Cardiology Evidence Evolution

5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped cardiology practice.

SGLT2 Inhibitors in Heart Failure

From glucose-lowering agent to pillar of heart failure therapy

EMPA-REG signal (2015) → DAPA-HF (2019) → EMPEROR-Preserved → DELIVER → ESC Class I

From warfarin monopoly to a new standard

Warfarin → RE-LY (2009) → ROCKET-AF → ARISTOTLE → ENGAGE

Faster, safer chest pain rule-out

Conventional troponin → hs-cTn → 0/1h ESC → 0/3h pathway → single rule-out

Finding the sweet spot

12-month dogma → DAPT → short-duration → TWILIGHT P2Y12 monotherapy → personalized

Lower is better — without a floor

Statin ceiling → FOURIER/ODYSSEY → lower-is-better → inclisiran siRNA → access