In other words, large mega-trials like DECLARE-TIMI are very valuable, but parallel smaller mechanistic studies like this can enhance their value by helping to explain the mechanisms producing the mega-trial results and/or helping to identify a subgroup who get a particular benefit meaning that the drug becomes more cost effective in that subgroup. Overall, this trial might, in conjunction with a mega-trial, help decide the course of future research (should LVH be a favoured target?) and help decide how to apply the results of a mega-trial in clinical practice.