Complete revascularisation after STEMI guided by angiography-derived physiology cut major events by 38%

The edition in brief

In AIR-STEMI, 1,823 patients with STEMI and multivessel disease were randomised, after culprit treatment, to complete revascularisation guided by functional coronary angiography or by conventional angiography. At 17.9 months the composite of death, MI, stroke or TIA, or ischaemia-driven revascularisation was 8.9% vs 13.7% (HR 0.62), and contrast kidney injury or major bleeding was also lower. SWITCH-SWEDEHEART, a stepped-wedge cluster trial of 17,095 patients after PCI for acute coronary syndrome, found death, MI or stroke at one year was 11.1% under a default prasugrel policy and 11.8% under ticagrelor (adjusted OR 0.90, 0.77 to 1.06). In AIEOP-BFM ALL 2017, replacing two chemotherapy cycles with blinatumomab in 709 children with high-risk B-cell leukaemia raised estimated four-year event-free survival from 70.3% to 83.0% and cut treatment-related infection from 69% to 24%. The anti-IL-33 antibody tozorakimab reduced moderate or severe COPD exacerbations by about 30% in two replicate phase 3 trials without an eosinophil requirement. In a Swedish placebo-controlled trial, intrauterine mepivacaine reduced pain during IUD placement in nulliparous women by about 15 mm on a 100 mm scale.