Cardiology

ARB use associated with lower 1-year MACE than ACEI in large real-world ASCVD cohort

In a propensity-matched cohort of 1,203,920 adults with ASCVD, ARB users had lower 1-year MACE incidence than ACEI users (7.0% vs 8.6%). ARB use was associated with lower hazards for MACE (HR 0.77), ischemic stroke (HR 0.76), acute MI (HR 0.85), and all-cause mortality (HR 0.73). The analysis used TriNetX real-world data with 1:1 propensity matching across demographics, comorbidities, medications, and labs. Authors emphasize non-causality; differences may reflect confounding, adherence, or treatment selection rather than pharmacologic superiority. 1

AHA scientific statement standardizes cardiovascular endpoints for oncology trials

This statement provides a framework to select, define, and adjudicate cardiovascular endpoints tailored to oncology drug mechanisms. It aligns definitions for heart failure, arrhythmias, myocarditis, thrombosis, and MACE with surveillance and adjudication best practices. Practical guidance covers decentralized trial designs, independent adjudication, and statistical handling of competing risks and late toxicities. Harmonized endpoints aim to improve safety signal detection and regulatory acceptance without hindering cancer therapeutic innovation. 2

Pivotal device trials rarely embed equity-focused design or analyses

Scoping review of 74 pivotal device studies found age and sex were commonly reported but infrequently analyzed (age 18.9%, sex 14.8% subgroup analyses). Race/ethnicity appeared in 35.1% of trials and PROGRESS-Plus variables in 9.5%, with explicit EDI framing in only 2.7% of studies. None performed population benchmarking or representativeness analyses, and structural recruitment barriers were infrequently acknowledged. Limited EDI integration constrains external validity and equitable applicability of device evidence. 3