Domenico Simone Castiello

Among patients with anterior myocardial infarction, adding low-dose rivaroxaban to dual antiplatelet therapy did not significantly reduce left ventricular thrombus formation at 1 month but increased minor bleeding. ja.ma/4cF3mo4

After the two recent meta-analyses published in The Lancet and NEJM, one could argue that the case is settled: following myocardial infarction, beta-blockers should be prescribed to patients with an LVEF <40%, may be considered in those with an LVEF of 40–49%, and in patients with an LVEF ≥50% only if there are other indications, such as hypertension, atrial fibrillation, or heart failure. The guidelines are partially misaligned with the emerging evidence and will most likely be updated in the near future.

🫀 First-in-human valve-in-valve TAVI in mechanical prostheses Bench-to-bedside study: disc dislodgement & retrieval followed by successful TAVI. Published in European Heart Journal. 👉 academic.oup.com/eurheartj/adva… @escardio @PCRonline @secardiologia @CNIC_CARDIO @sacyl @TCTMD

A comprehensive contemporary overview of Optimal Medical Therapy Targeting Metabolic status (Diabetes & Obesity) for Secondary Prevention after PCI:mdpi.com/3705586 @FeliceGragnano @me_canonico @DSCastiello @espogiov @paolocalabro1 @arturocesaro @DanieleGiacoppo @AGrecoMD

Here is the usual overview of the papers that attracted the most attention in EuroIntervention in 2025. I'm pleased with this year’s statistics. The steady increase in the journal’s impact factor over recent years (now 9.5) is translating into a higher volume of submissions, making the selection of the limited proportion of articles we can publish increasingly competitive. The practical consequence is a progressive rise in average quality. Studies that only a few years ago might have been published elsewhere are now appearing in EuroIntervention. A virtuous cycle that we hope to sustain in 2026, with the continued contribution of our reference community of interventional cardiologists, which the journal aims to reflect both academically and in daily practice. Coronary is back? Among the most cited themes this year are standardization of definitions and endpoints, acute coronary syndromes, physiology- and imaging-guided decision-making, optimization of antithrombotic strategies, and the management of complex patient subsets.

#DAPT after valve-in-valve #TAVR may be associated with a lower 1-yr incidence of stroke. In contrast, no significant difference was observed for other major ischemic and bleeding outcomes or for premature valve deterioration. jacc.org/doi/10.1016/j.… #JACCINT @saia_francesco

Validation of IVUS-defined optimal stent expansion criteria for favorable 1-year clinical outcomes 🔗pcronline.com/PCR-Publicatio… This individual patient data analysis 🔎 of the 3 largest RCTs evaluating IVUS-guided stent optimisation showed that an MSA > 5.5 mm2 was associated with reduced TVF at one year. Read this new journal club review ✍️ by @RuxSava and @NicolaRyanI1 #interventionalcardiology

📢Prosegue la Rubrica dei Casi Clinici dalle Scuole di Specializzazione Italiane 📍Università della Calabria - Cosenza 📌Erosione di Placca in un Giovane Paziente con STEMI: una Scelta Difficile @Albertopolimeni @DSCastiello 📖 Leggi il caso completo sul nostro sito!

-Drug-coated balloons for coronary bifurcation lesions -@FezziSimone et al. explore the role of #DCB as a stent-sparing strategy in bifurcation #PCI, highlighting procedural optimisation, hybrid approaches, and future research needs. eurointervention.pcronline.com/article/drug-c… @Dr_TRissanen @Mattialunardi @BernardCortese @FlavioRibichini @MdScarsini

After CORMICA trial comfirmed the benefit of tailored, stratified therapy, the PROMISE trial shows consistent results in MINOCA. In-depth diagnosis re-classified significantly the diagnosis of epicardial spasm (13.3% -> 35.6%). A strickling reminder: Ach test is not negligible.

“Moderate” is not benign and “severe” may demand earlier reconsideration in aortic stenosis scenario. Are we still too comfortable in the waiting room while the disease is working? #VHD #AS #AorticInterventionTiming

The PROCTOR trial shakes the foundation with SVG PCI outperforming native vessel PCI: 1-year MACE 19% vs. 34%. This finding challenges decades of “native is best” dogma. Time to ask: Do we need to rewrite guidelines? #TCT2025 #JACC #CABG #PCI

The PARTHENOPE Trial, which evaluated an individualized strategy of post-PCI antiplatelet therapy using the DAPT Score compared with standard of care, broke new ground on a number of fronts. @djc795, @EricSecemskyMD and I wrote about it in @JACCJournals. jacc.org/doi/10.1016/j.…

The idea of low-dose intracoronary fibrinolysis is fascinating, but the STRIVE trial showed no improvement in reperfusion with low-dose alteplase in STEMI patients undergoing pPCI with large thrombus burden. Elegant study, unfortunate results, unlike what we are starting to see in stroke. @mmamas1973 @ahakeem143 @mirvatalasnag @drptca @Ortega_Paz @DLBHATTMD @SripalBangalore @Hragy @SVRaoMD @HadyLichaaMD @DrPascalMeier @sbrugaletta @Costa_F_8 @aakriti_15 @djc795 @nadig_cardio @dukwoo_park @omendiz @jedicath

NEW in EuroIntervention: a State-of-the-Art review on #antithrombotictherapy in complex #PCI. Balancing ischemic protection with bleeding risk remains one of the greatest challenges in this setting. This paper discusses periprocedural and long-term management strategies, underlining the importance of a tailored, patient-centred approach. Full text available here: ow.ly/IALF50WXrmz @DSCastiello @piccoloraf

📚 ICOT CONSIGLIA 🩺 A State-of-the-Art review 🫀🔍 Antithrombotic therapy in complex percutaneous coronary intervention 📍@EuroInterventio, 2025, @DSCastiello et al. 🔗 Leggi il paper completo qui: eurointervention.pcronline.com/article/antith…

🚨 New issue out today! Highlights: ✅ State-of-the-Art: Antithrombotic therapy in complex PCI ✅ TAVI & redo-TAVI insights ✅ Left main CAD original research ✅ Calcium mapping with 3DStent and more Read here 👉eurointervention.pcronline.com/issue/volume-2… #CardioTwitter

📢 Hot off the press in the latest issue of @EuroInterventio ! I am truly delighted to share the publication of our state-of-the-art review: “Antithrombotic therapy in complex percutaneous coronary intervention” 🔗Read here: eurointervention.pcronline.com/article/antith… @piccoloraf @IndolfiCiro

In this state-of-the-art review, the authors summarize current antithrombotic strategies for patients undergoing complex PCI and discuss evidence from randomized clinical trials evaluating these regimens in this context. eurointervention.pcronline.com/article/antith…

I think I have a positive bias toward the PARTHENOPE trial, not only because I was part of the Steering Committee and deeply respect the work behind it, but also because it does something rarely done when validating risk scores: randomization. Usually, we see validation based on discrimination or area under the curve, but in reality, the true test of a score’s utility is whether randomization to a score-guided versus non–score-guided strategy makes a difference on clinical outcomes. Just think of how many scores we use every day that lack this kind of validation. jacc.org/doi/10.1016/j.…