Weekly Cardiology Research Analysis
This week’s cardiology literature highlights rapid advances spanning therapeutics, devices, and diagnostic/physiology tools. A randomized trial validated a fully bioresorbable ASD occluder with noninferior closure and near-complete degradation at 2 years, while a prespecified pooled randomized analysis showed high‑dose influenza vaccine reduces influenza/pneumonia and cardiorespiratory hospitalizations in older adults. Mechanistic and clinical studies (including a prespecified SELECT analysis of
Summary
This week’s cardiology literature highlights rapid advances spanning therapeutics, devices, and diagnostic/physiology tools. A randomized trial validated a fully bioresorbable ASD occluder with noninferior closure and near-complete degradation at 2 years, while a prespecified pooled randomized analysis showed high‑dose influenza vaccine reduces influenza/pneumonia and cardiorespiratory hospitalizations in older adults. Mechanistic and clinical studies (including a prespecified SELECT analysis of semaglutide) further clarify non–weight-loss cardioprotective pathways and practical strategies to refine procedural planning and risk stratification.
Selected Articles
1. Bioresorbable vs Metallic Occluders for Transcatheter Atrial Septal Defect Closure: A Randomized Clinical Trial.
In a multicenter noninferiority randomized trial (n=229) of secundum ASD closure, a bioresorbable occluder achieved similar closure success and device-related safety to a metallic occluder at 6 months and 2 years, with approximately 99.8% device degradation by 2 years. The trial demonstrated comparable short- and mid-term clinical outcomes and prospectively assessed device resorption.
Impact: First randomized validation of a fully bioresorbable ASD occluder with 2-year clinical outcomes and near-complete resorption addresses concerns about permanent metallic implants and future transseptal access.
Clinical Implications: Bioresorbable occluders can be considered an alternative to metallic devices for secundum ASD closure, particularly when future left atrial access or minimizing long-term implant-related complications is a priority.
Key Findings
- 6-month closure success: 96.5% (bioresorbable) vs 97.4% (metallic); noninferiority achieved.
- Two-year outcomes: no significant difference in closure success or device-related adverse events; ~99.8% device degradation at 2 years.
2. Effectiveness of high-dose influenza vaccine against hospitalisations in older adults (FLUNITY-HD): an individual-level pooled analysis.
A prespecified individual-level pooled analysis of two harmonized randomized trials (total n=466,320) found high-dose inactivated influenza vaccine reduced hospitalisation for influenza or pneumonia (relative vaccine effectiveness 8.8%) and lowered cardiorespiratory and laboratory-confirmed influenza hospitalizations in older adults without increasing serious adverse events.
Impact: Provides large randomized-trial–based pooled evidence to inform vaccine policy for older adults, with measurable reductions in clinically meaningful hospitalizations.
Clinical Implications: Health systems and clinicians should consider preferential use of high-dose influenza vaccine in older adults to reduce influenza/pneumonia and cardiorespiratory hospitalizations; cost-effectiveness and implementation should be evaluated locally.
Key Findings
- Primary endpoint: hospitalization for influenza or pneumonia reduced with HD-IIV versus SD-IIV (rVE 8.8%, 95% CI 1.7–15.5).
- Secondary outcomes: reductions in cardiorespiratory hospitalizations (rVE 6.3%) and lab-confirmed influenza hospitalizations (rVE 31.9%); similar serious adverse event and mortality rates.
3. Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial.
In a prespecified analysis of SELECT (n=17,604), semaglutide reduced major adverse cardiovascular events consistently across baseline adiposity strata. Waist circumference reduction mediated about one-third of the observed benefit, while overall cardioprotection was largely independent of baseline adiposity and not linearly explained by early weight loss.
Impact: Clarifies that semaglutide’s cardiovascular benefit extends beyond weight loss and refines therapeutic rationale for its use in secondary prevention among overweight/obese patients without diabetes.
Clinical Implications: Supports semaglutide consideration for cardiovascular risk reduction irrespective of baseline adiposity; clinicians can use waist circumference as one monitoring metric but should recognize additional non‑adiposity mechanisms.
Key Findings
- Semaglutide reduced MACE consistently across baseline bodyweight and waist circumference categories in 17,604 patients.
- Waist circumference reduction mediated ~33% of the MACE benefit; no linear link between early weight loss (week 20) and MACE in semaglutide arm.