Domenico Galante

Another great experience this year at EuroPCR 2025! @PCRonline I had the privilege to present our latest findings:
• Physiology-guided DCB-PCI 🎯 – a promising and minimalist approach, balancing safety, efficacy, and vessel preservation, with clinical outcomes comparable to standard physiology-guided DES-PCI.
• Contrast-induced IMR 💡 – a simpler, valid surrogate for thermodilution-based IMR, with strong potential for broader clinical application. A great moment to reconnect with friends and colleagues 🤝 and learn from leading experts in the field! A special thanks to my mentor for the continuous guidance and support – @AntonioMariaLe2 #EuroPCR2025 #InterventionalCardiology #DCB #FFR #IMR #Microcirculation #FullPhysiology

Another micro-axial flow pump trial, this time in high-risk PCI—same leap of faith, same outcome. Result? No benefit. If anything, a signal in the wrong direction. We keep expanding “protected PCI” without proof it protects patients—only operators. When doing more starts to look like doing harm, it’s time to pause. #ACC26 nejm.org/doi/full/10.10…

#ACCC26 👇 ORBITA-CTO doi.org/10.1016/j.jacc… EDITORIAL 👇 doi.org/10.1016/j.jacc… 👋 @rallamee @ziadalinyc @DrKeeble @DrOzanDemir @esbrilakis

Fantastic meeting in Rome! See you in Munich!

Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial Withdrawal of HF therapy following AF rhythm control for prior AFCM and recovered LVEF was not associated with a decline in LVEF for most patients in the following 6 months #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @hfcollaboratory @AndrewJSauer @ankeetbhatt @gcfmd @SJGreene_md @dranulala @biljana_parapid @AnastasiaSMihai academic.oup.com/eurheartj/arti…

Plaque rupture with thrombosis drives ACS, and thin-cap fibroatheroma is the archetypal high-risk plaque. There are consistent features of vulnerability across imaging modalities (large plaque burden, small MLA, TCFA, high LCBI, positive remodelling, etc.), with risk increasing when multiple features coexist. Yet absolute event rates remain low, consistent with pathology data showing most plaque ruptures are clinically silent. So should we prophylactically stent high-risk plaques? According to this Viewpoint, completed trials (PROSPECT ABSORB, PREVENT) suggest no durable reduction in death or MI versus optimal medical therapy—benefits are limited to fewer revascularisations, at the cost of many unnecessary PCIs. With modern medical therapy, a wait-and-see strategy appears safe, avoiding most interventions without adverse consequences. For now, data favor surveillance and aggressive medical therapy over preventive PCI. READ THE VIEWPOINT: eurointervention.pcronline.com/article/high-r…

Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial academic.oup.com/eurheartj/arti…

Conservative management of #FFR ≤0.80 lesions was linked to higher cardiovascular risk compared with either #PCI of FFR ≤0.80 lesions or deferral of FFR >0.80 lesions, which had similar outcomes. jacc.org/doi/10.1016/j.… #JACCINT #TAVR

Among 28k patients with Takotsubo cardiomyopathy, beta blockers led to a ⬇️ in mortality! Check out our latest analysis in EHJ ACVC. Grateful for the mentorship @SarasVallabhMD 🙏🏻! @JDawnAbbott1 @kritisoni99 @RamezOdat1 @dr_siddharthh @BPushparaji @EHJACVCEiC

Very proud of this milestone study coming from a beautiful friendship! Many thanks to all the authors and co-authors (...)! @GianlucaCampo78 @ehj_ed @domdoct

I’m very proud and truly honored to be part of this new milestone paper ✨, which for the first time provides a comprehensive description of all ANOCA endotypes, outlining their underlying pathophysiological mechanisms and proposing guided, mechanism-based treatment strategies. 📄 It has been an honour to collaborate and grow alongside leading experts in this field 🤝. Grateful to the entire team and to my mentors for this opportunity. @AntonioMariaLe2 @ehj_ed doi.org/10.1093/eurhea…

Patterns of Restenosis after Left Main Bifurcation Stenting. Irrespective of a 1 or 2 stent strategy the Lcx ostium remains problematic @AMaznyczka @Ryvetsprog @GoranEBC @BURZOTTA_F @MohanedEgred @jacockburn @h_evald @dmylotte @MPAOSS @mmlindsay71 ahajrnls.org/3XqFRGr

Very proud to be present when 2 genius as Tommaso Gori and Antonello Leone were talking for the first time of this idea... one year after the paper is out.... we were in Bruxelles ... raining day... and the big idea came out... 💡 💡 💡

In patients with suspected ANOCA, assessment of the symptomatic, electrocardiographic, and haemodynamic responses to adenosine and acetylcholine identifies distinct endotypes and enables mechanism-guided stratified medicine doi.org/10.1093/eurhea… #ANOCA #FFR #CAD #MI #cardiotwitter, @ESC_Journals, @escardio

A new paper in #EHJ redefines endotypes of angina with non-obstructive coronary arteries. Read the results of prospective multicentre study 👉 ow.ly/69fb50XqmOp @RoccoMontone @ehj_ed

@DrDamluji What about the % of patients stratified by CHA2DS2-VAs score? It s interesting to know the risk profile of patients population.

🥸2️⃣0️⃣Conclusion: In the OCEAN trial, after successful AF ablation, aspirin and rivaroxaban had similar efficacy, but bleeding was higher with rivaroxaban. Stroke events were rare overall.

Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation: @NEJM @AHAScience #AHA25 🥸 NEJM is publishing negative studies - great! 😱 Ocean trial results below 👇👇👇👇

In the randomized PROCTOR trial, SVG #PCI was assoc w/ improved 1-yr clinical outcomes compared w/ native vessel PCI, primarily driven by lower rates of PCI-related MI & clinically driven target coronary territory #revasc. jacc.org/doi/10.1016/j.… #TCT2025 #JACC #cvMI #cvCABG

VICTORY trial: OCT-guided PCI involving lesion preparation with OPN™ balloon was non-inferior to intravascular lithotripsy on stent expansion rate for treating severely calcified coronary lesions. #TCT2025 View the slides here: clinicaltrialresults.org/wp-content/upl…

SELUTION DeNovo - non inferiority for TVF at 1 yr demonstrated. Randomisation before lesion prep ➡️ 20% DES use in DEB arm ➡️ 50% non inferiority margin of overall tvf in both arms !!!!! ➡️ TVF 4.4 vs 5.3% in des and deb arms This is a landmark moment- analogous to introduction of DES (even with generous non inferiority margin) #TCT2025 @crfheart Wild clapping in audience @Hragy @jgranadacrf @mirvatalasnag @drptca @SrihariNaiduMD @realarainmd @DrAsifQasim @DavidWienerMD @sbrugaletta @alaide_chief

SGLT2i & UTI: Continue or Stop? 🧩 Key Question: What happens when patients with T2DM on SGLT2 inhibitors develop a new-onset UTI? Should therapy be continued or discontinued thereafter? 🔍 Key Finding (EHJ, 2025 | doi:10.1093/eurheartj/ehaf788) In >61,000 T2DM patients on SGLT2i (2015–2022): 🔹 6.3% developed a new-onset UTI during follow-up. 🔹 Those with UTI had markedly higher risks of:   🫀 CV composite events (HR 3.18; 95% CI 2.88–3.51)   💧 Renal composite events (HR 2.51; 95% CI 2.32–2.72) After UTI, 32% stopped SGLT2i.  🚫 Discontinuation increased:   🫀 CV risk → HR 1.35 (1.20–1.53)   💧 Renal risk → HR 1.35 (1.21–1.51)  💊 No significant reduction in recurrent UTI risk (HR 0.96). 💡 Take-Home Message 🌊 New-onset UTI is a marker of vulnerability — signalling higher cardio-renal risk. ❌ Stopping SGLT2 inhibitors post-UTI worsens CV and renal outcomes, without lowering reinfection risk. ✅ Best approach:  – Treat UTI appropriately 🔬  – Resume or continue SGLT2 inhibitor once infection resolves  – Maintain long-term CV-renal protection 🌿 🩺 Clinical Insight “UTI is a complication; discontinuation is a setback.” Keep the molecule — protect the heart & kidney, not just the bladder. 💚 Source: 📘 European Heart Journal (2025): Wu M-Z et al., Urinary tract infection and continuation of sodium–glucose cotransporter-2 inhibitors in diabetic patients. 🔗 academic.oup.com/eurheartj/adva…

Original Article: Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (AQUATIC trial) nej.md/45AU4Wp #Cardiology