Acute coronary syndromes (ACS) are sudden, life-threatening events where blood flow to the heart muscle is severely reduced — including heart attacks (STEMI and NSTEMI) and unstable angina. Treatment in the first hours determines how much heart muscle survives, and research is rapidly refining what works best for which patients.
What's actually going on in research
Researchers are testing whether shorter or single-drug blood-thinner regimens after a heart attack maintain protection while reducing bleeding risk. New approaches to reopening blocked arteries — including better stents, different imaging during the procedure, and faster transport-to-treatment systems — are being compared head-to-head. Studies are also testing how to identify high-risk patients earlier using genetics, blood markers, and AI-assisted ECG reading.
Smarter blood thinners
After a heart attack, patients typically take two blood thinners for 12 months. Recent trials are testing whether 1-3 months on dual therapy followed by a single drug works just as well — preventing repeat events while cutting bleeding complications. Several Phase 3 studies of this approach have results expected over the next 1-2 years.
P2Y12 monotherapy
A specific class of blood thinners called P2Y12 inhibitors (including ticagrelor and prasugrel) is being tested alone — without aspirin — in selected patients after stenting. Early results suggest the bleeding-reduction benefit may outweigh the slight increase in clotting risk for the right patients.
AI-assisted ECG diagnosis
Algorithms that read ECGs faster and catch subtle patterns missed by human review are being tested in emergency departments and ambulances. The goal is to identify the most dangerous heart attacks (STEMI) within minutes, reducing the time between symptoms and the procedure that reopens the artery.
What to know before you search
Eligibility typically depends on the type of event (STEMI, NSTEMI, or unstable angina), how much time has passed since symptom onset, prior medications, and whether you have had a stenting procedure or bypass surgery.
What types of trials are currently open
- Treatment trials — Testing new drugs or drug combinations in people after a heart attack or unstable angina to see if they prevent repeat events or reduce bleeding.
- Procedure trials — Comparing different stent types, imaging techniques during catheterization, and approaches to reopening blocked arteries.
- Diagnostic trials — Testing faster ways to identify heart attacks in the emergency department or ambulance, including AI-assisted ECG reading and blood-marker tests.
- Prevention trials — In people who have already had a heart attack, testing strategies and medications to prevent the next event.
- Supportive care trials — Testing cardiac rehabilitation programs, home monitoring, and recovery support after a hospital discharge.
Recently added Acute Coronary Syndromes trials
Feasibility Study of a Digital Interactive Life-style Platform for Individuals After Rehabilitation
The goal of this clinical trial is to evaluate the feasibility and usability of a digital lifestyle platform designed to support patients after discharge from inpatient rehabilitation. It will also assess patient engagement and the potential of the platform to support long-term self-management and healthy lifestyle behaviors in an outpatient setting. The main questions it aims to answer are: Is the platform feasible and acceptable for patients after rehabilitation? Do patients engage with and regularly use the platform over time? Can personalized digital recommendations support adherence to healthy behaviors and self-management? Researchers will evaluate a telemedicine platform that delivers individualized suggestions, including lifestyle applications, educational content, and advice from healthcare professionals. The content is tailored to patient needs and continuously adapted based on patient feedback. Participants will: Use the digital platform after discharge from inpatient rehabilitation for a defined follow-up period Receive personalized recommendations through the platform Rate the usefulness of recommendations to enable continuous adaptation Attend study visits or remote assessments to evaluate usability, engagement, and outcomes Continue standard outpatient care alongside the intervention
Single vs. Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Intervention With DCB-only Strategy (KONG-FREEDOM-I)
This investigator-initiated, multicenter, open-label, randomized clinical trial evaluates the safety and efficacy of single antiplatelet therapy (SAPT) utilizing a P2Y12 inhibitor compared to dual antiplatelet therapy (DAPT) in the chronic coronary syndrome (CCS) and stable Acute Coronary Syndrome (S-ACS) patients undergoing percutaneous coronary intervention (PCI) with the latest generation rapamycin drug-coated balloon (DCB) without stent implantation. The study aims to assess rates of ischemic and bleeding adverse events.
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