Preventive 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.

In the VITAL-AF trial, three validated risk models (CHARGE-AF, ECG-AI, and combined CH-AI) discriminated 2-year incident AF, with ECG-AI and CH-AI showing higher AUROCs. Applying a risk-guided screening approach enriched detection in the highest-risk decile (CH-AI), yielding a modest increase in AF diagnosis rate and a number-needed-to-screen of 43 per year, suggesting ECG-based AI plus clinical factors can identify individuals who may benefit most from screening while raising trade-offs in population coverage.

This review summarizes key 2025 cardiovascular advances affecting generalists and subspecialists, including updates in hypertension, heart failure, anticoagulation for atrial fibrillation, imaging for suspected CAD, post-MI beta-blocker and invasive management debates, new therapies for hypertrophic cardiomyopathy and hyperlipidemia, and evidence on coffee use in atrial fibrillation.