Transcatheter tricuspid repair cuts death or heart failure admission; dropping aspirin in STEMI fails

The edition in brief

In TRIC-I-HF, 360 patients (mean age 80) with symptomatic severe tricuspid regurgitation were randomised to transcatheter repair plus medical therapy or medical therapy alone. Repair won on a hierarchical composite at one year (win ratio 2.42) and three-year freedom from death or heart failure hospitalisation was 52.4% vs 21.0% (HR 0.40). In PREMIUM, 2,216 Japanese patients with STEMI were randomised to low-dose prasugrel alone or with aspirin from before primary PCI; monotherapy failed non-inferiority for death, stroke or MI (11.0% vs 8.5%, HR 1.34), despite less major bleeding. TARGET-CTCA found routine outpatient CT coronary angiography after MI rule-out in 3,170 intermediate-risk patients did not reduce cardiac death or MI over three years (HR 0.95). PIFPAF-PFA found adding posterior wall isolation to pulsed field pulmonary vein isolation did not significantly reduce recurrence in persistent AF (RR 0.75, 0.51–1.09). BRIDGE, a cluster-randomised trial, found an in-hospital lipid protocol raised the share reaching LDL cholesterol below 70 mg/dL at six months from 73.7% to 86.4%.