This Week In Cardiology

More from ESC: the SCOFF trial and fasting before cardiac cath, MATTERHORN, humbling data with AI, plus a reflection on the work of being a patient 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. Fasting Before Cardiac Procedures The SCOFF Trial https://doi.org/10.1093/eurheartj/ehae573 II. MV repair for Functional MR Large Trials Support Mitral Valve Repair in Heart Failure MATTERHORN https://www.nejm.org/doi/full/10.1056/NEJMoa2408739 III. AI in Medicine Rapidx AI Project https://healthtranslationsa.org.au/project/rapid-x-ai/ PROTEUS Trial Rationale paper https://pubmed.ncbi.nlm.nih.gov/37192698/ IV. Time Toxicity Time Toxicity https://link.springer.com/article/10.1007/s00520-024-08844-1 Thread X https://x.com/EnriqueSoto8/status/1833587144256065859 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medici

Feedback on ABYSS and beta-blockers, more ESC recap, including SHAM-PVI, FINEARTS-HF, and RESHAPE HF2 trials 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. Feedback on ABYSS Setbacks After Stopping Beta-Blockers https://www.medscape.com/viewarticle/setbacks-after-stopping-beta-blockers-2024a1000fv7 Beta-Blockers Post-MI? No for Me, Even After the ABYSS Trial https://www.medscape.com/viewarticle/beta-blockers-post-mi-no-me-even-after-abyss-trial-2024a1000fva ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 QOL paper REDUCE AMI https://doi.org/10.1093/ehjcvp/pvae062 Atenolol ED paper 10.1016/j.ehj.2003.08.016 II. SHAM-PVI JAMA SHAM-PVI paper https://jamanetwork.com/journals/jama/article-abstract/2823283 Gupta QOL paper https://pubmed.ncbi.nlm.nih.gov/33952593/ III. FINEA

From ESC: post-MI beta blockers, a new therapy for ATTR-CM, holding RASi before non-cardiac surgery, good news in HFpEF, and an ESC preview 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. ABYSS ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 II. ATTR -CM HELIOS B Positive Top Line Results for Vutrisiran in Cardiac Amyloidosis https://www.medscape.com/viewarticle/positive-top-line-results-vutrisiran-cardiac-amyloidosis-2024a1000cjj HELIOS A https://www.tandfonline.com/doi/full/10.1080/13506129.2022.2091985 HELIOS B https://www.nejm.org/doi/full/10.1056/NEJMoa2409134 III. STOP or NOT Trial Observational Study Showing Benefits of Holding RASi https://doi.org/10.1097/ALN.0000000000001404 STOP or NOT Protocol Paper -- https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-

Suicidal ideation and GLP-1 agonists, a repeat of PARADIGM HF in Chagas CM, CASTLE HTx critical appraisal, and primary prevention of SCD in HF 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. Suicidal ideation with GLP-1 Signal of Suicidality With GLP-1 RA Semaglutide, but Experts Urge Caution https://www.medscape.com/viewarticle/signal-suicidality-glp-1-ra-semaglutide-experts-urge-caution-2024a1000fa7 Disproportionality Analysis from World Health Organization Data on Semaglutide, Liraglutide, and Suicidality   Variability in Disproportionality paper https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.668765/full II. PARACHUTE HF: Repeating the Mistakes in PARADIGM HF PARACHUTE HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 SOLVD https://www.nejm.org/doi/full/10.1056/NEJM199108013250501 CONSENSUS trial https://www.nejm.org/doi/

Diuretic therapy in HFrEF, AF ablation, TACT 2 and the story of subgroups, and SGLT2 inhibitor underuse 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. Diuretic Therapy in HF Dapa vs Metolazone Trial https://doi.org/10.1093/eurheartj/ehad341 ADVOR https://www.nejm.org/doi/10.1056/NEJMoa2203094 II. Rapid Medication Titration for Acute HF ACC Decision Pathway https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002 III. SGLT2 Inhibitor Use in the US Shin and Colleagues; JACC  https://www.sciencedirect.com/science/article/abs/pii/S0735109724076332 Editorial  https://doi.org/10.1016/j.jacc.2024.07.001 IV. AF Ablation: General Anesthesia vs Conscious Sedation Da Riis-Vestergaard and Colleagues  https://doi.org/10.1093/europace/euae203 V. TACT 2 Published TACT 1 https://jamanetwork.com/journals/jama/fullarticle/1672238 TACT 1 DM https://www.ahajourna

Prediction models vs clinical judgement, CCTA quantification of atherosclerosis, AF ablation plus LAAO, atrial shunt devices, and HF medical therapy are 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.Clinical Prediction Models vs Clinical Judgement Did Statin Decision-Making Just Get Harder?  https://www.medscape.com/viewarticle/did-statin-decision-making-just-get-harder-2024a1000egl Colunga-Lozano and colleagues https://doi.org/10.1016/j.jclinepi.2023.10.016 Aug 02, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001429 II. CCTA Quantification of Atherosclerosis Atherosclerosis Quantification and Cardiovascular Risk: the ISCHEMIA Trial https://doi.org/10.1093/eurheartj/ehae471 Circulation ISCHEMIA sub study 2021 – Severity of CAD and Outcomes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049755 ISCHEMIA Trial https://www.nejm

Two downsides of PFA including autonomic tone and hemolysis, a bad surrogate in AF care, and controversies in defining cardiac risk 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 and Its (lack of) Effect on Autonomic Tone Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed? https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v Autonomic Tone Paper https://doi.org/10.1016/j.jacep.2024.05.005 ADVENT https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 II. Second PFA Study JACC-EP—on Hemolysis   Hemolysis study https://doi.org/10.1016/j.jacep.2024.05.001 MANIFEST 17K https://www.nature.com/articles/s41591-024-03114-3 Defaye Editorial https://www.jacc.org/doi/abs/10.1016/j.jacep.2024.06.007 III. A Self-serving Surrogate Marker:  Diagnosis to Ablation Time. CAPLA Study

Health and income, high BP in the hospital, and more on subclinical AF and when to use anticoagulants 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. Health and Income  A Cash Giveaway to Improve Health https://www.medscape.com/viewarticle/cash-giveaway-improve-health-2024a1000dhf?form=fpf JAMA RCT https://jamanetwork.com/journals/jama/fullarticle/2821454 NBER RCT https://www.nber.org/papers/w32711 Have We Missed the Hidden Cause of Medical Overuse? https://www.medscape.com/viewarticle/908309 Mar 17, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/989775 Other References  Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120 Rand Link https://www.rand.org/pubs

Vulnerable plaque and scientific method; industry payments to trainees; tirzepatide or semaglutide; trial interpretation; and PFA are the topics John Mandrola, MD, covers 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. Non-invasive Imaging for Vulnerable Plaque   PET Imaging Finds Vulnerable Plaques That Cause MI https://www.medscape.com/viewarticle/pet-imaging-finds-vulnerable-plaques-cause-mi-2024a1000cm2 JACC paper https://doi.org/10.1016/j.jacc.2024.03.419 Original JAMA-Card paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2806690 II. Industry Payments to Fellows JAMA Network Letter https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821267 III. GLP-1a Class Effect? Semaglutide Significantly Improves Chronic Kidney Disease https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9 Mounjaro Beats Ozemp

Venous closure devices, GLP1-s linked to blindness and cancer, resisting the urge to do an ECG, and transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation are the topics discussed 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 Listener Feedback Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study https://doi.org/10.1093/europace/euae105 II GLP1-s and Blindness Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255 Locke Twitter  https://x.com/doc_BLocke/status/1808972226655629610 When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808 III GLP1-s and Cancer Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients W

Screening echo, multivitamins, wasteful research, another PA sensor for HF, vascular closure devices, and GLP-1 marketing as science research are the topics John Mandrola, MD, discusses 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. Screening for Valvular HD in the Elderly EHJ-CV Imaging Paper https://doi.org/10.1093/ehjci/jeae127 II. Vitamins and Wasteful Research Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat   https:// www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv May 10, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1000772 Multivitamin Paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820369 Physicians Health Study II https://jamanetwork.com/journals/jama/fullarticle/1389615 III. FDA Has Approved Another PA Sensor Link to slides https://c212.net/c/link/?t=0&l=en&o=4

MRAs in HF with renal dysfunction, coronary autoregulation, the hubris of US doctors, NSTEMI in older patients, survival after STEMI, and new leaders at JACC are discussed by John Mandrola, MD. 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 Combined analysis (Matsumoto) II Coronary artery autoregulation with increasing stenosis NEJM Paper https://www.nejm.org/doi/full/10.1056/NEJMc2402216 III RECOVER IV Trial Gregg Stone, MD Tweet https://x.com/GreggWStone/status/1803583552354742416 DANGER-Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 IV NSTEMI Elderly Main Paper Datamethods https://discourse.datamethods.org/t/random-vs-fixed-effects-meta-analysis/7361 O’Fee Paper https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560 V MI Survival Danish Pap

Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF 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 ASPIRE AF https://classic.clinicaltrials.gov/ct2/show/NCT03968393 Butala paper: Stroke After TAVR With and Without EPD https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697 PROTECTED TAVR Heuts meta-analysis: EPD During TAVR https://heart.bmj.com/content/110/11/757 II. Statin Eligibility JAMA-IM: Data Analytic Choices and Predicting Vascular Events https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819821 Zeraatker Specification Analysis Paper https://doi.org/10.1016/j.jclinepi.2024.111278 PCE https://www.mdcalc.com/calc/3398/ascvd-atherosclerotic-cardiovascular-disease-2013-risk-calculator-aha-acc III. Heterogenous Tr

Cannabis and CV outcomes, post-CABG AF, embolic protection devices, emulation of randomization, and a preview heterogenous treatment effects 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. Cannabis It Sure Looks Like Cannabis Is Bad for the Heart, Doesn't It? https://www.medscape.com/viewarticle/1000250 Cannabis Use Tied to Increased Cardiovascular Risk https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk-2024a10000sc Cannabis for Chronic Pain and CV Safety https://doi.org/10.1093/eurheartj/ehad834 Editorial  https://academic.oup.com/eurheartj/article/45/6/485/7500073 Response to Letter  https://doi.org/10.1093/eurheartj/ehae314 UCLA paper https://jamanetwork.com/journals/

The FLOW trial of semaglutide, the DANCAVAS CV screening trial, non-invasive tests for chest pain, and conflicts of interest on social media are the topics John Mandrola, MD, discusses 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. Semaglutide for CKD Semaglutide Significantly Improves Chronic Kidney Disease https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9 FLOW Trial II. CV Screening Judicious CVD Screening May Work in Men: DANCAVAS https://www.medscape.com/viewarticle/980153 DANCAVAS 6-Year Outcomes https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004403 DANCAVAS Main Trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 III. Non-invasive Cardiac Testing in Chest Pain Circulation Outcomes Paper https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010457 Scot Heart https://www.nejm.org/doi/full/10.10

Clues in SCAF, a DOAC antidote trial, another negative lytic trial in stroke, JAMA changes to observational studies, and BP in stroke care 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. ARTESIA Substudy Sadly, ARTESIA Doesn't Answer a Common Question in Cardiology  https://www.medscape.com/viewarticle/998215 ARTESIA Substudy NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 ARTESIA https://www.nejm.org/doi/10.1056/NEJMoa2310234 II. DOAC Reversal ANNEXA-1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2313040 III. Lytic Therapy in Acute Stroke Thrombolysis Offers No Benefit for Mild Stroke https://www.medscape.com/viewarticle/iv-thrombolysis-offers-no-benefit-mild-stroke-2024a10009p7 TEMPO-2 Trial https://doi.org/10.1016/S0140-6736(24)00921-8 The Case Against Thrombolytic Therapy in Stroke IV. Observational Research JAMA Special Comm

An Impella update, another TAVI vs SAVR trial, two studies on angina and PCI, another null substudy from REVIVED-BCIS, and semaglutide 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. Impella Update CHRIP BCIS 3 https://classic.clinicaltrials.gov/ct2/show/NCT05003817 Danger-Shock Podcast https://www.medscape.com/viewarticle/1000675 II. TAVI vs SAVR Notion 2 Trial EHJ https://doi.org/10.1093/eurheartj/ehae331 DEDICATE-DZHK6 III. Angina and PCI Orbita 2 Sub-analysis Orbita Star https://www.jacc.org/doi/10.1016/j.jacc.2024.04.001 IV. Complete Revascularization Main REVIVED trial https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 JACC Substudy https://www.jacc.org/doi/10.1016/j.jacc.2024.04.043 V. Semaglutide Semaglutide CV Benefits Irrespective of Weight Loss: 4-Year SELECT Data https://www.medscape.com/viewarticle/semaglutide-cv-benefits-irresp

Inclisiran, sodium-channel blocker safety, analytic flexibility, the work-up of patients with HF, and BP in older patients 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. Inclisiran Update ORION 4 https://classic.clinicaltrials.gov/ct2/show/NCT03705234 II. Sodium-Channel AADs UPenn Paper https://doi.org/10.1016/j.jacep.2024.01.021 Three Questions Editorial https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 EAST Post-hoc Review https://doi.org/10.1093/europace/euae121 III. Analytic Flexibility   Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https://www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv Specification Curve Analysis of Red Meat Data https://doi.org/10.1016/j.jclinepi.2024.111278 IV. The Work-up of Patients With HF Durstenfeld and colleagues, UCSF

The DEDICATE trial of TAVR vs SAVR, more on renal denervation, inclisiran, and marketing disguised as science 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. TAVR vs SAVR TAVI Comparable With SAVR in Lower-Risk Aortic Stenosis https://www.medscape.com/viewarticle/tavi-comparable-savr-lower-risk-aortic-stenosis-2024a100074o?form=fpf DEDICATE https://www.nejm.org/doi/full/10.1056/NEJMoa2400685 Partner 3 https://www.nejm.org/doi/full/10.1056/NEJMoa1814052 Evolut Low Risk https://www.nejm.org/doi/full/10.1056/NEJMoa1816885 Barili meta-analysis https://doi.org/10.1093/ejcts/ezab516 II. Renal Denervation Alcohol-Mediated Renal Denervation Promising in Hypertension https://www.medscape.com/viewarticle/alcohol-mediated-renal-denervation-promising-hypertension-2024a10007eg TARGET 1 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.069291 III. Inc

A listener defends colored boxes in guidelines; mysteries of non-culprit coronary lesions during PCI, and of AF ablation; and surrogate markers 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. Mystery of What to Do in the Cath Lab after Fixing the Culprit Lesion – The FULL REVASC Trial Complete Revascularization Not Superior to Culprit-Only PCI After MI https://www.medscape.com/viewarticle/complete-revascularization-not-superior-culprit-only-pci-2024a10007ik FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149 FIRE Trial https://www.nejm.org/doi/10.1056/NEJMoa2300468 COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 Cohen Tweet on FULL REVASC https://x.com/djc795/status/1781361606238085532 II. AF Ablation Mysteries New Expert Consensus on Ablation Strategies for AF https://www.medscape.com/viewarticle/new-expert-co