initial combination therapy with ambrisentan (endothelin receptor antagonist) and tadalafil (nitric oxide potentiator)","c":"decreased the composite of death and hospitalization","o":"when compared to monotherapy of either drug","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1413687","subSubjectId":"92"},{"id":"208","name":"GRIPHON","year":"2015","p":"In patients with pulmonary arterial hypertension,","i":"selexipag (a prostacyclin-receptor agonist)","c":"decreased the composite of death, 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added to standard NSAID","c":"decreased time to symptom resolution and recurrence of pericarditis","o":"when compared to NSAID and placebo","note":"","link":"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1208536","subSubjectId":"97"},{"id":"275","name":"RHAPSODY","year":"2020","p":"In patients with recurrent pericarditis despite NSAID\/colchicine,","i":"rilonacept (an IL-1 inhibitor)","c":"decreased pericarditis pain and recurrence episodes","o":"when compared to placebo","note":"","link":"https:\/\/pubmed.ncbi.nlm.nih.gov\/33200890\/","subSubjectId":"97"}]}]}]