Transcatheter tricuspid repair cut events in a randomised trial; a maternal egg-and-peanut diet did not prevent infant allergy

The edition in brief

TRIC-I-HF randomised 360 patients, mean age about 80, with symptomatic severe tricuspid regurgitation to transcatheter repair plus medical therapy or medical therapy alone. The one-year hierarchical composite favoured repair (win ratio 2.42, 95% CI 1.76 to 3.33), and freedom from death or heart failure hospitalisation at three years was 52.4% against 21.0% (HR 0.40, 0.29 to 0.55); 5.9% had a major adverse event within 30 days. In PrEggNut, 2,137 pregnant women whose baby had a family history of allergy followed a high or standard egg and peanut diet from before 23 weeks to four months of lactation; IgE-mediated egg or peanut allergy at one year was 7.8% against 8.4% (RR 0.93, 0.69 to 1.26). A BMJ individual-participant-data network meta-regression of 35 trials (8,679 people) found escitalopram and amitriptyline associated with the largest QTc rises (8.7 ms and 5.3 ms against placebo) and no early increase in major cardiovascular events across 139 trials. In EPoS II, an interim analysis in 10,799 people with high-risk adenomas found a first surveillance colonoscopy at five years noninferior to three years for 5-year colorectal cancer incidence (0.77% vs 0.82%); guidelines currently recommend three years and the ten-year analysis is pending. The pearl covers what to check before attributing a long QTc to a drug.