This Week In Cardiology

Myocarditis and the COVID vaccine, lipid lowering guidelines, financial toxicity, and deprescribing statins are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1 – COVID Varied COVID Vaccination Rates May Lead to 'Two Americas' https://www.medscape.com/viewarticle/953658 Nearly All COVID Deaths in US Are Now Among Unvaccinated https://www.medscape.com/viewarticle/953703 2 - COVID Vaccine Myocarditis FDA to Add Myocarditis Warning to mRNA COVID-19 Vaccines https://www.medscape.com/viewarticle/953647 3 – Lipid Guidelines Clinicians Slow to Implement Lipid-Lowering Guidelines: GOULD Registry https://www.medscape.com/viewarticle/953688 - Use of Lipid-Lowering Therapies Over 2 Years in GOULD, a Registry of Patients With Atherosclerotic Cardiovascular Disease in the US https://jamanetwork.com/journals/jamacardiology/fullarticle/2780713 4 - Financial Toxicity Financial Burden Higher With CVD Than Cancer https://www.medscape.com/viewarticle/953687 - Atherosclerotic Cardi

COVID vaccine myocarditis, Christian Eriksen and sudden cardiac death, therapeutic hypothermia, and revascularization of stable CAD are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic 1- COVID-Vaccine-Myocarditis AHA: Don't Delay COVID Shot While CDC Reviews Myocarditis Cases https://www.medscape.com/viewarticle/953233 Myocarditis after BNT162b2 and mRNA-1273 Vaccination https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055913 2- Christian Eriksen Christian Eriksen: un survivant qui doit nous inspirer https://francais.medscape.com/voirarticle/3607279 Danish Soccer Player Suffered Cardiac Arrest During Euro Match https://www.webmd.com/news/20210614/danish-soccer-player-suffered-cardiac-arrest-during-euro-match Point/Counterpoint on Halting Implantation of the Subcutaneous ICD https://www.jacc.org/doi/10.1016/j.jacep.2021.03.006 3- Therapeutic Hypothermia Trial Supports Therapeutic Hypothermia in Nonshockable Cardiac Arrest https://www.medscape.com/viewart

COVID vaccine myocarditis, AF post-stroke, semaglutide, and iPhones and cardiac devices are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-Vaccine-Myocarditis More Evidence Links COVID Vaccines to Rare Cases of Myocarditis in Youth https://www.medscape.com/viewarticle/952905 - Symptomatic Acute Myocarditis in Seven Adolescents Following the Pfizer-BioNTech COVID-19 Vaccination https://pediatrics.aappublications.org/content/early/2021/06/04/peds.2021-052478 - At Least 18 Cases of Apparent Heart Problems in Young People in CT After COVID-19 Vaccine https://www.nbcconnecticut.com/news/coronavirus/connecticut-confirms-at-least-18-cases-of-apparent-heart-problems-in-young-people-after-covid-19-vaccination/2494534/ - C.D.C. Is Investigating a Heart Problem in a Few Young Vaccine Recipients https://www.nytimes.com/2021/05/22/health/cdc-heart-teens-vaccination.html - EMA Statement: https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessme

John Mandrola, MD, presents an ACC 2021 recap. https://www.medscape.com/twic ACC 2021 Reveiw I -- Left Atrial Appendage Closure LAAOS III: Surgical LAA Closure Cuts AF Stroke Risk by One Third https://www.medscape.com/viewarticle/951232 - Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 Watchman Registry: 1-Year Stroke Estimates Reassuringly Low https://www.medscape.com/viewarticle/951235 II - Angiotensin-Neprilysin Inhibition PARADISE-MI: Sacubitril/Valsartan Can't Beat Ramipril in Patients With Acute MI https://www.medscape.com/viewarticle/951236 Life Trial Rationale Paper: https://doi.org/10.1016/j.jchf.2020.05.005 III - Renal Denervation Ultrasound Renal Denervation Drops BP in Patients on Triple Therapy https://www.medscape.com/viewarticle/951248 IV -- Clopidogrel vs ASA post Stent HOST-EXAM: Clopidogrel Beats Aspirin as Monotherapy After Stenting https://www.medscape.com/viewarticle/951294 - Aspirin versus clopidogrel for chroni

The upcoming ACC meeting, polypharmacy, finerenone, and ethics and professionalism are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic ACC Preview: ACC.21 Looks to Repeat Success Despite Pandemic Headwinds https://www.medscape.com/viewarticle/950836 - Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/31050775/ Polypharmacy Hypertension Worsened by Commonly Used Prescription Meds https://www.medscape.com/viewarticle/950724 Finerenone Finerenone Scores Second Pivotal-Trial Success in Diabetic Kidney Disease https://www.medscape.com/viewarticle/951027 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 Ethics and Professionalism AHA/ACC Guidance on Ethics, Professionalism in Cardiovascular Care https://www.medscape.com/viewarticle/951018 - 2020 Ame

COVID-19 and BMI, TAVR vs SAVR, subcutaneous ICD, SGLT2 inhibitors, and physician-Moms are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 COVID-19 Severity Starts in Normal BMI Range, Especially in Young https://www.medscape.com/viewarticle/950568 - Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00089-9/fulltext TAVR vs SAVR VARC-3 Sets Goalpost for Future Aortic Valve Trials https://www.medscape.com/viewarticle/950012 - Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa799/6237954 TAVR Availability Patchy Growth of TAVR Programs Leaves Poorer Communities Behind https://www.medscape.com/viewarticle/950316 S-ICD Trade-offs Between Subcutaneous, Transvenous ICDs on Display i

COVID-19 and global vaccinations, AF screening, conduction-system pacing, FDA ban on menthol tobacco, and a heartfelt essay are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 Indians Rush for COVID-19 Vaccines as Death Toll Passes 200,000 https://www.medscape.com/viewarticle/950095 - Vaccine Breakthrough Infections with SARS-CoV-2 Variants https://www.nejm.org/doi/full/10.1056/NEJMoa2105000 AF Screening: Modest Clinical Gain for AF Screening of Asymptomatic Elderly: STROKESTOP https://www.medscape.com/viewarticle/949950 - Mass Screening for Untreated Atrial Fibrillation The STROKESTOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.014343 - Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials https://pubmed.ncbi.nlm.nih.gov/25596211/ - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350 Conduction System Pacing Keeping Pac

Cardiac status post COVID-19 in athletes, AF ablation, and bias against procedural doctors are the topics covered by John Mandrola, MD, in this week’s podcast https://www.medscape.com/twic COVID-19 COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e2.htm Professor Zeynep Tufekci Newsletter: https://www.theinsight.org/p/facts-are-pieces-of-a-puzzle-not Post-COVID-19 Cardiac Involvement in NCAA athletes SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054824 AF and Durable PV isolation Paroxysmal AF Can Recur but Burden Plunges After 'Durable' Ablation https://www.medscape.com/viewarticle/949566 Radiofrequency vs. Cryoballoon Catheter Ablation for Paroxysmal Atrial Fibrillation: Durability of Pulmonary Vein Isolation and Effect on AF Burden: The RACE-AF Randomized Controlled Trial https://www.ahajournal

COVID-19 vaccine-related clotting, vitamin D, anticoagulation strategies before PCI, and a good intervention at end of life are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19: How Some COVID-19 Vaccines Could Cause Rare Blood Clots https://www.medscape.com/viewarticle/949262 FAQ: What to Know About the J&J Vaccine Pause https://www.medscape.com/viewarticle/949231 Vitamin D Screening: Don't Screen for Vitamin D in General Population, Says US Task Force https://www.medscape.com/viewarticle/949167 Pre-PCI AC Decisions: Parity Whether Anticoagulation Is Halted or Not for Unplanned Cath https://www.medscape.com/viewarticle/949064 Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention https://doi.org/10.1016/j.jcin.2021.01.022 Pacemaker or Defibrillator Surgery without Interruption of Anticoagulation https://www.nejm.org/doi/full/10.1056/nejmoa1302946 Continued vs. interrupted direct oral anticoagulants

COVID-19, COVID-19 vaccines, hybrid AF ablation TAVR and who gets to be called a doctor are the topics by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 UK Regulators to Offer Under-30s Alternative to AZ COVID Vaccine https://www.medscape.com/viewarticle/948934 - News - Communicating the potential benefits and harms of the Astra-Zeneca COVID-19 vaccine https://wintoncentre.maths.cam.ac.uk/news/communicating-potential-benefits-and-harms-astra-zeneca-covid-19-vaccine/ Hybrid Ablation for Persistent AF - Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288 - Converge trial Rationale Paper https://doi.org/10.1016/j.ahj.2020.02.016 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350/ TAVR - TAVR F

COVID-19, long-COVID, the language of medicine, childhood obesity, and open notes are the topics covered by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 AstraZeneca COVID Vaccine: Clotting Disorder Mechanism Revealed? https://www.medscape.com/viewarticle/948560 Long COVID Long COVID Brings Welcome Attention to POTS https://www.medscape.com/viewarticle/948174 Keep Both 'Renal' and 'Nephro' in Glossary of Kidney Disease https://www.medscape.com/viewarticle/948451 'Striking' Increase in Childhood Obesity During Pandemic https://www.medscape.com/viewarticle/948350 COVID-19 and Changes in Child Obesity. https://pediatrics.aappublications.org/content/early/2021/03/01/peds.2021-050123 Starting Monday, Patients Can Read Your Notes: 5 Key Things https://www.medscape.com/viewarticle/948508 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine

COVID-19, AF detection post stroke, new measures of heart function, and structural racism in quality measures are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 NIH Rebukes AstraZeneca Vaccine Interim Data: 'Incomplete' https://www.medscape.com/viewarticle/947954 Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination https://jamanetwork.com/journals/jama/fullarticle/2777898 AF and Stroke Insertable Cardiac Monitors Improve AF Detection After Stroke https://www.medscape.com/viewarticle/947986 Perfection in LV Function Measurement Adding Strain Measure to LVEF Better Predicts Later HF https://www.medscape.com/viewarticle/948114 Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life https://jamanetwork.com/journals/jamacardiology/fullarticle/2777414 Is the Left Ventricular Ejection Fraction Measurement Still Preeminent?—New Measures to Quantify Subclinical Systolic Dysfunction https://jamanet

COVID-19, Fish Oil and AF risk, SGLT2 inhibitors and renal outcomes, and TAVR vs SAVR are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 EMA Launches Review of Clot Risk With AstraZeneca COVID Vaccine https://www.medscape.com/viewarticle/947393 AZ Vaccine Safe Overall but Questions Remain over Unusual Clots https://www.medscape.com/viewarticle/947733 Fish Oil and AF Dose-Related AF Risk With Omega-3 Fatty Acids? https://www.medscape.com/viewarticle/947542 Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777469 Omega-3 Fatty Acids and Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777450 SGLT2i and Renal Outcomes Ertugliflozin: Renal Benefits in Additional VERTIS CV Analyses https://www.medscape.com/viewarticle/947668 Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2004967

COVID-19, heart failure classifications, DOAC after bioprosthetic valves, and Medicare spending in the pandemic year Are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic I. COVID-19 Vaccination in Israel COVID-19 Vaccination Linked to Less Mechanical Ventilation https://www.medscape.com/viewarticle/946568 BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting https://www.nejm.org/doi/full/10.1056/NEJMoa2101765 II. Heart Failure Classification Heart Failure Redefined With New Classifications, Staging https://www.medscape.com/viewarticle/947048 Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure https://doi.org/10.1016/j.cardfail.2021.01.022 Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://

Cardiac studies in professional athletes after COVID-19 infection, percutaneous valve repair, AF screening, and social media are the topics discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment https://www.medscape.com/twic COVID and the Athletic Heart Incidence of Cardiac Pathology Post-COVID in Pro Athletes < 1% https://www.medscape.com/viewarticle/946902 Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening https://jamanetwork.com/journals/jamacardiology/fullarticle/2777308 Percutaneous Valve Repair Delirium Common, Costly After Mitral, Tricuspid Valve Repair https://www.medscape.com/viewarticle/946736 Prevalence and Impact of Post-Procedural Delirium After Percutaneous Repair of Mitral and Tricuspid Valves https://www.jacc.org/doi/full/10.1016/j.jcin.2020.11.031 AF Screening AF Screening in Asymptomatic Older Individuals Shows Promise https://www.medscape.com/v

Risk factors for COVID-19, CMR after COVID-19, and two important obesity studies are discussed in this week’s podcast. To read a partial transcript or to comment https://www.medscape.com/twic Cardiometabolic Conditions and COVID19 Most Severe COVID Tied to Four Cardiometabolic Conditions https://www.medscape.com/viewarticle/946488 Coronavirus Disease 2019 Hospitalizations Attributable to Cardiometabolic Conditions in the United States: A Comparative Risk Assessment Analysis https://www.ahajournals.org/doi/10.1161/JAHA.120.019259 CMR after COVID19 Myocardial Injury Seen on MRI in 54% of Recovered COVID https://www.medscape.com/viewarticle/946287 Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance https://doi.org/10.1093/eurheartj/ehab075 Obesity Trials Semaglutide for Weight Loss? A Good First STEP, With Caveats https://www.medscape.com/viewarticle/945630 Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/do

Bernard Lown, Type 2 MI, Sacubitril/Valsartan and COVID19 anticoagulation are discussed in this week’s podcast. To read a partial transcript or to comment https://www.medscape.com/twic COVID Israeli Study Finds Pfizer Vaccine 95% Effective Against COVID-19 https://www.medscape.com/viewarticle/945962 Bernard Lown Cardiologist, Antiwar Activist Bernard Lown Dies at 99 https://www.medscape.com/viewarticle/945966 Type 2 MI New Light Cast on Type-2 MI Aims to Sharpen Diagnosis, Therapy https://www.medscape.com/viewarticle/946075 Early AC in COVID19 More Evidence Supports Early Anticoagulation in COVID-19 https://www.medscape.com/viewarticle/945902 Sacubitril/Valsartan FDA Expands Sacubitril/Valsartan Indication to Embrace Some HFpEF https://www.medscape.com/viewarticle/945936 Five Reasons Sacubitril/Valsartan Should NOT Be Approved for HFpEF https://www.medscape.com/viewarticle/944168 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine

Prediabetes, AI and ECGs, HFpEF, and observational studies are the topics discussed by John Mandrola, MD in this week’s podcast. To read a partial transcript or to comment http://www.medscape.com/twic Pre-diabetes 'Prediabetes' Unlikely to Progress to Diabetes in Older Adults https://www.medscape.com/viewarticle/945511 Mobile QT Interval Measurement Using AI, Mobile ECG Aims to Expand QTc Screening Horizons https://www.medscape.com/viewarticle/945484 Giudicessi JR et al. Artificial Intelligence-Enabled Assessment of the Heart Rate Corrected QT Interval Using a Mobile Electrocardiogram Device | Circulation (ahajournals.org) https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.120.050231 HFpEF Exercise Quandary in HFpEF: Training Regimens Fall Short in Trial https://www.medscape.com/viewarticle/945621 Observational Study Follies Statins Linked to Reduced Postop Adhesions, Bowel Obstruction https://www.medscape.com/viewarticle/945686 You may also like: Medscape editor-in-chief Eric Topol, MD, and master

Carotid screening, AF and alcohol, subcutaneous ICD, and medical education are the topics discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment http://www.medscape.com/twic Carotid Screening USPSTF Again Recommends Against Carotid Stenosis Screening https://www.medscape.com/viewarticle/945202 Subcutaneous ICD Recall FDA Recalls Subcutaneous-ICD Leads Due to Fracture Risk https://www.medscape.com/viewarticle/945168 Alcohol and AF Alcohol and the Electric Atrium, Part 2: When BAC Exceeds the Legal Limit https://www.medscape.com/viewarticle/945297 Medical Education USMLE Stuns Again: Clinical Skills Test Permanently Ended https://www.medscape.com/viewarticle/944756 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medsca

AF and COVID-19, microthrombi in COVID-19 autopsies, vericiguat, and POTS are the topics covered by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment: http://www.medscape.com/twic AF and COVID AF at COVID-19 Admission Predicts Mortality, Demands Vigilance https://www.medscape.com/viewarticle/944802 Microthrombi and COVID Microthrombi, Necrosis Seen in COVID-19 Hearts on Autopsy https://www.medscape.com/viewarticle/944783 Vericiguat FDA Approval Adds Vericiguat (Verquvo) to HF Treatment Options https://www.medscape.com/viewarticle/944434 POTS: Lower-Body Compression Trims Orthostatic Tachycardia in POTS https://www.medscape.com/viewarticle/944791 Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment https://doi.org/10.1016/j.pcad.2020.03.010 Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance https://www.onlinecjc.ca/article/S0828-282X(19)31550-8/full