This Week In Cardiology

The loop diuretic duels, adverse events during hospital admissions, BP accuracy, and, again, left main revascularization strategies (again) are the topics John Mandrola 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. TRANSFORM HF Clarity on Torsemide vs Furosemide in HF: TRANSFORM-HF Published https://www.medscape.com/viewarticle/987128 • Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure https://jamanetwork.com/journals/jama/fullarticle/2800428 • RANSFORM-HF—Can We Close the Loop on Diuretics in Heart Failure? https://jamanetwork.com/journals/jama/fullarticle/2800445 II. Adverse Events in the Hospital Adverse Events Reported in One Quarter of Inpatient Admissions https://www.medscape.com/viewarticle/987091 • The Safety of Inpatient Health Care https://www.nejm.org/doi/full/10.1056/NEJMsa2206117 III. BP Accuracy Expe

FOURIER authors’ response, a possible practice-changing paper in electrophysiology, and the ATLAS and CAPLA trials 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. FOURIER Authors Respond Recount of FOURIER Data Finds Higher Mortality With Evolocumab; Trialists Push Back https://www.medscape.com/viewarticle/986634 Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data https://bmjopen.bmj.com/content/12/12/e060172 Letter to the Editor RE: "Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data". BMJ Open https://bmjopen.bmj.com/content/12/12/e060172.responses#letter-to-the-editor-re-restoring-mortality-data-in-the-fourier-cardiovascular-

Damar Hamlin, obesity and semaglutide, Open Data and PCSK9 inhibitors, and TAVI vs SAVR trials 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. Damar Hamlin Five Thoughts on the Damar Hamlin Collapse https://www.medscape.com/viewarticle/986550 II. Semaglutide and Obesity in Adolescents FDA Approves Wegovy (Semaglutide) for Obesity in Teens 12 and Up https://www.medscape.com/viewarticle/986403 • Once-Weekly Semaglutide in Adolescents with Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2208601 III. Open Data and PCSK9 inhibitors Evolocumab Added to Statins Cuts CV Events in FOURIER Trial https://www.medscape.com/viewarticle/877348 • Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data https://bmjopen.bmj.com/content/12/12/e060172 • Evolo

The top ten stories of the year plus a few honorary mentions. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Annual Wrap Ups on Medscape - Mandrola’s Top 10 Cardiology Stories of 2022 https://www.medscape.com/viewarticle/985607 - 2022 in Review Through a Cardiology Lens https://www.medscape.com/viewarticle/984505 - Top Cardiology Trials of 2022 https://www.medscape.com/viewarticle/985647 II REVIVED BCIS2 - Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/nejmoa2206606 - PCI Fails in Stable Disease Again: REVIVED-BCIS https://www.medscape.com/viewarticle/979862 - PCI Fails to Beat OMT in Ischemic Cardiomyopathy: REVIVED-BCIS2 https://www.medscape.com/viewarticle/979853 III GUIDE HF - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - CardioMEMS Remote HF Monitoring: Res

BP control over the long term, omecamtiv mecarbil, incentives and Goodhart’s law, and open science 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. Long-Term BP Control - Final SPRINT Data Confirm Lower BP Is Better https://www.medscape.com/viewarticle/951572 - Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control https://jamanetwork.com/journals/jamacardiology/fullarticle/2797064 - Let's Not SPRINT to Judgment About New Blood Pressure Goals https://www.acpjournals.org/doi/full/10.7326/M15-3123 - Should We SPRINT Toward New Blood Pressure Goals or Let the Dust Settle? https://doi.org/10.1016/j.amjmed.2016.04.022 II. Omecamtiv Mecarbil - FDA Panel Votes No on Omecamtiv Mecarbil for Heart Failure https://www.medscape.com/viewarticle/985593 - Omecamtiv Mecarbil Fails to Improve Exercise Capacity in HFrEF https://www.meds

Nudges, statins, AI, less-is-more in the ICU, myocarditis, exercise as medicine, and December in the hospital 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. Nudges and Statin Prescribing EHR Alerts to Both Doc and Patient May Boost Statin Prescribing https://www.medscape.com/viewarticle/984944 Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing https://jamanetwork.com/journals/jamacardiology/article-abstract/2798971 Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia https://jamanetwork.com/journals/jama/fullarticle/2719307 Lack of Efficacy of a Salience Nudge for Substituting Selection of Lower-Calorie for Higher-Calorie Milk in the Work Place https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488787/

SGLT2 inhibitors, publishing choices, second and third order effects of interventions, decision support, and patient selection for preventive procedures 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. EMPA Kidney - EMPA-Kidney Seals SGLT2 Inhibitors as 'Foundational' for CKD https://www.medscape.com/viewarticle/984439 - EMPA-Kidney Moves the Needle for SGLT2 Inhibitors in Kidney Disease https://www.medscape.com/viewarticle/983521 - Empagliflozin in Patients with Chronic Kidney Disease https://www.nejm.org/doi/pdf/10.1056/NEJMoa2204233 - Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy https://www.nejm.org/doi/10.1056/NEJMoa1811744 - Dapagliflozin in Patients with Chronic Kidney Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2024816 - Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney ou

AHA 2022, Part 2: IRONMAN, ECMO-CS, CTS-AMI, and PROGRESSIVE AF 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 I. Pushback on PROMINENT Zimerman Thread: https://twitter.com/AndreZimerman/status/1593019800036708353 II. IRONMAN IRONMAN Galvanizes Case for IV Iron Repletion in Heart Failure https://www.medscape.com/viewarticle/984030 Is Iron Replacement in Heart Failure Worth the Trouble? https://www.medscape.com/viewarticle/983622 - Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial https://doi.org/10.1016/S0140-6736(22)02083-9 III. ECMO-CS Avoid Routine Early ECMO in Severe Cardiogenic Shock: ECMO-CS https://www.medscape.com/viewarticle/983618 - Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shoc

AHA 2022 Part 1: ISCHEMIA-EXTEND, STRONG-HF, chlorthalidone vs HCTZ, experts vs practitioners; torsemide vs furosemide; and TG lowering are discussed by John Mandrola, MD, 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. AHA Meta-comments II. ISCHEMIA-Extended - ISCHEMIA-EXTEND: Conservative Stable CAD Management Holds Up https://www.medscape.com/viewarticle/983657 - Survival After Invasive or Conservative Management of Stable Coronary Disease https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062714 III. STRONG-HF - Rapidly, Fully Optimize HF Meds After Hospital Discharge: STRONG-HF https://www.medscape.com/viewarticle/983870 - STRONG HF: More Beats Less After Discharge for Heart Failure https://www.medscape.com/viewarticle/983698 - Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-labe

AF conversion in the ED, HRT, a shining example of evidence-based medicine and less-is-more, multimorbidity, and what’s coming at AHA 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. AF Conversion - IV Potassium and Magnesium an Acute Treatment for AF? https://www.medscape.com/viewarticle/983137 - Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797474 II. HRT - USPSTF Doesn't Change Postmenopausal Hormone Recommendations https://www.medscape.com/viewarticle/983349 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://doi.org/10.7326/0003-4819-117-12-1016 - Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Resu

ERASE AF follow-up, recreational drugs and AF, etripamil, misuse of science, and diabetes as a cardiovascular risk factor 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. Follow-up on ERASE AF II. Recreational Drugs Four Commonly Abused Drugs Linked With Atrial Fibrillation https://www.medscape.com/viewarticle/983052 III. Etripamil RAPID: Positive Data for Etripamil Nasal Spray in Paroxysmal SVT https://www.medscape.com/viewarticle/982787 - Milestone Pharmaceuticals Announces Positive Results from Phase 3 RAPID Clinical Trial of Etripamil Nasal Spray in Patients with Paroxysmal Supraventricular Tachycardia https://investors.milestonepharma.com/news-releases/news-release-details/milestone-pharmaceuticals-announces-positive-results-phase-3 IV. Misuse of Science When Bad Actors Hijack Good Research https://www.medscape.com/viewarticle/982936 - Level an

The ERASE AF ablation trial, left bundle pacing, finerenone, and perceptions of cardiology 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 Ablation - Low-Voltage Myocardium-Guided Ablation Trial of Persistent Atrial Fibrillation https://evidence.nejm.org/doi/10.1056/EVIDoa2200141 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 - Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2793452 - Circumferential Pulmonary Vein Isolation Plus Low-Voltage Area Modification in Persistent Atrial Fibrillation: The STABLE-SR-II Trial https://www.jacc.org/doi/full/10.1016/j.jacep.2022.03.012 - Effect of Catheter Ablation With Vein of Marsh

Chest pain evaluation in the ED, peer review, the NordICC trial, and a surgeon lost too early 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. Chest Pain Consensus Pathway - ACC Issues Guidance on ED Evaluation of Acute Chest Pain https://www.medscape.com/viewarticle/982302 - 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2022.08.750 - 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001030#d20522356e1 II. Peer Revie

Post-PCI antiplatelet therapy, palliative care in patients with HF, Watchman information on hospital websites, and HCM in athletes 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. Post-Stent Antiplatelet Therapy SMART-CHOICE 3-Year Results Support Dropping Aspirin After PCI https://www.medscape.com/viewarticle/981741 Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention https://jamanetwork.com/journals/jamacardiology/fullarticle/2796902 The Smart(est) Choice for Dual Antiplatelet Therapy is a Patient-Directed One https://jamanetwork.com/journals/jamacardiology/fullarticle/2796904 Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention https://jamanetwork.com/journals/jama/fullarticle/2736564 II. Palliative Care in HF Home-

Pulmonary embolism, coffee, when DOACs don’t work, lipoprotein (a), and the marginal benefits of current CV therapy 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. Pulmonary Embolism - Positive Data on Thrombectomy Catheter That Avoids Thrombolytics in Acute PE https://www.medscape.com/viewarticle/981322 - Acute Outcomes for the Full US Cohort of the FLASH Mechanical Thrombectomy Registry in Pulmonary Embolism https://eurointervention.pcronline.com/article/acute-outcomes-for-the-full-us-cohort-of-the-flash-mechanical-thrombectomy-registry-in-pulmonary-embolism - PEERLESS Study https://clinicaltrials.gov/ct2/show/NCT05111613 - Ultrasound-facilitated, Catheter-directed, Thrombolysis in Intermediate-high Risk Pulmonary Embolism (HI-PEITHO) https://clinicaltrials.gov/ct2/show/NCT04790370 - A Prospective, Single-Arm, Multicenter Trial of Catheter-Direct

In this week’s podcast, John Mandrola, MD, discusses the PROTECTED TAVR trial, renal denervation, left atrial appendage closure and deprescribing aspirin. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Cerebral Embolic Protection After TAVI - Clear Stroke Benefit Eludes Embolic Protection: PROTECTED TAVR https://www.medscape.com/viewarticle/980978 - Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement https://www.nejm.org/doi/10.1056/NEJMoa2204961 - Protection Against Cerebral Embolism During Transcatheter Aortic Valve Replacement https://doi.org/10.1016/j.jacc.2016.10.023 - Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 - Randomised Trial Of Intravenous Streptokinase, Oral Aspiri

The safety of very low LDL-C, the win-ratio analytic method, sacubitril/valsartan, SGLT2 inhibitors, and percutaneous left atrial appendage closure are discussed 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 PCSK9I Evolocumab Benefits Accrue With Longer Follow-up: FOURIER OLE https://www.medscape.com/viewarticle/979950 - Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/nejmoa1615664 - Long-Term Evolocumab in Patients with Established Atherosclerotic Cardiovascular Disease https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061620 II Analytic Methods and Re-Analysis of Old Trials - PARADISE-MI Results Obscured As Post Hoc Analysis Finds Flaws https://www.medscape.com/viewarticle/980776 - Angiotensin Receptor–Neprilysin Inhibition in Acute Myocardial Infarction https://www.nejm.org/doi/10.1056/NEJMoa2104508 - Impact of Sacub

A potential new anticoagulant, surveillance stress testing, a trial misinterpretation, an old diuretic, and AI in cardiology 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. Factor XI inhibitors - Factor XIa Inhibitor After MI, Stroke Encouraging in Early Phase 2 Studies https://www.medscape.com/viewarticle/979942 - AXIOMATIC-SSP: Cautious Optimism on Factor XI Inhibitor in Stroke https://www.medscape.com/viewarticle/979860 II. Surveillance Stress Testing - No Benefit of Routine Stress Test POST-PCI in High-Risk Patients https://www.medscape.com/viewarticle/979866 - Routine Functional Testing or Standard Care in High-Risk Patients after PCI https://www.nejm.org/doi/full/10.1056/NEJMoa2208335 III. New Diuretic for Acute Heart Failure - Vintage Drug Atop IV Loop Diuretics Boosts Decongestion in ADHF: ADVOR https://www.medscape.com/viewarticle/979851 -

A second ESC review covering REVIVED, the DANCAVAS CV screening trial, DELIVER on dapagliflozin in HF with mildly reduced EF, and the INVICTUS trial of rivaroxaban in rheumatic heart disease. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I REVIVED BCIS - PCI Fails to Beat OMT in Ischemic Cardiomyopathy: REVIVED-BCIS2 https://www.medscape.com/viewarticle/979853 - Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 - Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/nejmoa1100356 II DANCAVAS - DANCAVAS Misses Primary Endpoint but Hints at Benefit from Comprehensive CV Screening https://www.medscape.com/viewarticle/979854 - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 - Defibrillator Implantation in Pat

Early rhythm control in AF, treating coronary artery disease before transcatheter aortic valve implantation, and an ESC 2022 preview 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. Early Rhythm Control - Early AF Rhythm-Control Advantage Climbs With Comorbidity Burden: EAST-AFNET4 https://www.medscape.com/viewarticle/979627 - Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.122.060274 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 II. CAD and Aortic Stenosis - No Survival Gains Seen From Pre-TAVR PCI of Complex CAD https://www.medscape.com/viewarticle/979408 - The Effect of Coronary Lesion Complexity and Preprocedural Revascularization on 5-Year Outcomes After TAVR https://doi.org/10.1