Two large studies out of the Republic of Korea presented at TCT 2026 and published in JACC: Asia point to persistent gaps between evidence and real-world cardiovascular care, from the treatment of acute MI in patients with cancer to the use of guideline-recommended antiplatelet strategies after PCI.

In one study, a higher risk of cardiovascular death but a lower risk of acute myocardial infarction (MI) was observed among patients with cancer compared with the general population. Additionally, revascularization in patients with cancer who developed MI was associated with a lower risk of cardiovascular death than medical treatment alone.

Researchers analyzed data from approximately 682,000 patients newly diagnosed with cancer from 2016 to 2018 and a similar number of propensity score-matched individuals without cancer. The primary outcome was cardiovascular death.

Over an average follow-up period of six years, the incidence rates of cardiovascular death were 1,692.4 per 100,000 person years in patients with cancer and 796.3 in those without. The incidence rates of MI were 156.5 per 100,000 person-years, respectively.

Patients with pancreatic, hepatic, lung and hematologic cancer types had the greatest risk of cardiovascular death, while those with lung cancer and hematologic malignancy were at the highest risk of acute MI. Revascularization compared with medical treatment alone was tied to fewer incidences of cardiovascular death among those patients with cancer who developed MI.

“These findings indicate a possible health care disparity that acute MI in patients with cancer is systematically underdiagnosed and undertreated in routine clinical practice,” said Seung Hun Lee, MD, PhD, FACC, et al.

In another study, Keehwan Lee, MD, et al., analyzed antiplatelet strategies and DAPT-duration trends among more than 258,000 patients undergoing PCI between 2014 and 2021.

Overall results found that while antiplatelet strategies evolved over time, real-world, widespread adoption of guideline-recommended strategies was lacking. In addition, while the one-year cumulative incidence of major bleeding declined from 2014 to 2021, the rates of major adverse cardiovascular events were less uniform and varied according to clinical presentation and bleeding risk.

“Taken together, these findings provide a nationwide overview of evolving antiplatelet treatment patterns after PCI, characterized by a shift from extended toward standard-duration DAPT, modest expansion of other bleeding-avoidance strategies, and heterogeneous clinical outcome trends,” said Lee, et al.

Read all the simultaneously published research at the JACC Journals’ TCT 2026 Event Page. Visit ACC’s TCT 2026 Meeting Coverage to explore the late-breaking clinical trials and more.

Clinical Topics: Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention

Keywords: Transcatheter Cardiovascular Therapeutics, TCT26, Lung Neoplasms, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Myocardial Infarction, Hematologic Neoplasms