This Week In Cardiology

ACC Recap #1: DanGer Shock (plus a sobering JAMA research letter on Impella use), REDUCE-AMI, PREVENT, and EMPACT-MI are the topics John Mandrola, MD, covers in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. DanGer-Shock Trial Impella CP Improves Survival in STEMI, Cardiogenic Shock https://www.medscape.com/viewarticle/impella-cp-improves-survival-stemi-cardiogenic-shock-2024a10006kz Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 Published DanGer Shock Study  https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 JAMA Research letter https://jamanetwork.com/journals/jama/article-abstract/2817457 II. REDUCE-AMI Trial New Data Question Beta-Blockers Post-MI With Preserved EF https://www.medscape.com/viewarticle/new-data-question-beta-blockers-post-mi-preserved-ef-2024a10006y8 Beta-Blockers Post-MI Past Their Expiration Date: REDUCE

Statins and diabetes, AAD in patients with heart disease, tricuspid valve interventions, and an ACC preview are the topics John Mandrola, MD, discusses in this week’s podcast.This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Statins and Diabetes Meta-analysis in Lancet-Diabetes https://doi.org/10.1016/S2213-8587(24)00040-8 Editorial https://doi.org/10.1016/S2213-8587(24)00059-7 NEJM Paper on Gene Variants and DM https://www.nejm.org/doi/full/10.1056/nejmoa1604304 JAMA Paper on Gene Variants and DM https://jamanetwork.com/journals/jama/fullarticle/2565289 II. Anti-arrhythmic Drugs in Patients With Serious Heart Disease UPenn Paper on AADs for PVC Suppression https://doi.org/10.1016/j.jacep.2024.01.021 Three Questions for Evidence-Based Cardiac EP https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 CAST trial https://www.nejm.org/doi/full/10.1056/NEJM199103213241201 III. Tricuspid Valve Interventio

Intermittent fasting, anticoagulation decisions, heterogenous treatment effects, frailty in HF, the importance of the ECG, and industry conflicts are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Intermittent Fasting No, Intermittent Fasting Won't Kill You https://www.medscape.com/viewarticle/1000544 NEJM Paper on Time-Restricted Eating  https://www.nejm.org/doi/full/10.1056/NEJMoa2114833 JAMA TREAT Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 II. Stroke Prevention with OAC Shah Meta analysis of Vitamin K Agonists in AF https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010269 III. Heterogenous Treatment Effects in Trials Pivotal CV Trials May Not Apply to Complex Patients https://www.medscape.com/viewarticle/989129 Analysis of 8 Trials of Multimorbidity and Treatment Response https://doi.org/10.1016/j.amjm

p>Obesity drugs as ASCVD-modifiers, HR monitors, when journals publish obvious facts, and effect scores and sorting out signals from RCTs are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Denmark Notes II. FDA approval of Semaglutide FDA Approves Semaglutide for Cardiovascular Risk Reduction https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix Select Trial III. PPG Monitor Accuracy Research Letter https://doi.org/10.1016/j.jacc.2024.01.024 IV. AAD and Bradycardia Anti-arrhythmic Drugs Linked to Bradycardia in Patients With AF https://www.medscape.com/viewarticle/anti-arrhythmic-drugs-linked-bradycardia-patients-af-2024a10004vw JACC paper on AAD Adverse Effects https://doi.org/10.1016/j.jacc.2024.01.013 V. Finding Signals in RCTs   JAMA paper on Treatment Effects of Oxygen Targets DANISH trial

Plastics and heart disease, MINT trial letters-to-the-editor and Bayes theorem, and Brugada syndrome are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Plastics and Heart Disease Plastic Particles in Carotid Plaques Linked to CV Events https://www.medscape.com/viewarticle/plastic-particles-carotid-plaques-linked-cv-events-2024a10004ge Plastics and ASCVD Study https://www.nejm.org/doi/full/10.1056/NEJMoa2309822 Review https://www.nejm.org/doi/full/10.1056/NEJMra2300476 Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2400683 II. MINT trial LTE and Bayes Theorem In MI With Anemia, Results May Favor Liberal Transfusion: MINT https://www.medscape.com/viewarticle/998376 The MINT Study https://www.nejm.org/doi/full/10.1056/NEJMoa2307983 Letter-to-the-Editor https://www.nejm.org/doi/full/10.1056/NEJMc2400982 Likelihood Ratio https://www.cebm.ox.ac.uk

The Western AF meeting, aspirin, cannabis use, LVEF in athletes, and shared decision making before ICD implantation are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. ASA in Primary Prevention Campbell Meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065420 Swedish Observational study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.028321 ASPREE https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 II. Cannabis Cannabis Use Tied to Increased Cardiovascular Risk https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr It Sure Looks Like Cannabis Is Bad for the Heart, Doesn’t It? https://www.medscape.com/viewarticle/1000250 Journal of the AHA Observational Study https://www.ahajournals.org/doi/full/10.1161/JAHA.123.030178 III. Low EF in Athletes Reduced Ejection Fraction in

Reading incidental CAC on chest CT scans, exercise benefits in women vs men, PCI with or without imaging, and trial non-reporting are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Incidental CAC on Chest CT Incidental CAC Tweet When Does a Calcium Score Equate to Secondary Prevention?: Insights From the Multinational CONFIRM Registry https://doi.org/10.1016/j.jcmg.2023.03.008 II. Exercise Health Gains of Exercise Greater in Women? https://www.medscape.com/viewarticle/health-gains-exercise-greater-women-2024a10003fv Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality III. PCI With or Without Imaging Intravascular Imaging in PCI: Time for a Guideline Update? https://www.medscape.com/viewarticle/995677  Meta-analysis paper Lancet https://doi.org/10.1016/S0140-6736(23)02454-6 Imaging uptake paper https:/

An update in trial interpretation, CI, and P-values; percutaneous tricuspid Interventions; and news on HDL and humility in Medicine are the topics John Mandrola, MD, covers in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Evidence of Absence Is not Absence of Evidence Feb 09, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1000101 ARCADIA Trial https://jamanetwork.com/journals/jama/fullarticle/2814933 FOURIER Trial https://www.nejm.org/doi/full/10.1056/nejmoa1615664 Sample Size Calculator https://clincalc.com/stats/samplesize.aspx II. Tricuspid Valve Interventions FDA OKs First Transcatheter Tricuspid Valve Replacement https://www.medscape.com/viewarticle/fda-oks-first-transcatheter-tricuspid-valve-replacement-2024a10002dq FDA Panel in Favor of TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-panel-favor-triclip-tricuspid-regurgitatio

Beta-blocker withdrawal in HFpEF, the ARCADIA trial, food as medicine, and bariatric surgery are the topics John Mandrola, MD, discusses in today’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. HFpEF and Heart Rate PRESERVE HF Substudy https://jamanetwork.com/journals/jamacardiology/fullarticle/2814596 PRESERVE HF Original https://doi.org/10.1016/j.jacc.2021.08.073 II. ARCADIA trial ARCADIA Main Paper: Apixaban vs ASA https://jamanetwork.com/journals/jama/fullarticle/2814933 KAMEL’s AF and Stroke Paper 10.1161/STROKEAHA.115.012004 AVERROES Substudy -- 10.1016/S1474-4422(12)70017-0 III. Food as Medicine Food-As-Medicine Trial results: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2812982 NPR Story https://www.npr.org/sections/thesalt/2017/05/08/526952657/fresh-food-by-prescription-this-health-care-firm-is-trimming-costs-and-waistline IV. Bariatric Surgery Weight Loss Surgery Yiel

FDA approves PFA for AF ablation, flawed comparisons of TEER vs MV surgery and PCI vs CABG, and cardiologists struggling with board exams are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. PFA FDA Okays Boston Scientific PFA System for Paroxysmal AF https://www.medscape.com/viewarticle/fda-okays-boston-scientific-pfa-system-paroxysmal-af-2024a1000275 Pulsed-Field Ablation for AF: The Promise and the Reality https://www.medscape.com/viewarticle/995675 ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 EU-PORIA Registry https://doi.org/10.1093/europace/euad185 Tomlinson/Mandrola Editorial https://www.jacc.org/doi/10.1016/j.jacc.2020.07.032 II. TEER vs MV Surgery EHJ Paper https://doi.org/10.1093/eurheartj/ehae046 III. ISCHEMIA Post-Hoc Studies JACC Post-Hoc ISCHEMIA Trialhttps://doi.org/10.1016/j.jacc.2023.11.002 Main ISCHEMIA paper htt

LAAO, more evidence that stable CAD is stable, CRT benefit over the long-term, and AF monitoring after stroke are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. LAAO This Week in Cardiology Podcast, Dec 15, 2023 https://www.medscape.com/viewarticle/999282 European Heart Journal paper https://academic.oup.com/eurheartj/article/45/3/214/7471675 LAAOS 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 II. CAD after Transcatheter Aortic Valve Implantation Cleveland Clinic Observational study https://doi.org/10.1093/eurheartj/ehae019 ACTIVATION trial  https://doi.org/10.1016/j.jcin.2021.06.041 III. Cardiac Resynchronization Therapy Original RAFT 2010 https://www.nejm.org/doi/full/10.1056/nejmoa1009540 Long-term RAFT  https://www.nejm.org/doi/full/10.1056/NEJMoa2304542 Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2312419 IV. AF Monitoring Afte

Listener feedback on antiplatelet therapy after PCI, bempedoic acid, off-Label PFO Closure, and palliative care are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback on Antiplatelet Therapy After PCI Long-term Clopidogrel Has Advantages After Coronary Stenting https://www.medscape.com/viewarticle/long-term-clopidogrel-has-advantages-after-coronary-stenting-2024a10000c8 Host Exam Study;  Extended FU of Host-Exam https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062770 II. Bempedoic Acid This Week in Cardiology July 7, 2023 https://www.medscape.com/viewarticle/994089 NEJM: Bempedoic Acid and CV Outcomes JAMA: Primary Prevention Analysis https://jamanetwork.com/journals/jama/fullarticle/2806646 JAMA-Cardiology: Total Events Analysis https://jamanetwork.com/journals/jamacardiology/fullarticle/2813647/ III. Off-Label PFO Cl

GLP-1s and BaroStim Neo revisited, a new drug for transthyretin amyloid CM, clopidogrel vs ASA years after PCI and stent, and statins are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. GLP-1s and Obesity, BaroStim Neo Revisited FDA Expands Label for CVRx Barostim System in HF https://www.medscape.com/viewarticle/fda-expands-label-cvrx-barostim-system-hf-2023a1000wsx JAMA Cardiology Special Communication – BDP https://jamanetwork.com/journals/jamacardiology/fullarticle/2810726 II. ATTR Cardiomyopathy ATTRibute-CM NEJM paper https://www.nejm.org/doi/full/10.1056/NEJMoa2305434 Circulation Review of TTR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.078915 ATTR-ACT (Tafadimis) https://www.nejm.org/doi/10.1056/NEJMoa1805689 III. Clopidogrel vs ASA Years After PCI Long-term Clopidogrel Has Advantages After Coronary Stenting https://www.medscape

Neuro-modulation in HF, private equity owned hospitals, HCM, SCD and ICD re-evaluated, and peer review are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Neuromodulation for HFrEF FDA Expands Label for CVRx Barostim System in HF https://www.medscape.com/viewarticle/fda-expands-label-cvrx-barostim-system-hf-2023a1000wsx BeAT HF trial https://doi.org/10.1016/j.jacc.2020.05.015 II. Private Equity Takeover of US Hospitals Hospital Adverse Events Rise After Private Equity Acquisition https://www.medscape.com/viewarticle/hospital-adverse-events-rise-after-private-equity-2023a1000wya Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition: https://jamanetwork.com/journals/jama/article-abstract/2813379 RSS audio: https://bi.medscape.com/pi/editorial/studio/audio/2024/core/999557.mp3 III. Hypertrophic Cardiomyopathy

FDA approves PFA, breakthrough in PAH, residual leaks after percutaneous LAAO, OAC in low to intermediate risk people are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. FDA Approves PFA FDA Approves First Pulsed Field Ablation System for AF https://www.medscape.com/viewarticle/fda-approves-first-pulsed-field-ablation-system-af-2023a1000vit - PULSED AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064329 - ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 - MANIFEST https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064959 II. Pulmonary HTN Positive Topline Data for Sotatercept in PAH: STELLAR https://www.medscape.com/viewarticle/982407 - STELLAR https://www.nejm.org/doi/10.1056/NEJMoa2213558 - Editorial on STELLAR https://www.nejm.org/doi/full/10.1056/NEJMe2300324 III. Peri-Device Leaks - Greek Meta-analysis https:/

Three aspects of the recent AF guideline documents and a possible new treatment of POTS are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I AF Guidelines ACC/AHA Issue Updated Atrial Fibrillation Guideline https://www.medscape.com/viewarticle/998956 - Guideline doc: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 - CASTLE AF https://www.nejm.org/doi/full/10.1056/nejmoa1707855 - Analysis of US Inpatient Sample https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-73 - RAFT AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057095 - Beta Blockers in AF https://pubmed.ncbi.nlm.nih.gov/25193873/ Section 2 AF Guidelines – EARLY Rhythm Control Gets Emphasis - STOP AF https://www.nejm.org/doi/full/10.1056/NEJMoa2029554 - EARLY AF https://www.nejm.org/doi/full/10.1056/nejmoa2029980 - EAST https://www.nejm.org/doi/fu

More from AHA including SGLT2 inhibitors, blood transfusion after MI; cracks in the armor of Factor XI inhibitors; and renal denervation are the topics John Mandrola, MD, covers in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. DAPA MI Potential Dapagliflozin Benefit Post-MI Is Not a 'Mandate' https://www.medscape.com/s/viewarticle/998378 - NEJM Evidence: Dapagliflozin After MI https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300286 II. Blood Transfusion Strategy Post MI In MI With Anemia, Results May Favor Liberal Transfusion: MINT https://www.medscape.com/viewarticle/998376 - MINT NEJM -- https://www.nejm.org/doi/full/10.1056/NEJMoa2307983 - REALITY https://jamanetwork.com/journals/jama/fullarticle/2776201 - PROTECTED TAVR - https://www.nejm.org/doi/full/10.1056/NEJMoa2204961 III. FACTOR XI Impressive Bleeding Profile With Factor XI Inhibitor in AF: AZALEA https://www.medscape.com/viewarti

An AHA Recap: SELECT, ORBITA2, and ARTESIA are the trials John Mandrola, MD, reviews in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic American Heart Association 2023 on theHeart.org | Medscape Cardiology https://www.medscape.com/viewcollection/37277 I. SELECT Trial Semaglutide 'A New Pathway' to CVD Risk Reduction: SELECT https://www.medscape.com/viewarticle/998373 Positive Results From SELECT Begins a New Era in Cardiology https://www.medscape.com/viewarticle/998217 Is It Time for Cardiologists to Treat Obesity? https://www.medscape.com/viewarticle/998391 - SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 - SUSTAIN 6 https://www.nejm.org/doi/full/10.1056/nejmoa1607141 II. ORBITA 2 Angioplasty Finally Proven Beneficial in Stable Angina: ORBITA-2 https://www.medscape.com/s/viewarticle/998375 ORBITA-2 Saves Interventional Cardiology and Challenges Current Guidance https://www.med

Renal denervation, a potential deadly decision in the ED, GLP-1 agonists, and an AHA preview are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Renal Denervation FDA OKs Paradise Renal Denervation System for Hypertension https://www.medscape.com/viewarticle/998237 - Company Press Release https://www.recormedical.com/recor-medical-and-otsuka-medical-devices-announce-first-fda-approved-renal-denervation-system-for-the-treatment-of-hypertension/ - Six-month Meta-analysis of RDN Studies https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.123.066941 - March This Week in Cardiology with RDN Discussion https://www.medscape.com/viewarticle/989014 II. Potential Deadly Decisions in the ED Even One Night in the ED Raises Risk for Death https://www.medscape.com/viewarticle/998080 - JAMA Internal Medicine Study III. Tirzepatide Approval FDA Approves Tirzepa

Tricuspid regurgitation therapy, two more left atrial appendage trials, and reflections on being too soft on medical science are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Tricuspid Regurgitation Trilogy TAVR Safe, Effective in Aortic Regurgitation https://www.medscape.com/viewarticle/997782 The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? https://www.medscape.com/viewarticle/989105 Transcatheter Tricuspid Valve Repair Effective, Safe for Regurgitation: TRILUMINATE https://www.medscape.com/s/viewarticle/989103 - TRILUMINATE NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 II. LAA Occlusion Different Strengths for LAA Closure Devices? https://www.medscape.com/viewarticle/962893 - Swiss Apero – Original paper https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057859 - Swiss Apero – One-year https://www.