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Davide Capodanno: 10 Trials to Watch at the ESC Hot Lines
Davide Capodanno/LinkedIn
Aug 24, 2026, 16:52

Davide Capodanno: 10 Trials to Watch at the ESC Hot Lines

Davide Capodanno, Full Professor of Cardiology at the University of Catania, shared a post on X:

“The 10 trials I am most looking forward to at the ESC Hot Lines next week (in no particular order):

  • LIBREXIA-ACS, where milvexian could end up like apixaban in APPRAISE-2, perhaps with less bleeding. Rivaroxaban did not exactly have an easy story after ATLAS ACS 2 either, despite the positive results. Although we know the trial was stopped for futility, the data remain important in the rollercoaster of FXI inhibitor trials.
  • EPIDAURUS, because I will be the Discussant in Hot Line 3. It compares ticagrelor or prasugrel with clopidogrel in patients with atrial fibrillation and acute coronary syndrome. So I know everything about it, but I am not telling you.
  • SWITCH-SWEDEHEART, because if this trial is positive for prasugrel, this might finally be the moment when I call back all my patients on ticagrelor and switch them one by one. If not, we can say we have been joking all along and that ISAR-REACT 5 was just an episode.
  • PREMIUM, because after NEOMINDSET and STOPDAPT-3, a third negative trial for an aspirin-free strategy (meaning P2Y12 inhibitor monotherapy from the outset) would probably put this rather radical idea to rest, making it indefensible.
  • ISOLEDS, comparing OCT- versus IVUS-guided PCI in distal left main disease. After OPTIMAL and IVUS-CHIP, which we are still recovering from, we really need something that leaves angiography out of the comparison.
  • TAVI-PCI, because I don’t know about you, but after NOTION-3 and PRO-TAVI, I am still somewhat confused.
  • POPular-ACE, one of my favourites because it addresses a simple question with a potentially clear answer that we could implement in the cath lab the very next day: do we actually need protamine after TAVI or not?
  • AIR-STEMI, continuing the elemental saga of the Ferrara group (the same investigators behind FIRE) this time using angio-derived FFR to identify non-culprit lesions in STEMI. There is some confusion here too, given that FLOWER-MI was negative while FRAME-AMI was positive.
  • A-CLOSE, evaluating chronic clopidogrel monotherapy and continuing the story started by HOST-EXAM and SMART-CHOICE 3 against aspirin, while resembling OPT-BIRISK in its comparison with DAPT.
  • PRAGUE-26, which deserves a special mention because I really like the idea of tackling a complicated problem with an extremely simple and inexpensive approach. The results could surprise us and tell us that the solution has been sitting right there all along: alteplase directly instilled into the pulmonary arteries—a strategy we practically never use, and perhaps we are wrong not to.”

Davide Capodanno

Find more posts featuring Davide Capodanno on Hemostasis Today.

A-CLOSE ACS Acute coronary syndrome AF AIR-STEMI Alteplase Apixaban APPRAISE-2 Aspirin ATLAS ACS 2 Atrial Fibrillation Blood Cardiology clopidogrel DAPT Davide Capodanno EPIDAURUS ESC Ferrara group FFR FIRE FLOWER-MI FRAME-AMI FXI FXI inhibitor Health Hematology Hemostasis Hemostasis News Hemostasis Today HOST-EXAM ISAR-REACT 5 ISOLEDS IVUS-CHIP LIBREXIA-ACS Medicine milvexian NEOMINDSET NOTION-3 OPT-BIRISK OPTIMAL PCI POPular-ACE PRAGUE-26 prasugrel PREMIUM PRO-TAVI Protamine Rivaroxaban SMART-CHOICE 3 STEMI STOPDAPT-3 SWITCH-SWEDEHEART TAVI TAVI-PCI ticagrelor
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