geoffrey modest medical blogs

  A secondary analysis of the CONNECT trial, that stands for (a bit of a stretch...)  “A Randomized Comparison of Long-Term Vascular Healing Between Biodegradable Polymer vs Durable Polymer Everolimus Eluting Stents in Acute ST-Elevation Myocardial Infarction” found that a lower target LDL level was associated with decreased neoatherosclerosis, which is associated with subsequent stent failure (see   LDL goal after stent JAMAcardiol2025  in dropbox, or doi:10.1001/jamacardio.2025.4723)   Details : -- the CONNECT trial was a prospective, multicenter, open-label, assessor-blind, randomized clinical trial to investigate the association between achieving guideline-endorsed target LDL levels with long-term neoatherosclerosis formation after current-generation drug-eluting stent implantation. This trial was conducted in 7 centers in 2 countries (Switzerland and Japan)     -- patients at least 18 years old were eligible if they presented with a...

  A recent secondary analysis of the ISCHEMIA trial found that conservative management of stable angina found that the average number of days alive and not in the hospital was higher than with invasive management ( see  cad stable ischemia trial jamacard2021  in dropbox, or doi:10.1001/jamacardio.2021.1651 )   Details: -- 5179 patients enrolled in the ISCHEMIA trial were assessed for the prespecified analysis of days alive out of hospital (DAOH), which includes both death and days out of the hospital collectively -- patients had stable coronary disease with moderate or severe ischemia, randomized to invasive vs conservative management (angiography/revascularization vs meds, with both groups receiving optimal medical therapy) -- see  http://gmodestmedblogs.blogspot.com/2020/05/ischemia-trial-stable-angina-conserv.html  for details of the study Results: -- DAOH at one mon th, comparing conservative vs invasive management: 30.8 vs 28.4 days, p<0.001 --...