{"id":8461,"date":"2025-08-30T14:22:12","date_gmt":"2025-08-30T11:22:12","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8461"},"modified":"2025-08-30T14:22:12","modified_gmt":"2025-08-30T11:22:12","slug":"six-trials-of-interest-at-esc-2025","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/six-trials-of-interest-at-esc-2025\/","title":{"rendered":"Six Trials of Interest at ESC 2025:"},"content":{"rendered":"
Six Trials of Interest at ESC 2025:<\/div>\n
<\/div>\n
1. DIGIT-HF (Digitoxin in HFrEF)<\/div>\n
\u2022 Old digitalis drugs have long been criticized.<\/span><\/div>\n
\u2022 The DIG trial showed no mortality benefit, but did reduce HF hospitalizations.<\/span><\/div>\n
\u2022 DIGIT-HF tests digitoxin (safer pharmacology than digoxin) in HFrEF patients.<\/span><\/div>\n
\u2022 Challenge: proving a 20% benefit on top of strong modern therapies is unlikely.<\/span><\/div>\n
\u2022 So far, digoxin\/digitoxin has only been shown to reduce HF hospitalizations, without improving survival \u2014 most often used in HFrEF patients, especially those with atrial fibrillation.<\/span><\/div>\n
\u2022 If the trial shows no harm, digitoxin could regain interest as an option.<\/span><\/div>\n
2. Beta-Blockers After MI (REBOOT-CNIC & BETAMI-DANBLOCK)<\/div>\n
\u2022 Beta-blockers are still routinely used after MI, but this is based on old 1980s trials, before PCI and modern therapy.<\/span><\/div>\n
\u2022 Recent smaller trials (REDUCE-AMI, ABYSS) showed no clear benefit in patients with preserved EF (>40%).<\/span><\/div>\n
\u2022 REBOOT-CNIC (Spain, >8000 pts) and BETAMI-DANBLOCK (Norway\/Denmark, >4000 pts) will provide definitive answers.<\/span><\/div>\n
\u2022 Key point: If these confirm no benefit, routine beta-blocker use after MI with normal EF may end.<\/span><\/div>\n
3. AQUATIC (OAC + Aspirin in Stable CAD\/AF)<\/div>\n
\u2022 Many AF patients on anticoagulation are also prescribed aspirin for CAD.<\/span><\/div>\n
\u2022 The AFIRE trial (Japan) showed OAC alone was as effective and safer.<\/span><\/div>\n
\u2022 AQUATIC tests OAC + aspirin vs OAC alone in stable CAD.<\/span><\/div>\n
\u2022 Key point: Likely to confirm OAC alone is better and safer, reducing bleeding risk.<\/span><\/div>\n
4. ALONE-AF (Stopping OAC After AF Ablation)<\/div>\n
\u2022 Big daily question: can patients stop OAC after successful AF ablation?<\/span><\/div>\n
\u2022 This trial tests stopping vs continuing OAC after 1 year without AF recurrence (with \u22651 stroke risk factor).<\/span><\/div>\n
\u2022 Key point: If safe, many post-ablation patients may be able to discontinue OAC, reducing overtreatment.<\/span><\/div>\n
5. REFINE-ICD (Better ICD Selection Post-MI)<\/div>\n
\u2022 Most ICDs for primary prevention never deliver therapy \u2192 many patients get no benefit.<\/span><\/div>\n
\u2022 REFINE-ICD uses two ECG markers (heart rate turbulence + T-wave alternans) in post-MI patients with EF 35\u201350% to guide ICD implantation.<\/span><\/div>\n
\u2022 Key point: Could allow ICDs only for those at real risk.<\/span><\/div>\n
<\/div>\n
Quick Notes\u201d :<\/div>\n
1. DIGIT-HF: Digitoxin may cut HF hospitalizations, but no survival benefit; mostly for HFrEF + AF.<\/span><\/div>\n
2. Beta-blockers after MI: Likely no benefit if EF >40%; big trials may end routine use.<\/span><\/div>\n
3. AQUATIC: OAC alone safer than OAC + aspirin in stable CAD\/AF.<\/span><\/div>\n
4. ALONE-AF: Trial may allow safe OAC discontinuation post-ablation.<\/span><\/div>\n
5. REFINE-ICD: ECG markers may guide ICDs to those who truly need them.<\/span><\/div>\n
<\/div>\n
ESC 2025 \u2013 Hot Line Presentation Schedule (Madrid)<\/div>\n
\u2022 DIGIT-HF: Friday, 29 August at 11:30 (Press Conference 1).<\/span><\/div>\n
\u2022 REBOOT-CNIC & BETAMI-DANBLOCK: Saturday, 30 August around 11:00 (Press Conferences 2 & 3).<\/span><\/div>\n
\u2022 AQUATIC: Sunday, 31 August at 08:51 (Press Conference 6).<\/span><\/div>\n
\u2022 ALONE-AF: Sunday, 31 August at 17:30 (Press Conference 7 or 8).<\/span><\/div>\n
\u2022 REFINE-ICD: Will also be presented in a Hot Line session (exact time to be confirmed in the ESC schedule).<\/span><\/div>\n
<\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

Six Trials of Interest at ESC 2025: 1. DIGIT-HF (Digitoxin in HFrEF) \u2022 Old digitalis drugs have long been criticized. \u2022 The DIG trial showed no mortality benefit, but did reduce HF hospitalizations. \u2022 DIGIT-HF tests digitoxin (safer pharmacology than digoxin) in HFrEF patients. \u2022 Challenge: proving a 20% benefit on top of strong modern […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8461","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8461","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8461"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8461\/revisions"}],"predecessor-version":[{"id":8462,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8461\/revisions\/8462"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8461"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8461"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8461"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}