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Hi, everyone.

This is John Mandrola from the heart.org medscape cardiology, and this is this week in cardiology. We're back after a break

from Thanksgiving. This week I'm talking about is less is more after PCI, the target first trial.

I'll also talk about a negative trial that is actually really positive.

Aspirin versus anticoagulation in terms of bleeding, AEDs, and Factor 11 inhibitors are not dead yet.

So let's first start with some listener feedback, and I'm going to have it short.

I've received so much listener feedback

that I just want to summarize. Most of the feedback is on the issue of culprit-only PCI versus

complete revasculization at the time of STEMI. I think it's time to let it rest for now. I see

non-culpate lesions as chronic and stable, and that's why the full revasped trial was negative,

but others don't.

They see these lesions as less than stable because they're occurring in the setting of a stemmy.

Of course, the trials are mixed, but in my opinion, they lean more towards no benefit for complete revascularization on serious outcomes.

So I guess the compromise could be just don't mandate routine anything in the guidelines.

If I were the czar of these procedures, I would say you aren't compelled to do every non-culpricle

lesion routinely, but if there were

areas where you felt concerned, it's hard to argue against it. Still, though, I lean on the

notion that even in the best trials, like the complete trial, which are positive based on a

reduction of MI rather than any hard outcomes like CV death or death.

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