Acute coronary syndromes include heart attacks and unstable angina — sudden blockages in the arteries that feed the heart. Treatment has advanced dramatically, with stents, clot-busting drugs, and rapid-response teams now standard in most hospitals. Research is focused on preventing a second event, limiting heart damage, and catching problems before they turn critical.
What's actually going on in research
Trials are testing PCSK9 inhibitors and other cholesterol-lowering drugs to prevent repeat heart attacks, anti-inflammatory drugs like colchicine and canakinumab that target heart disease differently than statins, glucose-lowering drugs that also protect the heart, and new antiplatelet combinations that balance clotting prevention with bleeding risk. Researchers are also studying ways to detect unstable plaques before they rupture.
Anti-inflammatory therapy
Colchicine, an old gout drug, reduces repeat heart attacks when added to standard treatment. Researchers are testing other inflammation-blocking drugs to see if calming immune activity in artery walls prevents future events.
Advanced lipid lowering
PCSK9 inhibitors and inclisiran can drive LDL cholesterol far below what statins achieve. Studies are testing whether pushing cholesterol this low after a heart attack prevents second events better than current targets.
Cardioprotective metabolic drugs
SGLT2 inhibitors and GLP-1 receptor agonists, originally diabetes drugs, reduce heart attacks and heart failure. Trials are testing them in people without diabetes who've had acute coronary events.
What to know before you search
Eligibility typically depends on the type of acute event, time since the event, cholesterol levels, kidney function, and current medications including antiplatelet drugs.
What types of trials are currently open
- Prevention trials — Testing drugs or lifestyle interventions to prevent a second heart attack in people who've already had one acute event.
- Antiplatelet trials — Comparing combinations of drugs that prevent blood clots, looking for the best balance between preventing blockages and avoiding serious bleeding.
- Lipid-lowering trials — Testing aggressive cholesterol reduction with PCSK9 inhibitors, bempedoic acid, or other drugs added to statins.
- Imaging studies — Using advanced CT or ultrasound to identify unstable plaques before they cause heart attacks, then testing early interventions.
- Cardiac protection trials — Testing drugs or procedures given during or immediately after a heart attack to limit muscle damage and preserve heart function.
Recently added Acute Coronary Syndromes trials
Common Femoral Vein-to-Artery Diameter Ratio for Detection of Elevated LVEDP
This prospective cross-sectional diagnostic accuracy study enrolled patients undergoing coronary angiography and left heart catheterization at Burapha University Hospital, Thailand. The diameters of the common femoral vein and common femoral artery were measured using ultrasonography, and the common FVD/FAD ratio was calculated. LVEDP, measured during left heart catheterization, served as the reference standard. An elevated LVEDP (\>16 mmHg) was defined as volume overload. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.
Take a daily aspirin dose after receiving a heart stent
This is a randomized, open-label, active-controlled, non-inferiority clinical trial (the ASPIRE-LD trial) conducted in China. It aims to compare the efficacy and safety of low-dose aspirin (50 mg once daily) versus standard-dose aspirin (100 mg once daily), both in combination with a P2Y12 inhibitor, in patients who have successfully undergone percutaneous coronary intervention (PCI) and plan to receive at least 12 months of dual antiplatelet therapy (DAPT). A total of 2640 eligible patients will be randomly assigned in a 1:1 ratio to receive either 50 mg or 100 mg of enteric-coated aspirin daily, plus a P2Y12 inhibitor (ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily, prescribed according to routine clinical practice). All participants will be followed for 12 months after randomization. The primary goal is to verify that 50 mg aspirin is non-inferior to the 100 mg standard dose in preventing major adverse cardiac and cerebrovascular events (MACCE: cardiovascular death, non-fatal myocardial infarction, definite/probable stent thrombosis, and ischemic stroke) at 12 months post-PCI. If non-inferiority is confirmed, the study will further test whether 50 mg aspirin reduces clinically relevant bleeding events (BARC type 2, 3, or 5) better than the standard dose. The study is sponsored by the First Hospital of Jilin University and will be carried out in 10-15 tertiary hospitals across China. Its findings will provide evidence for optimizing aspirin dosing in post-PCI DAPT.
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