This Week In Cardiology

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.

More on the Million Hearts RCT, ENRICH AF, TAVI vs SAVR, the Partner 3 and Evolut-low-risk trials, and myocardial viability 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. Listener Feedback Million Hearts CMS 'Million Hearts' CVD Risk Reduction Model Works https://www.medscape.com/viewarticle/997551 -  RCT JAMA -    https://jamanetwork.com/journals/jama/fullarticle/2810696 AC in ICH - ENRICH AF Oral Anticoagulation in ICH Patients With AF: New Data https://www.medscape.com/viewarticle/997547 -  Lancet Neurology Meta-analysis https://doi.org/10.1016/S1474-4422(23)00315-0 -  ENRICH AF letter https://doi.org/10.1016/S0140-6736(23)02025-1 II.  TAVI vs SAVR Low-Risk TAVR Studies: Divergent Long-Term Results  https://www.medscape.com/viewarticle/997784 -  Partner 3 Main Results -  Partner 3 – Five Year -  Original EVOLUT -LR https://www.nejm.org/doi/10.105

Listener feedback, oral anticoagulation in patients with ICH, an example of statistical significance but not clinical significance, and statins and diabetes 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 October 13, 2023 This Week in Cardiology Podcast   https://www.medscape.com/viewarticle/997281 -  European Heart Journal: IVI for PCI   https://doi.org/10.1093/eurheartj/ehad430 -  Elgendy Meta-analysis of Imaging in PCI:   https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.116.003700 -  ULTIMATE:   https://www.jacc.org/doi/10.1016/j.jacc.2018.09.013 -  ILUMEIN IV: https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 -  OCTOBER:  https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 -  Main STEP-HFpEF paper -  Letter to the Editor on Lack of Obesity Paradox  https://doi.org/10.1016/j.amjcard.2019.04.037 II. Anticoagulation i

Three stories regarding GLP-1 agonists, imaging during PCI, and the power of sham controls in procedure trials 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. FLOW Trial Positive Novo Nordisk Stops Ozempic Kidney Trial After Early Signs of Success https://www.medscape.com/s/viewarticle/997237 -  FLOW Trial – press release https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=166327 II. STEP HFpEF Semaglutide Win in HFpEF With Obesity Regardless of Ejection Fraction: STEP-HFpEF https://www.medscape.com/viewarticle/997185 The GLP-1 Agonist Semaglutide in HFpEF Cleared a Low Bar https://www.medscape.com/viewarticle/995872 -  STEP HFpEF substudy -   STEP HFpEF main paper III. GLP-1 Agonist Adverse Effects GLP-1 Agonists Linked to Higher Risk for Rare but Serious GI Complications https://www.medscape

Coated vs uncoated ASA, a new trial in CAD, conflicts of interest, first AF in the hospital, and changing HTN scoring and CHADSVASC 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. ASA No Benefit of Enteric-Coated Aspirin vs Uncoated in CVD https://www.medscape.com/viewarticle/997119 -  JAMA Cardiology: Coated vs Uncoated ASA https://jamanetwork.com/journals/jamacardiology/fullarticle/2809795 -  ADAPTABLE https://www.nejm.org/doi/10.1056/NEJMoa2102137 II. RECHARGE -  Revascularization Choices Among Under-Represented Groups Evaluation (The RECHARGE Program) https://www.pcori.org/research-results/2023/revascularization-choices-among-under-represented-groups-evaluation-recharge-program -  Gaudino/Stone: Reconsidering Coronary Revascularization Trials III. Conflicts of Interest -  Financial Conflicts of Interest in Public Comments on Medicare National Cove

Reader feedback, leadless pacing, ABIM, SGLT2 inhibitors, peri-operative MI after cardiac surgery, and. AHA late-breakers 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. Reader Feedback Sep 22, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/996694 -   ODYSSEY OUTCOMES trial https://www.nejm.org/doi/full/10.1056/nejmoa1801174 -   FOURIER https://www.nejm.org/doi/full/10.1056/nejmoa1615664 II. Leadless Pacing -   Leadless vs Transvenous Pacemaker Study https://doi.org/10.1093/europace/euad269 III. ABIM News Heart Societies Ready to Split From ABIM Over Long-Standing MOC Disputes https://www.medscape.com/viewarticle/996747 IV. SGLT2 inhibitors Empagliflozin Gets FDA Nod for CKD Without T2D or HF https://www.medscape.com/viewarticle/996873 -   EMPA-Kidney https://www.nejm.org/doi/full/10.1056/NEJMoa2204233 V. Peri-Op MI after Ca

Coronary calcium, cardiac arrest survival, Factor XI drug findings, APCs and a potential new board certification in cardiology are the topics 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 Coronary Artery Calcium -   CONFIRM Registry - https://doi.org/10.1016/j.jcmg.2023.03.008 -   CURE -- https://www.nejm.org/doi/full/10.1056/nejmoa010746 II Cardiac Arrest Cardiac Arrest Centers No Benefit in OHCA Without STEMI https://www.medscape.com/viewarticle/995885 -   Cycling coverage https://velo.outsideonline.com/road/road-racing/nathan-van-hooydonck-forced-to-end-to-racing-career-due-to-heart-condition/ -   ARREST https://doi.org/10.1016/S0140-6736(23)01351-X -   SCD in Athletes Bob Harrington and Manesh Patel https://www.medscape.com/viewarticle/995575 III Factor XI Trial Halted for Bleeding Reduction With Abelacimab vs Rivaroxaban in AF https://www.medscape.com/vie