What's Hot in Clots: October 2026

We’re off to a new season. Fall isn't exactly my cup of tea, but many around me enjoy the colorful days. And it's the perfect time for the 3Ps: Pumpkins, pomegranates, and of course, papers!

Global burden of venous thromboembolism: Forgotten no more!

The Global Burden of Disease initiative has done amazing work over the past several years,  furthering our knowledge of prevalence and/or incidence of many cardiovascular and noncardiovascular conditions and their associated mortality and nonfatal complications. However, VTE was historically dumped into their “garbage codes,” where its impact has been attributed to other conditions. To change the status quo, yours truly and a team of investigators from around the world have worked for the past 3 years to produce estimates of the global burden of DVT and PE. There’s a lot more to do for data harmonization and addressing areas of data deserts, but here’s our first attempt. (And conservatively, there are more than 1.6 million new PEs and more than 2.5 million new DVTs every year!) 

Machine learning to assess suspected PE in the ED?

This study shows promising findings with machine learning tools for ruling out PE in the ED. What may be needed is additional external validation to ascertain its good performance with different EHR systems and “missingness” tolerance. Read more.

You think you know your aspirin? Think again!

Aspirin has been an available antithrombotic agent for a gazillion years, and yes, we’ve hoped that coated aspirin would mitigate some of the adverse GI effects. But guess what? If it were that simple, I wouldn’t bore you with it in this blog. In fact, we lack any prior decent-sized RCTs testing coated vs. plain (chewable) aspirin in patients with stable ASCVD. We’ve decided to tackle this challenge through a new clinical outcomes trial. Enrollment is complete for 3,000 participants, but we need more time for follow-up. Read more.

Clinical management of MI: A fresh look

The ACC/AHA guideline for management of MI came out last year, but I still found this new review to be a breath of fresh air for MI management. The figures are particularly helpful and the tables are also very readable. Read more. And if you’re interested in more MI news, read my recent editorial on the new Fifth Universal Definition of MI here.

Catheter-directed fibrinolysis for PE: A clear win? Unnecessary for most? Or a little bit of both?

Results of the PRAGUE-26 trial are now published. Findings of this trial of catheter-directed fibrinolysis are similar to those of ultrasound-facilitated fibrinolysis in HI-PEITHO, a reduction in composite outcome and deterioration, no significant increase in major bleeding, and no change in death. From a statistical perspective, it’s a clear win—though nearly 9 out of every 10 patients also did okay with anticoagulant monotherapy. Certainly good news, but I think we have more work to do!