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In today’s episode of Cardiology Digest, we look at three recent research papers that can impact your clinical practice. They’re from NEJM Evidence, the European Heart Journal, and The New England Journal of Medicine.
STUDY #1: Today’s journey begins with a study examining the interplay between influenza and myocardial infarctions. Could the flu shot be more than just a seasonal precaution?
de Boer, AR, Riezebos-Brilman, A, van Hout, D, et al. 2024. Influenza infection and acute myocardial infarction. NEJM Evid. 7:EVIDoa2300361. (https://doi.org/10.1056/EVIDoa2300361)
STUDY #2: Next, we wade into a cath lab debate over fasting protocols. Join us to explore research that flips traditional pre-procedure fasting requirements on their head. Are we on the brink of a new era?
Ferreira, D, Hardy, J, Meere, W, et al. 2024. Fasting vs no fasting prior to catheterisation laboratory procedures: The SCOFF trial. Eur Heart J. Published online. (https://doi.org/10.1093/eurheartj/ehae573)
STUDY #3: Finally, we dig into the complexities of anticoagulation in transcatheter aortic-valve replacement patients. This study sheds light on the choice between interrupting or continuing anticoagulation, and has implications for everyday practice.
van Ginkel, DJ, Bor, WL, Aarts, HM, et al. 2024. Continuation versus interruption of oral anticoagulation during TAVI. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2407794)
Tune in for a captivating discussion that promises to enrich your clinical acumen!
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In this episode of Medmastery’s Cardiology Digest, we dive into three groundbreaking studies that are set to reshape our understanding and approach to cardiology.
STUDY #1: First, we discuss a landmark piece of research that sheds new light on the benefits of percutaneous coronary intervention for patients with significant coronary artery disease who need a transcatheter aortic valve replacement. This study addresses important questions about patient selection for this intervention.
Lønborg, J, Jabbari, R, Sabbah, M, et al. 2024. PCI in patients undergoing transcatheter aortic-valve implantation. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2401513)
STUDY #2: Next, we examine an insightful meta-analysis that evaluates patient-level data to inform the future of dual antiplatelet therapy after percutaneous coronary intervention. Discover the factors influencing the transition to ticagrelor monotherapy post-PCI and why this could change current guideline recommendations.
Valgimigli, M, Hong, S, Gragnano, F, et al. 2024. De-escalation to ticagrelor monotherapy versus 12 months of dual antiplatelet therapy in patients with and without acute coronary syndromes: A systematic review and individual patient-level meta-analysis of randomized trials. Lancet. 10456: 937–948. (https://doi.org/10.1016/S0140-6736(24)01616-7)
STUDY #3: Lastly, we take a closer look at the EPIC-CAD study, which aligns with previous findings from the AFIRE trial. Learn why anticoagulant monotherapy is now being considered for the majority of patients with atrial fibrillation who require anticoagulation and have stable coronary artery disease, and what this means for your clinical practice.
Cho, MS, Kang, D-Y, Ahn, J-M, et al. 2024. Edoxaban antithrombotic therapy for atrial fibrillation and stable coronary artery disease. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2407362)
Tune in to this episode for an engaging in-depth discussion of these studies and stay ahead in the ever-evolving field of cardiology!
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Puuttuva jakso?
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Stay ahead with the newest cardiology research findings that could change your clinical practice!
STUDY #1: First up, we explore new data on edoxaban dosage for older patients with atrial fibrillation. If we could give older patients a lower dose of edoxaban to reduce the risk of bleeding, will they still benefit from a lower risk for stroke?
Zimerman, A, Braunwald, E, Steffel, J, et al. 2024. Dose reduction of edoxaban in patients 80 years and older with atrial fibrillation: Post hoc analysis of the ENGAGE AF-TIMI 48 randomized clinical trial. JAMA Cardiol. Published online. (https://doi.org/10.1001/jamacardio.2024.1793)
STUDY #2: Next, we delve into the nuanced world of invasive versus noninvasive treatment of non-ST-segment elevation myocardial infarction (NSTEMI). You’ll find out if mortality rates go up when we use a less invasive approach.
Kunadian, V, Mossop, H, Shields, C, et al. 2024. Invasive treatment strategy for older patients with myocardial infarction. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2407791)
STUDY #3: Lastly, we break down the latest findings on chelation therapy in patients with stable coronary artery disease and diabetes. Tune it to see whether the latest data challenges your perspective on the efficacy of EDTA in reducing cardiovascular risks.
Lamas, GA, Anstrom, KJ, Navas-Acien, A, et al. 2024. Edetate disodium-based chelation for patients with a previous myocardial infarction and diabetes: TACT2 randomized clinical trial. JAMA. Published online. (https://doi.org/10.1001/jama.2024.11463)
Join us to uncover these critical insights, discussions, and more. Let's turn data into actionable wisdom and elevate your cardiology practice.
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Welcome to the latest episode of Medmastery’s Cardiology Digest, where In less than 15 minutes we’ll get you up to date on breakthrough studies and advancements in cardiology that can impact your clinical practice!
STUDY #1: Brace yourself for insights into a study that evaluated rapid uptitration of evidence-based therapies for heart failure. Join us as we dissect the feasibility, resource demands, and patient implications?
Biegus, J, Mebazaa, A, Davison, B, et al. 2024. Effects of rapid uptitration of neurohormonal blockade on effective, sustainable decongestion and outcomes in STRONG-HF. J Am Coll Cardiol. 4: 323–336. (https://doi.org/10.1016/j.jacc.2024.04.055)
STUDY #2: Next, we examine a recent paper that challenges hospital-centric treatment paradigms for acute pulmonary embolism. Discover how some low-risk patients could benefit from home treatment, and what conditions are essential to ensure their safety and effective care.
Luijten, D, Douillet, D, Luijken, K, et al. 2024. Safety of treating acute pulmonary embolism at home: An individual patient data meta-analysis. Eur Heart J. 32: 2933–2950. (https://doi.org/10.1093/eurheartj/ehae378)
STUDY #3: Finally, we dive into a large cohort study looking at bariatric surgery in obese patients with obstructive sleep apnea, and see whether losing weight actually had a significant impact on cardiovascular outcomes.
Aminian, A, Wang, L, Al Jabri, A, et al. 2024. Adverse cardiovascular outcomes in patients with obstructive sleep apnea and obesity: Metabolic surgery vs usual care. J Am Coll Cardiol. Published online. (https://doi.org/10.1016/j.jacc.2024.06.008)
This episode promises to be packed with actionable insights on this thought-provoking cardiology research. Don’t miss out—press play and enrich your practice today!
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This week, we have three compelling research papers that are sure to expand your clinical acumen.
STUDY #1: We explore the debate surrounding the new PREVENT calculator’s impact on predictions of 10-year risk for atherosclerotic cardiovascular disease and statin eligibility. Will the current guidelines from the American Heart Association and American College of Cardiology remain the gold standard, or are we on the cusp of a significant paradigm shift?
Diao, JA, Shi, I, Murthy, VL, et al. 2024. Projected changes in statin and antihypertensive therapy eligibility with the AHA PREVENT cardiovascular risk equations. JAMA. Published online. (https://doi.org/10.1001/jama.2024.12537)
Grant, JK, Ndumele, CE, and Martin, SS. 2024. The evolving landscape of cardiovascular risk assessment. JAMA. Published online. (https://doi.org/10.1001/jama.2024.13247)
Khan SS, and Lloyd-Jones, DM. 2024. Statins for primary prevention of cardiovascular disease — With PREVENT, what's a clinician to do? JAMA. Published online. (https://doi.org/10.1001/jama.2024.13887)
Khan, SS, Matsushita, K, Sang, Y, et al. 2023. Development and Validation of the American Heart Association’s PREVENT Equations. J Circulation. 6: 430-449. (https://doi.org/10.1161/CIRCULATIONAHA.123.067626)
STUDY #2: Next, we dive into a great study examining the connection between antihypertensive medications and eczematous dermatitis in older adults. This extensive population-based research offers great insights that could change your approach to managing hypertension in patients with dermatologic concerns. Could your favorite antihypertensive medication be the culprit behind your patient's new skin condition?
Ye, M, Chan, LN, Douglas, I, et al. 2024. Antihypertensive medications and eczematous dermatitis in older adults. JAMA Dermatol. Published online. (https://doi.org/10.1001/jamadermatol.2024.1230)
Joly, P, Benoit-Corven, C, Baricault, S, et al. Sophie Baricault. 2007. Chronic Eczematous Eruptions of the Elderly Are Associated with Chronic Exposure to Calcium Channel Blockers: Results from a Case–Control Study. J Invest Derm. 12: 2766-2771. (https://doi.org/10.1038/sj.jid.5701018)
Summers, EM, Bingham, CS, Dahle, KW, et al. 2013. Chronic Eczematous Eruptions in the Aging
Further Support for an Association With Exposure to Calcium Channel Blocker. JAMA Dermatol. 7: 814-818. doi:10.1001/jamadermatol.2013.511STUDY #3: Finally, we dissect a hotly discussed study linking semaglutide with non-arteritic anterior ischemic optic neuropathy. Garnering attention both in academia and the lay media, this study's robust methodology lends significant weight to its findings. But does this potential risk necessitate altering prescribing habits for semaglutide?
Hathaway, JT, Shah, MP, Hathaway, DB, et al. 2024. Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide. JAMA Ophthalmol. 2024. Published online. (https://doi.org/10.1001/jamaophthalmol.2024.2296)
Join us for a closer look at these pivotal studies. It's a conversation you won’t want to miss.
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In this episode of Cardiology Digest, we dive into top journals like JAMA Cardiology to bring you three of the most compelling recent research papers from the field of cardiology.
STUDY #1: First, see how the new Boston Scientific cryoballoon measures up against Medtronic's product. Did the newcomer outshine the veteran, or does it come with hidden risks? Discover the head-to-head results and what they mean for the future of atrial fibrillation cryoablation.
Reichlin, T, Kueffer, T, Knecht, S et al. 2024. PolarX vs Arctic Front for cryoballoon ablation of paroxysmal AF: The randomized COMPARE CRYO study. JACC Clin Electrophysiol. In Press, Corrected Proof. (https://doi.org/10.1016/j.jacep.2024.03.021)
STUDY #2: Next, we explore the intersection of aging, aortic stenosis, and osteosarcopenia in elderly patients undergoing transcatheter aortic valve replacement. This study highlights a radiographic method that reveals a high-risk subpopulation within this demographic. See how this insight can shape our approach to transcatheter aortic valve replacement, and what it means for patient care strategies.
Solla-Suarez, P, Arif, S, Ahmad, F, et al. 2024. Osteosarcopenia and mortality in older adults undergoing transcatheter aortic valve replacement. JAMA Cardiol. 7: 611-618. (https://doi.org/10.1001/jamacardio.2024.0911)
O'Gara, P, Guduguntla, V, Bonow, R, et al. 2024, Osteosarcopenia and mortality after transcatheter aortic valve replacement. JAMA Cardiol. 7: 618-619. (https://doi.org/10.1001/jamacardio.2024.1018)
STUDY #3: Finally, we turn our attention to the pressing issue of hypertensive disorders in pregnancy. Discover why close postpartum monitoring is critical and what the latest research suggests about the persistence of hypertension in new mothers. Could longer follow-ups hold the key to better postpartum care?
Hauspurg, A, Venkatakrishnan, K, Collins, L, et al. 2024. Postpartum ambulatory blood pressure patterns following new-onset hypertensive disorders of pregnancy. JAMA Cardiol. Published online (https://doi.org/10.1001/jamacardio.2024.1389)
Join us to unravel these important studies and their implications for your practice and patients. Ready to stay ahead in the rapidly evolving world of cardiology? Hit play and let's get started!
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Ready to dig into the latest cardiology research? In less than 15 minutes, we'll give you the low-down on three new studies that’ll help you in clinical practice.
STUDY #1: First, we explore safety outcomes for carotid artery stenting and see how this could impact your clinical discussions and decision-making. And if you practice in the U.S., now that Medicare and Medicaid cover this procedure for a broader range of patients, this info will prove to be especially important.
Uchida, K, Sakakibara, F, Sakai, N, et al. 2024. Real-world outcomes of carotid artery stenting in symptomatic and asymptomatic patients with carotid artery stenosis. JACC Cardiovasc Interv. 9: 1160-1162. (https://doi.org/10.1016/j.jcin.2024.03.014)
STUDY #2: Next, we tackle a common cardiology conundrum: how should we handle significant coronary artery disease lesions discovered incidentally in patients with severe aortic stenosis who are undergoing transcatheter aortic valve replacement? Is it better to treat these lesions beforehand, or is there a better strategy? We'll probe the debate, highlighting the potential implications of this new data.
Colaiori, I, Paolucci, L, Mangiacapra, F, et al. 2024. Natural history of coronary atherosclerosis in patients with aortic stenosis undergoing transcatheter aortic valve replacement: The role of quantitative flow ratio. Circ Cardiovasc Interv. 0: e013705. (https://doi.org/10.1161/CIRCINTERVENTIONS.123.013705)
STUDY #3: Lastly, we sip our way through the nuances of coffee consumption and its impact on blood pressure and cardiac arrhythmias. A new study lets us know whether our patients' daily caffeine fix can be left off the list of cardiac concerns.
Trevano, F, Vela-Bernal, S, Facchetti, R, et al. 2024. Habitual coffee consumption and office, home, and ambulatory blood pressure: Results of a 10-year prospective study. J Hypertens. 6: 1094-1100. (https://doi.org/10.1097/HJH.0000000000003709)
Join us to break down these studies, and elevate your cardiology knowledge!
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In less than 15 minutes, Medmastery’s Cardiology Digest will give you the low-down on some of the most compelling studies in cardiology that clinicians with an interest in cardiovascular health need to know about.
STUDY #1: We kick things off by exploring exactly where the CHA2DS2-VASc score fits into anticoagulation decisions in patients with silent atrial fibrillation. Building on the main findings from the ARTESiA and NOAH-AFNET 6 trials, this study sparks a thought-provoking discussion on the future of risk stratification. Tune in to hear insights that could shape your clinical practice.
Lopes, RD, Granger, CB, Wojdyla, DM, et al. 2024. Apixaban versus aspirin according to CHA2DS2-VASc score in subclinical atrial fibrillation: Insights from ARTESiA. J Am Coll Cardiol. In Press, Journal Pre-proof. (https://doi.org/10.1016/j.jacc.2024.05.002)
STUDY #2: Next, we break down misconceptions surrounding race and treatment efficacy in heart failure with reduced ejection fraction. This study shines a light on the impacts of renin-angiotensin system inhibition across different racial groups. See how these findings challenge the outdated genetic constructs of race, and what they mean for your approach to patient care.
Shen, L, Lee, MM, Jhund, PS, et al. 2024. Revisiting race and the benefit of RAS blockade in heart failure: A meta-analysis of randomized clinical trials. JAMA. 24: 2094–2104. (https://doi.org/10.1001/jama.2024.6774)
STUDY #3: Finally, we turn our focus to the V142I transthyretin gene variant, to evaluate its impacts on cardiovascular health within the U.S. Black population. This research not only highlights the need for targeted genetic screening but also raises important questions about the accessibility of costly treatments for transthyretin amyloidosis.
Selvaraj, S, Claggett, B, Shah, SH, et al. 2024. Cardiovascular burden of the V142I transthyretin variant. JAMA. 21: 1824–1833. (https://doi.org/10.1001/jama.2024.4467)
Maurer, MS, Miller, EJ, Ruberg, FL, et al. 2024. Addressing health disparities—The case for variant transthyretin cardiac amyloidosis grows stronger. JAMA. 21: 1809–1811. (https://doi.org/10.1001/jama.2024.2868)
Yancy, CW. 2024. Heart failure in African American individuals, Version 2.0. JJAMA. 21: 1807–1808. (https://doi.org/10.1001/jama.2024.5217)
Don't miss out on this rich discussion that promises to enhance your understanding and expertise!
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In this episode of Cardiology Digest, we explore groundbreaking studies from the past couple of months that are expanding our understanding of best practices for atrial fibrillation management, as well as lipid-lowering therapies after an acute myocardial infarction.
STUDY #1: First up, what happens when a seemingly promising ablation strategy for nonparoxysmal atrial fibrillation disappoints? We're diving into why early nonrandomized trials can often give us hope, but the real story unfolds when randomized trials are performed. How does pulmonary vein isolation stack up against additional treatments, and is there a role for the routine use of left atrial appendage ligation in atrial fibrillation ablation?
Lakkireddy, DR, Wilber, DJ, Mittal, S, et al. 2024. Pulmonary vein isolation with or without left atrial appendage ligation in atrial fibrillation: The aMAZE randomized clinical trial. JAMA. 13: 1099–1108. (https://jamanetwork.com/journals/jama/article-abstract/2816924)
STUDY #2: Next, can early rhythm control in atrial fibrillation significantly reduce dementia risk? Our second study reveals compelling associations that persist even after rigorous sensitivity analyses. We explore the aggressive use of antiarrhythmic medications in treating new-onset atrial fibrillation, and see what recent research suggests about this approach.
Lee S-R, Choi, E-K, Lee, S-W, et al. 2024. Early rhythm control and incident dementia in patients with atrial fibrillation and prior stroke. JACC Clin Electrophysiol. Online ahead of print. (https://www.sciencedirect.com/science/article/abs/pii/S2405500X24001889)
STUDY #3: Lastly, we turn our attention to older adults who’ve had an acute myocardial infarction, and what to do about lipid-lowering therapy—what's the latest evidence? This new study provides welcome insights, especially given the previous exclusion of this age group from randomized trials. How do high-intensity therapies fare in older patients compared to their younger counterparts, and what potential confounders should we keep in mind? See how these findings impact clinical practice!
Fayol, A, Schiele, F, Ferrières, J, et al. 2024. Association of use and dose of lipid-lowering therapy post acute myocardial infarction with 5-year survival in older adults. Circ Cardiovasc Qual Outcomes. 5: e010685. https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010685
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
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Welcome to the latest episode of Cardiology Digest, where we chart a course through groundbreaking studies that are shaping cardiology practice!
STUDY #1: First, we discuss the nuanced world of drug interactions involving diltiazem and direct-acting oral anticoagulants like apixaban and rivaroxaban. Tune in as we scrutinize the study's limitations and practical implications for your patients with atrial fibrillation.
Ray, WA, Chung, CP, Stein, CM, et al. 2024. Serious bleeding in patients with atrial fibrillation using diltiazem with apixaban or rivaroxaban. JAMA. 18: 1565–1575. (https://jamanetwork.com/journals/jama/article-abstract/2817546)
STUDY #2: Next, we turn our attention to a case-control study examining the bleeding risks associated with the combination of selective serotonin reuptake inhibitors and anticoagulants in patients with atrial fibrillation. Are the bleeding risks substantial enough to rethink this combination therapy, or are there scenarios where the benefits outweigh the dangers? We'll leave no stone unturned.
Rahman, AA, Platt, RW, Beradid, S, et al. 2024. Concomitant use of selective serotonin reuptake inhibitors with oral anticoagulants and risk of major bleeding. JAMA. 3: e243208. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816687)
STUDY #3: Finally, we explore a fascinating meta analysis that looked at renal denervation and its long-term efficacy in controlling blood pressure. See how renal denervation stacks up against traditional antihypertensive medications and what you need to consider when thinking about incorporating it into your treatment arsenal.
Sesa-Ashton, G, Nolde, JM, Muente, I, et al. 2024. Long-term blood pressure reductions following catheter-based renal denervation: A systematic review and meta-analysis. Hypertension. 6: e63–e70. (https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22314)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
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Pacemaker Essentials (5 CME)
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In this episode of Cardiology Digest, we delve into three pivotal papers to help us navigate modern cardiology and patient care strategies.
STUDY #1: First, we explore findings from a Swedish study that questions the blanket application of beta-blockers after an acute myocardial infarction in patients with normal left ventricular ejection fraction. Are we witnessing the end of an era in how we manage these patients? The complexities and nuances of this study are thought-provoking!
Yndigegn, T, Lindahl, B, Mars, K, et al. 2024. Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. 15: 1372–1381. (https://doi.org/10.1056/NEJMoa2401479)
Steg, PG. 2024. Routine beta-blockers in secondary prevention—On injured reserve. N Engl J Med. 15: 1434–1436. (https://doi.org/10.1056/NEJMe2402731)
STUDY #2: Next, the integration of artificial intelligence in healthcare takes center stage, with a groundbreaking approach that uses AI in combination with routine chest x-rays. Could this offer a novel way to assess elevated risks for major adverse cardiovascular events, especially in settings where detailed clinical data might be lacking? The implications could transform patient screenings and prognostic assessments.
Weiss, J, Raghu, VK, Paruchuri, K, et al. 2024. Deep learning to estimate cardiovascular risk from chest radiographs: A risk prediction study. Ann Intern Med. 4: 409–417. (https://doi.org/10.7326/M23-1898)
STUDY #3: Lastly, we’ll look into an exciting advancement in interventional cardiology with the introduction of drug-coated balloons. Fresh from their recent FDA approval in March of this year, these innovative devices represent a significant breakthrough for treating patients with in-stent restenosis, especially those who haven’t responded well to multiple drug-eluting stents.
Yeh, RW, Shlofmitz, R, Moses, J, et al. 2024. Paclitaxel-coated balloon vs uncoated balloon for coronary in-stent restenosis: The AGENT IDE randomized clinical trial. JAMA. 12: 1015–1024. (https://doi.org/10.1001/jama.2024.1361)
Kundu, A and Moliterno, DJ. 2024. Drug-coated balloons for in-stent restenosis—Finally leaving nothing behind for US patients. JAMA. 12: 1011–1012. (https://doi.org/10.1001/jama.2024.0813)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
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In this episode of Medmastery’s Cardiology Digest, we delve into a trio of intriguing cardiology studies that raise as many questions as they answer. Whether you're a seasoned clinician or a medical student, these studies have implications that could influence your approach to patient care.
STUDY #1: First, we turn our attention to the role of GLP-1 agonists in cardiovascular disease prevention among non-diabetic patients who are overweight or obese. With a focus on injectable semaglutide this study examines its cost-effectiveness and potential side effects. The findings might alter how we manage cardiovascular risk in these patients!
Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 Nov 11; [e-pub]. (https://doi.org/10.1056/NEJMoa2307563)
STUDY #2: Next, we’ll explore a compelling meta-analysis that could sway future guidelines and recommendations. They evaluated the outcomes of physiologic guidance and intravascular imaging in percutaneous coronary interventions (PCI), to see if these techniques improve patient outcomes beyond what’s possible with angiographic guidance alone.
Kuno T et al. Comparison of intravascular imaging, functional, or angiographically guided coronary intervention. J Am Coll Cardiol 2023 Dec 5; 82:2167. (https://doi.org/10.1016/j.jacc.2023.09.823)
STUDY #3: Finally, we’re going to examine the nuances of anticoagulation in patients with subclinical atrial fibrillation. The balance between preventing strokes and avoiding bleeding complications is a delicate one. With new data suggesting nuanced approaches, this segment will provide valuable insights for us when we’re prescribing or considering anticoagulation therapies.
Healey JS et al. Apixaban for stroke prevention in subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMoa2310234)
Svennberg E. What lies beneath the surface — Treatment of subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMe2311558)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
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Percutaneous Coronary Intervention Essentials (6 CME)
Percutaneous Coronary Intervention Essentials Workshop (6 CME)
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In this episode of Medmastery’s Cardiology Digest, we bridge the gap between academic research and clinical practice, exploring three cardiology studies that provide important insights, some of which may even challenge what you think you know.
STUDY #1: First, we explore a study from JAMA Internal Medicine that sheds light on the intricate relationship between chronic inflammation and cardiovascular health in patients with rheumatoid arthritis (RA). The big question is whether there’s a link between RA and the development of aortic stenosis, and if so, what does it mean for the future of patient care?
Johnson TM et al. Aortic stenosis risk in rheumatoid arthritis. JAMA Intern Med 2023 Jul 31; [e-pub]. (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2807944)
STUDY #2: Next, we tackle a meta-analysis from the British Journal of Sports Medicine that reveals practical insights about the best form of exercise to reduce blood pressure. The conclusion may surprise you, offering a fresh perspective on exercise regimens and their role in combating hypertension. But to grasp the full scope of these revelations, you'll have to tune in.
Edwards JJ et al. Exercise training and resting blood pressure: A large-scale pairwise and network meta-analysis of randomized controlled trials. Br J Sports Med 2023 Jul 25; [e-pub]. (https://bjsm.bmj.com/content/57/20/1317)
STUDY #3: Lastly, we discuss a study that assesses the risks associated with subsequent pregnancies in women who have experienced peripartum cardiomyopathy (PPCM). We find out the magnitude of the potential for adverse events, including death.
Pachariyanon P et al. Long-term outcomes of women with peripartum cardiomyopathy having subsequent pregnancies. J Am Coll Cardiol 2023 Jul 4; 82:16. (https://www.jacc.org/doi/10.1016/j.jacc.2023.04.043)
Each of these studies offers a piece of the larger puzzle of cardiovascular health, challenging us to rethink strategies for prevention, monitoring, and treatment. Don't miss this episode, where curiosity meets clinical expertise, unlocking new horizons in cardiology.
Learn more with these courses:
Hypertension Mini: https://www.medmastery.com/courses/hypertension-mini
Cardiac MRI Essentials: https://www.medmastery.com/courses/cardiac-mri-essentials
Echo Masterclass—The Valves: https://www.medmastery.com/courses/echo-masterclass-valves
Show notes:
Visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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This week on Medmastery’s Cardiology Digest, we're peeling back the layers of three enlightening studies that are pushing the boundaries of what we know about cardiac care.
STUDY #1: First, we revisit the use of an everyday medication to check if it’s doing more harm than good in the elderly. Aspirin, long touted for its preventative benefits, is under scrutiny for its role in anemia. Should we rethink the use of aspirin in primary prevention, especially among the older population?
McQuilten, ZK, Thao, LTP, Pasricha, S-R, et al. 2023. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: A secondary analysis of the Aspirin in Reducing Events in the Elderly trial. Ann Intern Med. 7: 913–921. (https://www.acpjournals.org/doi/10.7326/M23-0675)
STUDY #2: Then, we shift focus to a comparison of approaches to mitral valve repair: the less-invasive minithoracotomy versus the conventional median sternotomy. Patient outcomes and success rates are put under the microscope, so we can tease apart what truly makes a difference in the final result. Is it the size of the incision or the skill of the hands making it?
Akowuah, EF, Maier, RH, Hancock, HC, et al. 2023. Minithoracotomy vs conventional sternotomy for mitral valve repair: A randomized clinical trial. JAMA. 22: 1957–1966. (https://jamanetwork.com/journals/jama/fullarticle/2805908)
STUDY #3: Lastly, we wrap up with an insightful discussion on compression stockings after acute DVT, to see if they can prevent post-thrombotic syndrome. Do we have enough evidence to make confident recommendations on the real benefits and drawbacks of compression wearables? And how long should patients use them? We delve into the practical aspects of incorporating the findings of this paper into patient care.
Meng, J, Liu, W, Wu, Y, et al. Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials. Thromb Res. 225: 79–86. (https://www.thrombosisresearch.com/article/S0049-3848(23)00090-7/fulltext)
Join us as we dig into the actionable insights from these studies, so we can all better optimize our patients’ outcomes!
Learn more with these courses:
Cardiac MRI Essentials: https://www.medmastery.com/courses/cardiac-mri-essentials
Echo Masterclass—The Valves: https://www.medmastery.com/courses/echo-masterclass-valves
Show notes:
Visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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Today we dive into three cardiology papers with important insights for cardiac care.
STUDY #1: We explore an analysis that compares Coronary CT Angiography (CCTA) with stress modalities like SPECT-MPI. We see if CCTA has the potential to reduce the need for invasive angiography, and how it stacks up against other testing strategies.
Zito, A, Galli, M, Biondi-Zoccai, G, et al. 2023. Diagnostic strategies for the assessment of suspected stable coronary artery disease: A systematic review and meta-analysis. Ann Intern Med. 6: 817–826. (https://www.acpjournals.org/doi/10.7326/M23-0231)
STUDY #2: We discuss the approval of a dual-chamber leadless pacemaker system by the FDA. Although this study supports the efficacy of this innovative approach in certain scenarios, it also raises important concerns.
Knops, RE, Reddy, VY, Ip, JE, et al. 2023. A dual-chamber leadless pacemaker. N Engl J Med. 25: 2360–2370. (https://www.nejm.org/doi/10.1056/NEJMoa2300080)
STUDY #3: We look at a comprehensive retrospective study that evaluates aggressive management of hypertension in hospitalized adults. What are the ramifications of minimizing the use of BP-lowering agents, particularly intravenous ones, in certain inpatient scenarios?
Anderson, TS, Herzig, SJ, Jing, B, et al. 2023. Clinical outcomes of intensive inpatient blood pressure management in hospitalized older adults. JAMA Intern Med. 7: 715–723. (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2805021)
Join us as we dissect these studies, unpacking their methodologies, outcomes, and the intriguing questions they raise.
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast
Learn more with these courses:
Pacemaker Essentials: https://www.medmastery.com/courses/pacemaker-essentials
Pacemaker Essentials Workshop: https://www.medmastery.com/workshops/pacemaker-essentials-workshop
Coronary Angiography Essentials: https://www.medmastery.com/courses/coronary-angiography-essentials
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In our latest episode, we venture into the heart of cardiology innovation, exploring groundbreaking studies that are reshaping how we approach common cardiovascular conditions.
STUDY #1: Our journey begins with a Lancet paper that looks at a potential alternative for treating supraventricular tachycardias (SVTs). Imagine a world where the distress of SVTs can be alleviated without ablation, a rush to the emergency department or the complexities of intravenous therapy. An intranasal medication might be the key, offering a beacon of hope for patients seeking simpler, yet effective solutions. But how effective is this approach, and what does it mean for the future of SVT management?
Stambler, BS, Camm, AJ, Alings, M, et al. 2023. Self-administered intranasal etripamil using a symptom-prompted, repeat-dose regimen for atrioventricular-nodal-dependent supraventricular tachycardia (RAPID): A multicentre, randomized trial. Lancet. 10396: 118–128. (https://doi.org/10.1016/S0140-6736(23)00776-6)
STUDY #2: Transitioning to the realm of antiplatelet therapy, we confront the longstanding question of P2Y12 inhibitors versus aspirin. Will these new findings tilt the balance and shift our approach to secondary coronary prevention? The nuances of this study prompt a deeper reflection on patient-centric care and the economics of new-generation medications.
Gragnano, F, Cao, D, Pirondini, L, et al. 2023. P2Y12 inhibitor or aspirin monotherapy for secondary prevention of coronary events. J Am Coll Cardiol. 2: 89–105. (https://doi.org/10.1016/j.jacc.2023.04.051)
STUDY #3: Lastly, we explore the potential of bempedoic acid in the landscape of cholesterol management, particularly for patients who are intolerant to statins. With cardiovascular diseases looming as a pervasive threat, the quest for alternative treatments is critical. We see if bempedoic acid could play a potential role in reducing major cardiovascular events, either alongside, or perhaps in lieu of, traditional statin therapy.
Nissen, SE, Menon, V, Nicholls, SJ, et al. 2023. Bempedoic acid for primary prevention of cardiovascular events in statin-intolerant patients. JAMA. 2: 131–140. (https://doi.org/10.1001/jama.2023.9696)
Kazi, DS. 2023. Bempedoic acid for high-risk primary prevention of cardiovascular disease: Not a statin substitute but a good plan B. JAMA. 2: 123–125. (https://doi.org/10.1001/jama.2023.9854)Each study we discuss brings its own set of questions, implications, and possibilities for the future of cardiology. From the practicalities of new drug administrations to the cost and effectiveness of established therapies, this episode will get you up to speed!
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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Our latest episode dissects three groundbreaking studies that are reshaping our understanding of the heart and its intricate connections to the body and mind.
STUDY #1: First, we explore the potential of high-sensitivity cardiac troponin I (hs-cTnI) in risk-stratifying patients with known coronary artery disease. While current guidelines don't yet recommend these tests, could there be untapped value in using troponin concentration as a preventive treatment guide? Join us as we explore the intriguing possibilities and implications presented in this study from the Journal of the American College of Cardiology.
Wereski, R, Adamson, P, Daud, NSS, et al. 2023. High-sensitivity cardiac troponin for risk assessment in patients with chronic coronary artery disease. J Am Coll Cardiol. 6: 473–485. (https://doi.org/10.1016/j.jacc.2023.05.046)
STUDY #2: Next, we shift our focus to the brain-heart connection. Ever wondered about the cognitive repercussions of a myocardial infarction (MI)? This study from JAMA Neurology sheds light on the potential cognitive consequences of an MI.
Johansen, MC, Ye, W, Gross, A, et al. 2023. Association between acute myocardial infarction and cognition. JAMA Neurol. 7: 723–731. (https://doi.org/10.1001/jamaneurol.2023.1331)
STUDY #3: Third, we dive deep (pun intended!) into decompression illness. Certain divers might want to reconsider their next dive because a recent Annals of Internal Medicine study suggests a primary mechanism behind decompression illness that could change the way we perceive diving risks. What are the implications for those passionate about the deep blue?
Lee, H-J, Lim, DS, Lee, J, et al. 2023. Decompression illness in divers with or without patent foramen ovale: A cohort study. Ann Intern Med. 7: 934–939. (https://doi.org/10.7326/M23-0260)
Don't miss out on these captivating discussions. Listen in to stay at the forefront of cardiology insights and to satiate your curiosity about these studies' findings. We promise, it's a heartbeat away from being your favorite episode yet!
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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Our latest episode of Cardiology Digest delves into some of the most intriguing and thought-provoking recent studies in the realm of heart health. Here's a sneak peek into what awaits you:
STUDY #1: We have the Amiodarone Enigma: An observational study in the Annals of Internal Medicine has brought up some concerns regarding the use of amiodarone in patients with heart failure, coronary disease, and renal failure. But is everything as it seems? Dive into the nuances of this study with us, as we explore whether the observed excess bleeding is truly due to the drug, or the elevated bleeding risk in these patients. Is it time to change our practice or do we need more compelling evidence?
Ray WA et al. Risk for bleeding-related hospitalizations during use of amiodarone with apixaban or rivaroxaban in patients with atrial fibrillation: A retrospective cohort study. Ann Intern Med 2023 Jun; 176:769. (https://doi.org/10.7326/M22-3238)
STUDY #2: We re-evaluate Aspirin for older patients, thanks to the ASPREE study that was recently published in JAMA Network Open. It looks like it’s time to reassess our recommendations and consider whether we’re truly informed about the pros and cons of aspirin as a risk-reduction strategy.
Cloud GC et al. Low-dose aspirin and the risk of stroke and intracerebral bleeding in healthy older people: Secondary analysis of a randomized clinical trial. JAMA Netw Open 2023 Jul 3; 6:e2325803. (https://doi.org/10.1001/jamanetworkopen.2023.25803)
STUDY #3: Lastly, we find out if there are health benefits to being a “weekend warrior”. Have you ever had patients question the health benefits of their active weekends? This study from JAMA sheds light on the potential importance of exceeding the 150-minute weekly threshold of moderate-to-vigorous physical activity. But just how beneficial is it? Tune in to find out!
Khurshid S et al. Accelerometer-derived “weekend warrior” physical activity and incident cardiovascular disease. JAMA 2023 Jul 18; 330:247. (https://doi.org/10.1001/jama.2023.10875)
Join us in this episode as we dissect these studies, offering insights and sparking discussions that could reshape our understanding of cardiology. Don't miss out on this enlightening journey!
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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Welcome to the latest episode of Cardiology Digest, where we dive into the pressing questions of today's medical research. Here's a glimpse of what's to come:
STUDY #1: Have you ever wondered about the optimal timing for introducing DOACs (direct-acting oral anticoagulants) after strokes due to atrial fibrillation? This New England Journal of Medicine study dives into the potential advantages of early DOAC introduction. You might be surprised at the rates of symptomatic intracranial hemorrhage. But remember, patient profiles vary—for example, what works for those with mild neurologic deficits might not hold true for everyone.
Fischer, U, Koga, M, Strbian, D, et al. 2023. Early versus later anticoagulation for stroke with atrial fibrillation. N Engl J Med. 26: 2411–2421. (https://doi.org/10.1056/NEJMoa2303048)
STUDY #2: Next, we’ll take a look at the curious case of rising hematocrit in certain chronic kidney disease patients who have anemia and were treated with SGLT-2 inhibitors. Did they have a genuine improvement in anemia or was it merely an illusion? SGLT-2 inhibitors are the focal point, and we'll dissect their multifaceted effects that may be at play here.
Koshino, A, Schechter, M, Chertow, GM, et al. 2023. Dapagliflozin and anemia in patients with chronic kidney disease. NEJM Evid. 6. (https://doi.org/10.1056/EVIDoa2300049)
STUDY #3: Hospitalization due to COVID-19 has presented a conundrum regarding post-discharge thromboprophylaxis. With the pandemic making such profound impacts on global health, it's crucial to address these concerns. See how new findings align with prior observational studies, and where rivaroxaban fits into all of this.
Wang, TY, Wahed, AS, Morris, A, et al. 2023. Effect of thromboprophylaxis on clinical outcomes after COVID-19 hospitalization. Ann Intern Med. 4: 515–523. (https://doi.org/10.7326/M22-3350)
STUDY #4: Cholesterol management remains pivotal in cardiac care. But the question our fourth study poses is this: do age differences impact the effectiveness of statins, particularly in lowering LDL cholesterol? A dive into this study could reshape perceptions on dosage recommendations for certain patient demographics.
Corn, G, Melbye, M, Hlatky, MA, et al. 2023. Association between age and low-density lipoprotein cholesterol response to statins: A Danish nationwide cohort study. Ann Intern Med. 8: 1017–1026. (https://doi.org/10.7326/M22-2643)
So, arm yourself with your favorite beverage and comfy earphones, and join us in uncovering the gems these studies hold. The revelations might just change the way you see these medications and treatments! 🎧🔍📚
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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Welcome to the latest episode of Medmastery’s Cardiology Digest, where we keep you up-to-date in the ever-evolving world of cardiology. This episode promises to be a riveting exploration of breakthrough studies!
STUDY #1: First, we'll delve into a national registry study on transcatheter mitral valve repair in a population that’s different from what the approval was initially based upon. We'll discuss the study's implications, as we eagerly await additional trials comparing this method to traditional surgery.
Makkar, RR, Chikwe, J, Chakravarty, T, et al. 2023. Transcatheter mitral valve repair for degenerative mitral regurgitation. JAMA. 20: 1778–1788. (https://doi.org/10.1001/jama.2023.7089)
STUDY #2: Next, we turn our attention to a ground-breaking study examining a standardized periprocedural management strategy using direct-acting oral anticoagulants for patients undergoing endoscopy. Given the study's complication rates and length of the anticoagulant interruption period, this novel approach may redefine standards for patients with atrial fibrillation.
Hansen-Barkun, C, Martel, M, Douketis, J, et al. 2023. Periprocedural management of patients with atrial fibrillation receiving a direct oral anticoagulant undergoing a digestive endoscopy. Am J Gastroenterol. 5: 812–819. (https://doi.org/10.14309/ajg.0000000000002076)
STUDY #3: Our third study puts the spotlight on the challenging mission to enhance the success rate for paroxysmal atrial fibrillation treatment. We'll explore whether wider-area ablation proved superior to standard ablation for reducing recurrence, contrast that to previous trials, and touch on what’s most important when considering the reasoning behind the choice of wider-area ablation versus standard ablation.
Nair, GM, Birnie, DH, Nery, PB, et al. 2023. Standard vs augmented ablation of paroxysmal atrial fibrillation for reduction of atrial fibrillation recurrence: The AWARE randomized clinical trial. JAMA Cardiol. 5: 475–483. (https://doi.org/10.1001/jamacardio.2023.0212)
STUDY #4: Lastly, we dissect a study centered on epicardial ablation for patients with Brugada syndrome who are suffering from ventricular fibrillation. Could this burgeoning therapy eventually replace the current implantable cardioverter–defibrillator approach?
Nademanee K et al. Long-term outcomes of Brugada substrate ablation: A report from BRAVO (Brugada Ablation of VF Substrate Ongoing Multicenter Registry). Circulation 2023 Mar 24; [e-pub]. (https://doi.org/10.1161/CIRCULATIONAHA.122.063367)
Join us as we unravel the complexities and potential game-changers these studies offer, and embark on a journey to better understand the future landscape of cardiology. Tune in and learn with Medmastery’s Cardiology Digest!
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
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