This Week In Cardiology

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

Reader feedback, imaging in the cath lab, AF ablation to relieve anxiety, and some possible help in hypertension 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. Reader Feedback Sep 08, 2023 This Week in Cardiology Podcast   https://www.medscape.com/viewarticle/996233 First Clinical Trial of CTO Procedures Fails to Deliver   https://www.medscape.com/viewarticle/877405 -   DanGerShock trial https://pubmed.ncbi.nlm.nih.gov/31176289/ II. Imaging in the Cath Lab Should Intravascular Imaging Be Almost Routine in PCI?    https://www.medscape.com/viewarticle/996375 -   ILUMIEN IV    https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 -   OCTOBER    https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 III. AF Ablation to Relieve Anxiety -   REMEDIAL Trial   https://jamanetwork.com/journals/jama/fullarticle/2809419 -   Sohaib and Francis; Meta analysis of Sym

ESC Recap Part 2: ECLS-SHOCK, FIRE, MULTISTARS-AMI, HEART FID, and DANPACE II are the trials 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. Cardiogenic Shock ECMO for Shock in Acute MI Won't Help, May Harm: ECLS-SHOCK  https://www.medscape.com/viewarticle/995882 -   ECLS-SHOCK trial  https://www.nejm.org/doi/full/10.1056/NEJMoa2307227 -   ECMO-CS trial  https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062949 II. FIRE TRIAL FIRE a Win for Physiology-Guided MI Complete Revascularization in Older Patients  https://www.medscape.com/viewarticle/995875 -   FIRE Trial  https://www.nejm.org/doi/full/10.1056/NEJMoa2300468 -   COMPLETE Trial  https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 III. Immediate vs Staged Revascularization Parity for Prompt vs Staged STEMI Complete Revascularization: MULTISTARS-AMI  https://www.medscape.com/viewarticle/995961 -   M

ESC Wrap-up 1: Obesity, heart failure with preserved EF and reduced EF, AF, frailty, evidence translation, and catheter ablation 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. FRAIL AF    -FRAIL-AF Study    https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066485    -The Most Important Study From ESC: FRAIL-AF    https://www.medscape.com/viewarticle/996063 II. STEP-HFpEF Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 GLP-1 Agonist Semaglutide in HFpEF Cleared Low Bar https://www.medscape.com/viewarticle/995872 Semaglutide’s Big Step in HFpEF With Obesity: Investigator Inteview https://www.medscape.com/viewarticle/995673    -Semaglutide in Obese Patients With  HFpEF    https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 III. NOAH AFNET 6 Anticoagulation No Benefit in Presumed AF Detected

GLP-1 agonists in HFpEF, DOACs for subclinical AF, renal denervation, and the matter of remaining in the profession 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. Obesity and HFpEF GLP-1 Agonists in HFpEF With Obesity: Are We There Yet? https://www.medscape.com/viewarticle/993980 Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 - Semaglutide in Obese Patients With HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 - Rationale/Protocol Paper https://doi.org/10.1016/j.jchf.2023.05.010 II. DOAC for Subclinical AF - NOAH-AFNET 6 Rationale/Protocol https://doi.org/10.1016/j.ahj.2017.04.015 - NOAH-AFNET 6 Trial Results https://www.nejm.org/search?q=NOAH+AFNET III. Renal Denervation ReCor Renal Denervation System Safe, Effective: FDA Panel https://www.medscape.com/viewarticle/995741 FDA Panel Split on

ICD generator change, less is more in VT management, co-morbidity in HF, and SGLT2i after AF ablation 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. ICD Gen Change - Patients’ Perspectives Regarding Generator Exchanges of Implantable Cardioverter Defibrillators https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.122.009827 - DEFINITE https://www.nejm.org/doi/10.1056/nejmoa033088 - SCD-HeFT https://www.nejm.org/doi/full/10.1056/nejmoa043399 - DANISH https://www.nejm.org/doi/10.1056/NEJMoa1608029 - Poole and colleagues; 11-year follow-up of  SCD-HeFT https://doi.org/10.1016/j.jacc.2020.05.061 - Editorial – Howell/Stecker https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010266 II. VT Therapy Crossed Wires: Ischemia Testing and Monomorphic VT Storm https://www.medscape.com/viewarticle/995401 - Cleveland Clinic Study   https://doi.org/10.1

Observational studies, another defense of digoxin, CTO-PCI, BP measurement, and a possible revolution in cardiovascular protection 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. Observational Research Yeh; Credibility in Observational  Research https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064645 Hernan; Causal Language in Observational Research  https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304337 Wang; RCT Duplicate Initiative https://jamanetwork.com/journals/jama/fullarticle/2804067 II. Defense of Digoxin Brophy; Beta Blockers, Digoxin, or Both https://doi.org/10.1016/j.cjca.2023.06.009 Dorian editorial https://doi.org/10.1016/j.cjca.2023.07.013 Ziff Digoxin Meta-analysis https://www.bmj.com/content/351/bmj.h4451.long DIG trial  https://www.nejm.org/doi/full/10.1056/nejm199702203360801 Davila Analysis of DIG Trial