This Week In Cardiology

ACC Recap Part 1: Sports, bempedoic acid NASCARs, tricuspid regurgitation, and more on revascularization of stable CAD. 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. Sports Cardiology Even Vigorous Exercise Appears Safe for Patients With Hypertrophic Cardiomyopathy: LIVE-HCM https://www.medscape.com/viewarticle/989351 - Lifelong endurance exercise and its relation with coronary atherosclerosis https://doi.org/10.1093/eurheartj/ehad152 - Increased average longevity among the "Tour de France" cyclists https://pubmed.ncbi.nlm.nih.gov/21618162/ II. Clear Outcomes Bempedoic Acid Cuts CV Events in Statin-Intolerant Patients: CLEAR Outcomes https://www.medscape.com/viewarticle/989100 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients https://www.nejm.org/doi/full/10.1056/NEJMoa2215024 - Bodgan Enache Tweet https://twitter.com/

Renal denervation, AF ablation, omecamtiv mecarbil, and an ACC Preview 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. AF Ablation - Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures https://www.jacc.org/doi/10.1016/j.jacc.2022.11.060 II. Renal Denervation Consistent BP Cut With Renal Denervation: More on RADIANCE https://www.medscape.com/viewarticle/989006 - Endovascular Ultrasound Renal Denervation to Treat HypertensionThe RADIANCE II Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2801849 - Patient-Level Pooled Analysis of Ultrasound Renal Denervation in the Sham-Controlled RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO Trials https://jamanetwork.com/journals/jamacardiology/fullarticle/2802098 - Is There a Role for Renal Denervation in the Treatment of

Reporting on potential fraud in medicine, AF, stroke, a possible new cholesterol-lowering drug, and the tone of debate in 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. Potential Fraud in Medicine Inside the Big Business of Clogged Arteries https://www.medscape.com/viewarticle/988448 II. AF Screening and Stroke STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke https://jamanetwork.com/journals/jamaneurology/fullarticle/2795865 III. Bempedoic Acid New Studies Give Bempedoic Acid a Bump as Lipid-Lowering Agent https://www.medscape.com/viewarticle/911100 - Rationale and design of the CLEAR-outcomes trial: Evaluating the effect of bempedoic acid on ca

Bradyarrhythmia during AF screening, thrombolysis in stroke, NP vs MD care, and the most biased paper this year — on LAAO — 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. Screening with ILR - Ade Adamson Tweet https://twitter.com/AdeAdamson/status/1625878856820482048?s=20 - The Rapid Rise in Cutaneous Melanoma Diagnoses https://www.nejm.org/doi/full/10.1056/NEJMsb2019760 - Loop Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 II. Thrombolysis in Mild Stroke Thrombolysis Not Necessary in Mild Nondisabling Stroke: ARAMIS https://www.medscape.com/viewarticle/988381 - PRISMS Trial https://jamanetwork.com/journals/jama/fullart

Drug and non-drug therapies for HFpEF, the search for AF, and exercise as medicine 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. SGLT2 Inhibitors in HFpEF Dapagliflozin Gets Expanded Heart Failure Indication in Europe https://www.medscape.com/viewarticle/988034 Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 II. HFpEF and Heart Rate Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 III. Stroke and AF STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease https://jamanetwork.com

A possible major breakthrough in thinking about diastolic dysfunction and HFpEF, MRI scanning and cardiac devices, and AF and dementia 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. New Thinking in HFpEF Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 - Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction: The myPACE Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2801001 - Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction https://doi.org/10.1016/j.jacc.2021.08.073 - A Targeted Treatment Opportunity for HFpEF: Taking Advantage of Diastolic Tone https://www.aha

Exercise for AF, drugs have more than one effect, AI bots and the future of medicine, and the good and bad news about prognosis 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. AF and Exercise Aerobic Exercise Can Reduce AF Frequency, Severity: ACTIVE-AF https://www.medscape.com/viewarticle/957322 An Exercise and Physical Activity Program in Patients With Atrial Fibrillation: The ACTIVE-AF Randomized Controlled Trial https://www.jacc.org/doi/full/10.1016/j.jacep.2022.12.002 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 II. GLP-1 Inhibitors and Retinopathy Eye Check Important Before Starting Semaglutide for Diabetes https://www.medscape.com/viewarticle/987418 Glucagon-like peptide 1-receptor agonists and A1c: Good for the heart but less so for the eyes? https://doi.org/1

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