Canadian VIGOUR Centre (CVC) is an academic research organization specializing in comprehensive full-service management of clinical trials of cardiovascular therapies, including study design, managing, monitoring, analyzing, and reporting trial results. Since inception in 1997, it has designed and delivered 72 clinical trials in CV medicine and surgery, including over 20,000 patients from Canada, and biosamples to match (>200,000 ECGs, >10,000 biosamples). In addition, large-scale datasets held by CVC represent six million people in Canada. Some of the ‘firsts’ and practice changing trials include time-to-treatment trials with fibrinolytics for myocardial infarction (establishing these as standard of care from first point of contact through to the hospital), the largest mega-trial in acute heart failure, the pivotal trial in a biomarker-guided strategy in heart failure, lipid lowering therapy trials with statins, ezetimibe, and PCSk9 inhibitors, and the largest trial in dietary sodium restriction in heart failure.