What's Hot in Clots, January 2026

Hope that you enjoyed the holidays and started a great New Year! Here we go with the summaries of the month:

Ticagrelor-based DAPT after CABG: Yes? No? Or it’s complicated?

A prior meta-analysis of RCTs had previously shown that ticagrelor-based DAPT, compared with aspirin monotherapy, led to significantly reduced incidence of vein graft failure (almost a 10% absolute risk reduction), although at the cost of excess bleeding (read more). So, it first took me by surprise to see a new RCT suggesting no benefit from ticagrelor-based DAPT in patients who had CABG due to acute coronary syndromes. The devil is in the details, though…perhaps incremental gain from keeping veins open is modest given the price to pay with excess bleeds. Read more.

COVID-19 and cardiovascular events among inpatients: Is it a thing of the past? Yes? No? Or it’s complicated?

I didn’t pre-plan the sequence of titles but this turns out to be true for the second paper in a row! Thankfully, COVID-19 is largely a thing of the past—we don’t deal with it as often as clinicians, or society-wide. That said, it’s also far from completely over. This investigation shows that if patients were sick enough to be hospitalized with COVID-19 (even in more recent years), they still had a substantial risk of cardiovascular and thrombotic events. 

What does this mean for clinicians? If you happen to see  patients with COVID-19 in 2026, my suggestion is to watch out for CV and thrombotic events and try to mitigate risk as best as possible. Read more.

Lupus and venous and arterial thrombosis: What do we know?

SLE is a serious systematic disorder with multi-organ complications. As a cardiologist, I see many forms of its thrombotic adverse events. This review is quite timely in summarizing the correlates for venous and arterial thrombotic events. Read more.

STEMI after receiving IVIg

When I first saw this report, it certainly caught my attention. IVIg is not infrequently used for treating many conditions—in this case, a patient with myasthenia gravis. However, the IVIg infusion was followed by chest discomfort, ST elevations, and angiographic evidence of coronary of thrombosis. Why is that? Well, it’s just a guess, but I’m guessing a combination of immune interactions and endothelial activation, as well as the transient hyperviscosity. Read more.

Crosstalk of inflammation and coagulation

Over the past few years, we’ve learned a lot more about the interconnectedness of inflammation and thrombosis. This timely review summarizes many related concepts and shares practical points for some of the common diseases. Read more, and listen to our companion podcast on this topic here. 

Behnood Bikdeli, MD, MS