Cardiology Research Updates

In this phase 3 randomized trial of 12,327 patients with noncardioembolic ischemic stroke or high-risk TIA on antiplatelet therapy, adding asundexian 50 mg daily reduced ischemic stroke incidence (6.2% vs 8.4%; HR 0.74) and the composite of cardiovascular death/MI/stroke without increasing major bleeding (1.9% vs 1.7%), with similar overall and serious adverse-event rates between groups.

Using a mouse model of cardiorenal HFpEF induced by aldosterone and high salt, the study found reversible diastolic dysfunction associated with a distinct fibroblast subpopulation and MR target gene upregulation; fibroblast-specific deletion of the mineralocorticoid receptor prevented diastolic dysfunction, implicating fibroblast MR signaling in HFpEF pathogenesis and as a target for MR antagonist benefit.

In a post hoc analysis of 224 asymptomatic severe AS patients with midwall fibrosis, greater fibrosis burden was associated with higher risk of death or unplanned AS-related hospitalization, driven mainly by hospitalizations; there was no clear interaction between fibrosis extent and benefit from early valve intervention versus conservative management, though patients with above-median fibrosis had fewer hospitalizations when randomized to early intervention.