Latest Cardiology and Cardiovascular Medicine research

Top 10 this week

Week of 1 November 2026

1. 1

   Impact of obesity on clinical outcomes and the treatment effect of catheter ablation in atrial fibrillation: insights from CABANA

   Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In 2,170 CABANA participants, catheter ablation reduced atrial fibrillation recurrence and improved symptoms and functional capacity regardless of obesity status. Obesity did not significantly change ablation's relative effect on cardiovascular hospitalization or death, but patients with class II obesity or higher had worse outcomes overall; the post hoc findings support combining rhythm control with attention to weight and related conditions.

2. 2

   Digital recruitment and prevalence of screen-detected atrial fibrillation in nationwide patch-based ECG screening: the NORSCREEN randomized clinical trial

   Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · Q1 journal · RCT · Evidence level 1 (High) · 4 August 2026

   In Norway's randomized trial, 19,723 higher-risk adults completed a mailed, 7-day ECG patch screening; 382, or 1.9%, had previously undiagnosed atrial fibrillation. Nearly 96% of those diagnosed started anticoagulation, showing that digital recruitment and remote screening can reach many people and prompt treatment, though the study does not establish whether screening reduces strokes.

3. 3

   Effect of In-Hospital Initiation of Dapagliflozin on Decongestion in Patients Hospitalized for Heart Failure: An Analysis of the DAPA ACT HF-TIMI 68 Trial

   JACC. Heart failure · Q1 journal · RCT · Evidence level 1 (High) · 30 August 2026

   In‑hospital dapagliflozin initiation improves decongestion in HF

4. 4

   Artificial Intelligence-Enabled Detection and Management of Physiological Instability in Heart Failure: Results of the Randomized LINK-HF2 Trial

   JACC. Heart failure · Q1 journal · RCT · Evidence level 1 (High) · 9 October 2026

   In this randomized feasibility study of 171 people discharged after heart failure hospitalization, AI-guided wearable monitoring reduced detected physiological instability, but rehospitalization rates were similar: 16.3% with monitoring and 18.7% with standard care. Patients generally accepted the patch and clinicians responded to alerts, but workflow and uncertainty about responses were barriers; whether a more targeted clinical response can improve outcomes remains unknown.

5. 5

   Antithrombotic strategy according to age in patients with atrial fibrillation and drug-eluting stents: a post hoc analysis of the ADAPT AF-DES randomised trial

   Age and ageing · Q1 journal · RCT · Evidence level 1 (High) · 3 August 2026

   In a post-hoc analysis of 960 AF patients with drug-eluting stents, those aged at least 75 years receiving NOAC monotherapy experienced a net adverse clinical event rate of 9.8% compared with 22.3% on NOAC + clopidogrel, a roughly 60% relative reduction. The benefit was not seen in younger patients, and bleeding rates were similarly lower across ages, suggesting age-guided antithrombotic tailoring may be worthwhile.

6. 6

   Adjunctive empirical superior vena cava isolation with fourth-generation cryoballoon in paroxysmal atrial fibrillation does not improve outcomes and increases complications: the randomized CISPAF trial

   Frontiers in cardiovascular medicine · Q1 journal · RCT · Evidence level 1 (High) · 26 August 2026

   Cryoballoon SVC isolation adjunct to PVI in paroxysmal AF trial

7. 7

   Efficacy and safety of Naoxintong capsule for secondary prevention after reperfused acute myocardial infarction: a randomized, double-blind, placebo-controlled, multicenter trial

   Phytomedicine : international journal of phytotherapy and phytopharmacology · Q1 journal · RCT · Evidence level 1 (High) · 15 July 2026

   In a multicenter trial of 379 post-reperfusion myocardial infarction patients, adding Naoxintong to guideline therapy lowered new-onset heart failure to 6% versus 14% with placebo and also reduced major cardiovascular events to 8% versus 15%. Serious and overall adverse events were fewer, suggesting a safe complementary option, though broader validation is needed.

8. 8

   Network and pairwise meta-analysis of the effects of novel hypoglycemic agents on cardiorenal outcomes in patients with type 2 diabetes and heart failure

   Frontiers in endocrinology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

   In a meta-analysis of 13,886 people with type 2 diabetes and heart failure, sodium-glucose cotransporter 2 inhibitors reduced the risk of heart-failure composite outcomes by 25% versus placebo; they also lowered heart-failure hospitalization and cardiovascular death. GLP-1 receptor agonists showed a similar reduction in the composite outcome, but kidney benefits were not statistically clear, and the analysis did not establish one drug class as superior.

9. 9

   Telerehabilitation vs. centre-based cardiac rehabilitation after acute coronary syndrome: results of the pragmatic TELECOR randomized trial

   European heart journal open · Q1 journal · RCT · Evidence level 1 (High) · 24 September 2026

   In this pragmatic randomized trial of 129 people after acute coronary syndrome, 86% in telerehabilitation and 79.7% in centre-based rehabilitation met at least four of seven risk-factor and lifestyle goals at 8 weeks; the difference was not statistically significant. Functional capacity and other outcomes also improved similarly, but the small trial leaves uncertainty about effects on cardiovascular events.

10. 10

    DEED-FRAIL trial: A cluster-randomized trial of a frailty-oriented multicomponent ED discharge intervention for older adults with geriatric vulnerability and acute heart failure

    European journal of internal medicine · Q1 journal · RCT · Evidence level 1 (High) · 26 September 2026

    In 472 older adults with acute heart failure discharged from emergency care, a multicomponent plan produced 30-day heart failure-related events in 13%, compared with 17% under usual care - a difference that was not statistically significant. Patients and caregivers reported greater satisfaction with the transition, but other clinical and patient-centered outcomes did not significantly differ.

Paper of the day, last two weeks

• Digital Health Intervention to Optimize Heart Failure Management After Hospital Discharge in Brazil (OPT-HF): A Randomized Clinical Trial

  Circulation. Heart failure · Q1 journal · RCT · Evidence level 1 (High) · 6 November 2026

  In a 154-patient Brazilian trial, a digital program pairing remote monitoring, teleconsultations and education improved medication optimization scores by 3 points more than usual care at 90 days. Hospitalizations were also less frequent, while deaths did not differ significantly; the small trial and short follow-up leave the longer-term effects uncertain.

• Hydralazine-isosorbide dinitrate in chronic heart failure with reduced ejection fraction: the H-HeFT trial

  European heart journal · Q1 journal · RCT · Evidence level 1 (High) · 4 November 2026

  Hydralazine‑isosorbide dinitrate did not change composite HF endpoint

• Long-term outcomes after percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting for left main coronary artery disease: a prospective analysis of the multicentre IRIS-MAIN registry

  Lancet (London, England) · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 3 November 2026

  Among 5,379 Asian patients treated for left main coronary disease, weighted 10-year mortality was 24.0% after stenting and 22.9% after bypass, with no statistically detectable difference. Because this was an observational registry, it cannot prove the procedures are equivalent or establish which is better for an individual patient; the findings support discussing trade-offs when both options are suitable.

• Long-Term Impact of Vutrisiran in Patients With TTR Amyloidosis With Cardiomyopathy: 1-Year Efficacy and Safety Outcomes From the HELIOS-B Open-Label Extension

  Circulation · Q1 journal · RCT · Evidence level 1 (High) · 3 November 2026

  Through month 48, patients who continued vutrisiran had a 37% lower risk of death or a first cardiovascular event than those who started on placebo and later switched to vutrisiran. Health status, heart-failure measures and biomarkers also favored earlier treatment, with no new safety signals; the comparison comes from an open-label extension, so longer follow-up is still needed.

• PCSK9-Targeting Therapies and Mortality: A Systematic Review and Meta-Analysis of Randomized Trials

  European journal of preventive cardiology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 2 November 2026

  In a meta-analysis of 32 randomized trials involving 77,178 participants, PCSK9-targeting therapies were associated with 12% lower all-cause mortality and fewer heart attacks, strokes, and coronary procedures. Most mortality evidence came from large trials of PCSK9 antibodies in people with known atherosclerosis, so a survival benefit in other populations, or with inclisiran specifically, remains uncertain.

• Behavior-Based Electrogram Mapping Identifies Potential Functional Substrates in Atrial Fibrillation: The KSP-AF Randomized Study

  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · Q1 journal · RCT · Evidence level 1 (High) · 2 November 2026

  In a single-center randomized trial of 100 patients having their first ablation, adding key spatiotemporal potential mapping to pulmonary vein isolation raised the share free of documented atrial fibrillation at 24 months, without antiarrhythmic drugs, from 48% to 74%. It also increased acute rhythm termination, but the results need confirmation in multicenter studies before wider adoption.

• Transcatheter Aortic Valve Replacement in Pure Aortic Regurgitation: The Randomized SEASON-AR Clinical Trial

  Circulation · Q1 journal · RCT · Evidence level 1 (High) · 31 October 2026

  In a randomized trial of 210 high-surgical-risk patients with severe aortic regurgitation, TAVR plus medical therapy lowered the 1-year rate of death, disabling stroke or heart failure rehospitalization from 24.8% to 8.3%, mainly by preventing rehospitalizations. Major bleeding and new pacemakers were more common after TAVR, mostly within 30 days; longer-term outcomes remain unknown.

• Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a reconstructed individual participant data meta-analysis of randomized controlled trials of intravascular ultrasound- and optical coherence tomography-guided strategies

  European heart journal open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 10 September 2026

  Across 23 randomized trials involving 21,176 patients, PCI guided by either intravascular ultrasound or optical coherence tomography was linked to about 25% fewer major cardiovascular events than angiography-guided PCI. The analysis found no significant difference between imaging methods, but reconstructed data and variation in IVUS benefit across regions and over time leave questions about how consistently results apply in practice.

• Comparative efficacy and safety of de-escalation, abbreviation, and standard potent P2Y12 inhibitor-based dual antiplatelet therapy strategies after acute coronary syndrome: a network meta-analysis

  European heart journal open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

  A network meta-analysis of seven randomized trials involving 20,673 patients found that switching to clopidogrel or shortening dual therapy and continuing a potent antiplatelet drug alone each reduced major bleeding by about 57% versus 12 months of standard therapy, without increasing major cardiovascular events. The strategies appeared comparable, but that comparison was indirect, so the best choice for individual patients remains unclear.

• Left Bundle-Branch Area Pacing vs Right Ventricular Pacing for Atrioventricular Block and Preserved Left Ventricular Function: The LEAP-Block Randomized Clinical Trial

  JAMA · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

  In a randomized trial of patients with atrioventricular block and preserved heart function, the 24-month composite of death, heart failure events, or upgrade to biventricular pacing occurred in 2.4% with left bundle-branch area pacing versus 12.5% with right ventricular pacing. The difference was driven mainly by fewer heart failure events; deaths and device complications did not differ, and longer-term outcomes remain unknown.

• Early Initiation of Dapagliflozin in Acute Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  Biomedicines · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 13 October 2026

  Early dapagliflozin initiation during acute heart failure hospitalization

• Cardiovascular outcomes of SGLT2 inhibitors across the spectrum of myocardial infarction: A systematic review and meta-analysis

  British journal of clinical pharmacology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

  Across 15 studies and 117,096 people, sodium-glucose cotransporter-2 inhibitors were associated with 26% lower odds of heart failure hospitalization after a heart attack. Overall mortality was also lower, but that finding was driven by observational studies and was not statistically significant in randomized trials; small-study effects and possible publication bias limit confidence in the results.

• CATHETER ABLATION VERSUS SHAM FOR SYMPTOMATIC ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND BAYESIAN META-ANALYSIS OF RANDOMIZED TRIALS

  Heart rhythm · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 22 October 2026

  In a review of four sham-controlled trials involving 468 patients, ablation improved quality-of-life scores by 13.5 points and reduced atrial fibrillation recurrence by about half. Results favored ablation across trials, but differences in patient symptoms, monitoring and blinding created substantial variation in the size of the quality-of-life benefit, whose evidence certainty was low.

• Quantitative Flow Ratio- vs Angiography-Guided Percutaneous Coronary Intervention: A Secondary Analysis of the FAVOR III China Trial

  JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

  In this randomized trial analysis, quantitative flow ratio-guided PCI was associated with fewer major cardiac events over 3 years in patients with multivessel disease: 12.1% versus 18.1%, with fewer heart attacks and repeat procedures. The difference was not statistically significant among patients without multivessel disease, but there was no evidence that benefit differed by disease status; further confirmation is warranted.

Evidence summaries in Cardiology and Cardiovascular Medicine

• Acute Coronary Syndrome
• Hyperlipidemia
• Aortic Dissection
• Aortic Stenosis
• Cardiogenic Shock
• Acute Myocardial Infarction
• HFrEF (Heart Failure with reduced Ejection Fraction)
• Marfan Syndrome
• Beta-Adrenergic Blockers
• Acute Pericarditis
• Kounis Syndrome
• Myocarditis
• Pulmonary Embolism (Opus)
• Hypertensive Emergency
• Anticoagulation in Atrial Fibrillation
• Heart Failure
• Cardiac Action Potential