Episodi

  • Alcohol and cancer, GLP-1 trial representativeness, diagnosing CAD, changing stroke rates in patients with AF, blanking periods after AF ablation are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. Surgeon General Causes Hoopla Regarding ETOH Warning

    Dry January: Should Doctors Make It Year-Round?

    https://www.medscape.com/viewarticle/dry-january-should-doctors-make-it-year-round-2025a100009t

    Surgeon General Warning https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new-advisory-link-alcohol-cancer-risk.html GBD 2016 Collaboration Lancet https://doi.org/10.1016/S0140-6736(18)31310-2 RCT Voskobonik and colleagues https://www.nejm.org/doi/full/10.1056/NEJMoa1817591 Marcus and colleagues; UCSF https://pubmed.ncbi.nlm.nih.gov/33516710/ Review of ETOH AF https://doi.org/10.1016/j.jacc.2016.08.074

    II. GLP-1 Agonists for Obesity –Trial vs Real World

    Generalizability of Trial Results https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2826335 HRS Document ICD http://dx.doi.org/10.1016/j.hrthm.2014.03.041

    III. Stress Testing and CAD Severity

    Reynolds and colleagues. Observational ISCHEMIA Sub-analysis https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.123.013743 Foy Meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 ISCHEMIA https://www.nejm.org/doi/full/10.1056/NEJMoa1915922

    IV. Changing Stroke Rates with AF

    Teppo and colleagues. Finnish Study https://doi.org/10.1016/j.jacep.2024.10.029 Quinn and colleagues. https://www.ahajournals.org/doi/10.1161/circulationaha.116.024057

    V. Patients’ Lives Don’t Pause for Blanking Periods

    Ruzieh and colleagues. https://doi.org/10.1016/j.ahjo.2024.100497

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  • Listener feedback, multiple studies in AF ablation,

    a DANISH trial substudy of ICDs in NICM, and more data on eye complications of GLP-1 agonists 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. CCTA Feedback

    Foy meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 DANCAVAS https://www.nejm.org/doi/full/10.1056/NEJMoa2208681

    II. Listener Feedback on my negative take of the OPTION Trial.

    Option trial https://www.nejm.org/doi/pdf/10.1056/NEJMoa2408308 My Preview https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz 4 Reasons to Question Percutaneous Left Atrial Appendage Closure After AF Ablation https://www.medscape.com/viewarticle/4-reasons-question-percutaneous-left-atrial-appendage-2024a1000l0u

    III. AF Ablation

    PVI Add-Ons Provide Better Control of Persistent AF

    https://www.medscape.com/viewarticle/pvi-add-ons-provide-better-control-persistent-af-2024a1000lcm

    VENUS https://jamanetwork.com/journals/jama/fullarticle/2772281 PROMPT AF https://jamanetwork.com/journals/jama/fullarticle/2826710 STAR AF 2 https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 CRRF-PeAF https://pmc.ncbi.nlm.nih.gov/articles/PMC9241129/ CAVAC trial https://doi.org/10.1161/CIRCEP.124.012917 CRRF-PeAF from multiple centers in Japan (not published)

    IV. DANISH Trial Substudy

    Danish Trial Substudy https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.124.071777 Danish Main https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 MADIT-2 EF Substudy https://doi.org/10.1016/S0002-9149(01)01729-5 SCD-HeFT subgroup https://www.nejm.org/doi/full/10.1056/NEJMoa043399 Appraisal of ICD to Prevent SCD https://doi.org/10.1016/j.jacc.2008.05.058

    V. Eye disease and GLP-1 Agonists

    Jul 26, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001384

    Semaglutide vs No Semagutide and Eye Disease https://link.springer.com/epdf/10.1186/s40942-024-00620-x Semaglutide vs SGLT- Inhibitors and Eye Disease https://www.medrxiv.org/content/10.1101/2024.12.09.24318574v1.full-text

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  • US doc's pay, the ticagrelor controversy and new RCTs, clopidogrel beats ASA, holding antiplatelets for non-cardiac surgery, and Prof Cleland and ASA dogma are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. US Healthcare

    Mandrola’s Top 10 Stories in 2024 https://www.medscape.com/viewarticle/mandrolas-top-10-stories-2024-2024a1000mxe?_gl=1*dcvmkh*_gcl_au*MTgzOTY2ODQ0Ni4xNzI5MjU4NjUz

    CMS Proposal

    II. Ticagrelor Controversy

    New Investigation Casts Doubt on Landmark Ticagrelor Trial

    https://www.medscape.com/viewarticle/new-investigation-casts-doubt-landmark-ticagrelor-trial-2024a1000n1d

    Doshi Review https://www.bmj.com/content/387/bmj.q2550 PLATO https://www.nejm.org/doi/full/10.1056/NEJMoa0904327 ISAR REACT 5 https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 Bates Review https://www.ahajournals.org/doi/epub/10.1161/JAHA.123.031606 Victor Serebuany and Dan Atar Editorial https://doi.org/10.1093/eurheartj/ehp545

    III. New Ticagrelor vs Clopdiogrel trial

    Preprint: https://www.medrxiv.org/content/10.1101/2024.11.06.24316875v1.full-text

    IV. Clopidogrel Better Than ASA Even in HBR

    Substudy Long-Term Aspirin vs Clopidogrel After Coronary Stenting by Bleeding Risk and Procedural Complexity HOST-EXAM 10.1016/S0140-6736(21)01063-1 HOST-EXAM-Extended https://doi.org/10.1161/CIRCULATIONAHA.122.062770

    V. ASA During Non-Cardiac Surgery

    ASSURE DES https://doi.org/10.1016/j.jacc.2024.08.024

    VII. Professor Cleland on ASA for Secondary Prevention

    Cleland Editorial https//jamanetwork.com/journals/jamacardiology/article-abstract/2827201 ASA Meta-analysis 10.1016/S0140-6736(09)60503-1 AMIS https://jamanetwork.com/journals/jama/fullarticle/368745 SAPAT 10.1016/0140-6736(92)92619-Q

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  • Tirzepatide vs semaglutide in obesity; GLP1a use is complicated; HF outcomes; the misuse of meta-analyses in HF; and a breakthrough in HF care are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. SURMOUNT 5

    Clinicaltrials.gov https://clinicaltrials.gov/study/NCT05822830 Press Release

    II. Access to GLP-1 Agonist Drugs

    CMS statement https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-medicare-advantage-and-medicare-part-d-prescription-drug

    III. SUMMIT TRIAL commentary

    Has Tirzepatide Scaled the HFpEF/Obesity SUMMIT?

    https://www.medscape.com/viewarticle/has-tirzepatide-scaled-hfpef-obesity-summit-2024a1000m2h

    IV. Blank Spot in HF Evidence – All cause hospitalizations

    Sayed and colleagues What Is Success in HF Trials? https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827168 EMPEROR-Preserved https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 Mayo Observational Study 10.1016/j.mayocp.2016.11.009 DIG Trial https://jamanetwork.com/journals/jama/fullarticle/195990

    V. Misuse of Meta-analysis by HF Community

    Lu and colleagues PARAGON/PARADIGM Meta-analysis https://jamanetwork.com/journals/jamacardiology/fullarticle/2823259 Desai 2004 https://jamanetwork.com/journals/jama/fullarticle/199995 PARADIGM HF https://www.nejm.org/doi/full/10.1056/NEJMoa1409077 PARAGON HF https://www.nejm.org/doi/full/10.1056/NEJMoa1908655

    VI Integration of Palliative Care Into HF Care

    Chuzi and colleagues Palliative Care in HF 10.1016/j.cardfail.2024.10.435 Kotecha and colleagues Beta-blocker Metaanalysis 10.1016/S0140-6736(14)61373-8

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  • An AHA review: the OPTION, SUMMIT, VANISH 2, SARAH, and CLEAR 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. OPTION Trial

    For AF, LAA Rivals Anticoagulants After Ablation

    https://www.medscape.com/viewarticle/af-laa-rivals-anticoagulants-after-ablation-2024a1000l7n

    4 Reasons to Question Percutaneous Left Atrial Appendage Closure After AF Ablation

    https://www.medscape.com/viewarticle/4-reasons-question-percutaneous-left-atrial-appendage-2024a1000l0u

    OPTION in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2408308

    II. SUMMIT Trial

    Tirzepatide Reduces Heart Failure Events in HFpEF With Obesity

    https://www.medscape.com/viewarticle/tirzepatide-reduces-heart-failure-events-hfpef-obesity-2024a1000kx5

    SUMMIT in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2410027

    III. VANISH Trial

    New Trial Result Pushes Past Antiarrhythmic Therapy After MI

    https://www.medscape.com/viewarticle/new-trial-result-pushes-past-antiarrhythmic-therapy-after-mi-2024a1000l08

    VANISH 2 https://www.nejm.org/doi/full/10.1056/NEJMoa2409501 VANISH 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1513614

    IV. Cardioprotection

    Common Heart Failure Drugs Ease Heart Damage During Chemo https://www.medscape.com/viewarticle/common-heart-failure-drugs-ease-heart-damage-during-chemo-2024a1000l14

    Strain Imaging Review Article https://www.jacc.org/doi/10.1016/j.jcmg.2024.07.011

    V. CLEAR trial

    Spironolactone Shows Mixed Results in Acute MI

    https://www.medscape.com/viewarticle/spironolactone-shows-mixed-results-acute-mi-2024a1000l41

    Routine Colchicine or MRA Post-MI: No CLEAR Benefit

    https://www.medscape.com/viewarticle/routine-colchicine-or-mra-post-mi-no-clear-benefit-2024a1000la2

    CLEAR-Spironolactone https://www.nejm.org/doi/full/10.1056/NEJMoa2405923 CLEAR-Colchicine https://www.nejm.org/doi/full/10.1056/NEJMoa2405922

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  • Tirzepatide, AF screening, and an AHA preview, including VT ablation, LAAC at the time of AF ablation, BP targets, and GLP1 agonists in HF are the topics John Mandrola, MD, covers 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. Tirzepatide

    SURMOUNT 1 – Three-year results https://www.nejm.org/doi/full/10.1056/NEJMoa2410819

    II. AF Screening

    GUARD AF https://www.jacc.org/doi/10.1016/j.jacc.2024.08.019 LOOP 10.1016/S0140-6736(21)01698-6 STROKE STOP 10.1016/S0140-6736(21)01637-8

    III. LAAC with AF ablation

    Mandrola Previews the OPTION Trial, the Most Worrisome Study at AHA 2024

    https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz

    The OPTION Trial
    Rationale https://doi.org/10.1016/j.ahj.2022.05.003

    IV. Blood Pressure Targets

    BPROAD https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13411 ACCORD - https://www.nejm.org/doi/full/10.1056/NEJMoa1001286

    V. GLP1a for HFpEF

    SUMMIT at Clinicaltrials.gov https://clinicaltrials.gov/study/NCT04847557

    VI. VT Ablation

    VANISH2 Rationale https://doi.org/10.1016/j.ahj.2024.04.009 VANISH 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1513614

    VII. Spironolactone Results of CLEAR-SYNERGY

    Nov 08, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001865

    'No Hint of Benefit' in Large Colchicine Trial

    https://www.medscape.com/viewarticle/no-hint-benefit-large-colchicine-trial-2024a1000ko4

    CLEAR SYNERGY Rationale https://pubmed.ncbi.nlm.nih.gov/38936755/

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  • The EARLY TAVR trial, colchicine after MI, and the TRISCEND II trial of tricuspid valve replacement 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. Early TAVR

    EARLY TAVR https://www.acc.org/latest-in-cardiology/clinical-trials/2024/10/24/14/42/early-tavr Rationale https://doi.org/10.1016/j.ahj.2023.11.019 AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 RECOVERY https://www.nejm.org/doi/full/10.1056/NEJMoa1912846 FAME 2 https://www.nejm.org/doi/full/10.1056/NEJMoa1205361 Rajkumar; Faith Healing in Unblinded Trials https://pubmed.ncbi.nlm.nih.gov/29530888/ PARTNER 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307447 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec

    II. Colchicine

    Meta-analysis https://doi.org/10.1016/j.eclinm.2024.102835 Clear-Synergy Rationale https://pubmed.ncbi.nlm.nih.gov/38936755/ COLCOT (post MI) https://www.nejm.org/doi/full/10.1056/NEJMoa1912388 LoDoCo (Chronic CAD) https://www.nejm.org/doi/full/10.1056/NEJMoa2021372

    III. TRISCEND II Trial

    TRISCEND II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2401918

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  • Listener feedback on PFA and STEMI/NSTEMI paradigm, oral semaglutide, symptomatic vs asymptomatic AF, and the win-ratio 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

    Oct 18, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001769

    Pulsed Field Ablation

    https://www.hrsonline.org/guidance/safety-alerts/boston-scientific-cardiac-cryoablation-system

    STEMI/NSTEMI https://doi.org/10.1016/j.jacadv.2024.101314

    II. Oral Semaglutide

    Press Release: https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=171480 Rationale Paper SOUL trial

    III. Symptomatic vs Asymptomatic AF

    Meta-analysis in EHJ Meta-analysis of rate vs rhythm-control strategies https://doi.org/10.1016/j.jacep.2024.03.006

    IV. The Win Ratio

    Pocock and colleagues https://doi.org/10.1093/eurheartj/ehae647

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  • Listener feedback on the c-statistic, atherosclerotic plaque imaging, WATCHMAN implant decisions in the US, and deprescribing 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

    Oct 11, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001735

    Nancy Cook; C-statistic https://doi.org/10.1161/CIRCULATIONAHA.106.672402

    II. Plaque Imaging

    New Evidence That Plaque Buildup Shouldn't Be Ignored

    https://www.medscape.com/viewarticle/new-evidence-plaque-buildup-shouldnt-be-ignored-2024a1000ihw

    Fuster and colleagues; Imaging vs CAC

    III. WATCHMAN Decisions

    Zeitler and colleagues. Long-term Outcomes

    IV. Deprescribing

    Cognitive Decline and Antihypertensive Use: New Data

    https://www.medscape.com/viewarticle/cognitive-decline-and-antihypertensive-use-new-data-2024a1000isw?form=fpf

    Jing and colleagues.

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  • Reader feedback on cardiac devices and PFA, a new paradigm in the language of MI, sudden cardiac death, and measuring blood pressure 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

    Sep 20, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001631

    Cardiac Devices

    https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724

    Impact of PFA on Intraluminal Esophageal Temperature https://onlinelibrary.wiley.com/doi/10.1111/jce.16096

    II. Towards a New Classification of MI

    McLaren and colleagues; From STEMI to OMI https://doi.org/10.1016/j.jacadv.2024.101314

    III. Sudden Death After MI.

    EHJ Paper; SCD After MI https://doi.org/10.1093/eurheartj/ehae326 Barsheshet and colleagues; Risk Score to Predict Benefit of ICD https://doi.org/10.1016/j.jacc.2012.02.036 Zegard and colleagues; Myocardial Fibrosis and SCD 10.1016/j.jacc.2020.10.046 MADIT RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107

    IV. BP Readings

    Poor Arm Position May Significantly Skew BP Readings

    https://www.medscape.com/viewarticle/poor-arm-position-may-significantly-skew-bp-readings-2024a1000icv?form=fpf

    ARMS Crossover RCT

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  • Reader feedback on LGE pre-ICDs, PFA for AF ablation, CTO-PCI, endovascular ablation of the greater splanchnic nerve in HFpEF, and data sharing are the topics John Mandrola, MD, covers this week.

    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

    Sept 27, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001666

    JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/

    II. Pulsed Field Ablation for AF

    Feb 02, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/999995

    ADMIRE Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.070333 ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291

    III. PCI for CTO

    EuroCTO One Year SAQ Results https://doi.org/10.1093/eurheartj/ehy220 EuroCTO Hard Outcomes https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusions Faith Healing and Subtraction Anxiety https://doi.org/10.1161/CIRCOUTCOMES.118.004665 DECISION CTO trial https://doi.org/10.1161/CIRCULATIONAHA.118.031313 ISCHEMIA CTO Rationale and Design https://doi.org/10.1016/j.ahj.2022.11.016

    IV. Greater Splanchnic Nerve Ablation for HFpEF

    REBALANCE HF https://jamanetwork.com/journals/jamacardiology/fullarticle/2823999

    V. Data Sharing

    The Pros and Cons of Clinical Trial Data Sharing

    https://www.medscape.com/viewarticle/862815

    Kramer and Nallamothu, Caution in Data Sharing https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.124.010257 Nosek, Variability in Analytic Methods https://journals.sagepub.com/doi/10.1177/2515245917747646 Zeraatker, Variability in Analytic Methods

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  • Surgical clearance, NICM assessment, dueling perspectives on PCI as first-line therapy for angina, GDMT in HFrEF 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. New ACC Peri-operative Guidelines Released

    ACC Guideline document https://www.jacc.org/doi/10.1016/j.jacc.2024.06.013 J Vasc Surg https://www.jvascsurg.org/article/S0741-5214(21)00335-9/fulltext McFalls and colleagues; CARP https://www.nejm.org/doi/full/10.1056/NEJMoa041905

    II. NICM – We may be doing it wrong in Selecting ICDs

    JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/ German CMR ICD Trial https://www.clinicaltrials.gov/study/NCT04558723 BRITISH CMR trial https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/britishusing-cmr-scar-as-risk-indication-tool-in-nicm-and-severe-lvsd/

    III. When Should PCI be Used in Chronic Stable CAD?

    Rajkumar and Al-Lamee; PCI First https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011201 Boden and De Caterina; Meds First https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011268 ORBITA 10.1016/S0140-6736(17)32714-9 ORBITA 2 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2310610

    IV. GDMT Underuse in HFrEF

    Greene and colleagues https://doi.org/10.1016/j.jchf.2024.08.002 DAPA HF https://www.nejm.org/doi/full/10.1056/NEJMoa1911303 RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001

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  • Listener feedback, K levels post cardiac surgery, cardiac device safety, disparities in preventive care, stopping trials early, and a SHAM-PVI update are the topics John Mandrola, MD, covers this week.

    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

    Sep 13, 2024 This Week in Cardiology Podcast

    https://www.medscape.com/viewarticle/1001596

    Sripal Bangalore Tweet on Yusef Meta-analysis https://x.com/SripalBangalore/status/1750116964893094125

    II. Post Cardiac Surgery AF

    TIGHT K Trial https://jamanetwork.com/journals/jama/fullarticle/2823246

    III. Evidence Base for New Cardiac Devices

    Annals of IM Survey Observational Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724

    IV. Disparities in Care

    JAMA Network Open Paper on Insurer Denials of Preventive Care https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823677

    V. Stopping Trials Early

    Kaul and Butler; Insights on Recent CKD Trials https://doi.org/10.1016/j.jacc.2024.07.026 Bassler Systematic Review https://jamanetwork.com/journals/jama/fullarticle/185591

    VI. Sham PVI

    AF Ablation Works…But: The Positive SHAM-PVI Trial

    https://www.medscape.com/viewarticle/af-ablation-works-positive-sham-pvi-trial-2024a1000gzl?&icd=login_success_email_match_fpf

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  • More from ESC: the SCOFF trial and fasting before cardiac cath, MATTERHORN, humbling data with AI, plus a reflection on the work of being a patient are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. Fasting Before Cardiac Procedures

    The SCOFF Trial https://doi.org/10.1093/eurheartj/ehae573

    II. MV repair for Functional MR

    Large Trials Support Mitral Valve Repair in Heart Failure

    MATTERHORN https://www.nejm.org/doi/full/10.1056/NEJMoa2408739

    III. AI in Medicine

    Rapidx AI Project https://healthtranslationsa.org.au/project/rapid-x-ai/ PROTEUS Trial Rationale paper https://pubmed.ncbi.nlm.nih.gov/37192698/

    IV. Time Toxicity

    Time Toxicity https://link.springer.com/article/10.1007/s00520-024-08844-1 Thread X https://x.com/EnriqueSoto8/status/1833587144256065859

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  • Feedback on ABYSS and beta-blockers, more ESC recap, including SHAM-PVI, FINEARTS-HF, and RESHAPE HF2 trials 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. Feedback on ABYSS

    Setbacks After Stopping Beta-Blockers

    https://www.medscape.com/viewarticle/setbacks-after-stopping-beta-blockers-2024a1000fv7

    Beta-Blockers Post-MI? No for Me, Even After the ABYSS Trial

    https://www.medscape.com/viewarticle/beta-blockers-post-mi-no-me-even-after-abyss-trial-2024a1000fva

    ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 QOL paper REDUCE AMI https://doi.org/10.1093/ehjcvp/pvae062 Atenolol ED paper 10.1016/j.ehj.2003.08.016

    II. SHAM-PVI

    JAMA SHAM-PVI paper https://jamanetwork.com/journals/jama/article-abstract/2823283 Gupta QOL paper https://pubmed.ncbi.nlm.nih.gov/33952593/

    III. FINEARTS HF

    Finerenone Benefits Heart Failure With Preserved EF

    https://www.medscape.com/viewarticle/finerenone-benefits-heart-failure-preserved-ef-2024a1000fza

    Topline Finerenone Results Point to Advance in Heart Failure

    https://www.medscape.com/viewarticle/topline-finerenone-results-point-advance-heart-failure-2024a1000fq2

    FINEHEARTS -HF NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 FIDELIO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 FIGARO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2110956 Why Have We Not Been Able to Demonstrate Reduced Mortality in Patients With HFmrEF/HFpEF? https://doi.org/10.1016/j.jacc.2024.08.033

    IV. RESHAPE HF

    TEER in Functional MR: Data Deluge, but No Easy Answers

    https://www.medscape.com/viewarticle/teer-functional-mr-data-deluge-no-easy-answers-2024a1000fvg

    Mitra FR https://www.nejm.org/doi/full/10.1056/NEJMoa1805374 COAPT https://www.nejm.org/doi/full/10.1056/NEJMoa1806640 RESHAPE- HF2 https://www.nejm.org/doi/full/10.1056/NEJMoa2314328 RESHAPE Subgroup paper https://doi.org/10.1016/j.jacc.2024.08.027

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  • From ESC: post-MI beta blockers, a new therapy for ATTR-CM, holding RASi before non-cardiac surgery, good news in HFpEF, and an ESC preview are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. ABYSS

    ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479

    II. ATTR -CM HELIOS B

    Positive Top Line Results for Vutrisiran in Cardiac Amyloidosis

    https://www.medscape.com/viewarticle/positive-top-line-results-vutrisiran-cardiac-amyloidosis-2024a1000cjj

    HELIOS A https://www.tandfonline.com/doi/full/10.1080/13506129.2022.2091985 HELIOS B https://www.nejm.org/doi/full/10.1056/NEJMoa2409134

    III. STOP or NOT Trial

    Observational Study Showing Benefits of Holding RASi https://doi.org/10.1097/ALN.0000000000001404 STOP or NOT Protocol Paper -- https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3247-1 JAMA STOP or NOT https://jamanetwork.com/journals/jama/fullarticle/2823118

    IV. GLP1a in HFpEF

    The GLP-1 Agonist Semaglutide in HFpEF Cleared a Low Bar https://www.medscape.com/viewarticle/995872

    STEP-HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 STEP-HFpEF-DM https://www.nejm.org/doi/full/10.1056/NEJMoa2313917 SELECT https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 FLOW https://www.nejm.org/doi/full/10.1056/NEJMoa2403347 Lancet Meta-analysis https://doi.org/10.1016/S0140-6736(24)01643-X

    V. ESC Preview

    Mandrola's Five Big Trials to Look for at ESC 2024

    https://www.medscape.com/viewarticle/mandrolas-five-big-trials-look-esc-2024-2024a1000fkt

    Topline Finerenone Results Point to Advance in Heart Failure

    https://www.medscape.com/viewarticle/topline-finerenone-results-point-advance-heart-failure-2024a1000fq2

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  • Suicidal ideation and GLP-1 agonists, a repeat of PARADIGM HF in Chagas CM, CASTLE HTx critical appraisal, and primary prevention of SCD in HF are the topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I. Suicidal ideation with GLP-1

    Signal of Suicidality With GLP-1 RA Semaglutide, but Experts Urge Caution

    https://www.medscape.com/viewarticle/signal-suicidality-glp-1-ra-semaglutide-experts-urge-caution-2024a1000fa7

    Disproportionality Analysis from World Health Organization Data on Semaglutide, Liraglutide, and Suicidality Variability in Disproportionality paper https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.668765/full

    II. PARACHUTE HF: Repeating the Mistakes in PARADIGM HF

    PARACHUTE HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 SOLVD https://www.nejm.org/doi/full/10.1056/NEJM199108013250501 CONSENSUS trial https://www.nejm.org/doi/full/10.1056/NEJM198706043162301 Meta-analysis of Low vs High Dose ACE/ARB https://doi.org/10.1161/CIRCHEARTFAILURE.117.003956 Meta-analysis of Sac/Val vs ARB/ACE Inhibitors https://link.springer.com/article/10.1007/s00228-024-03686-6 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508

    III. CASTLE HTx Critical Appraisal

    Critical Appraisal of CASTLE HTx https://doi.org/10.1016/j.jacc.2024.06.020 CASTLE HTx https://www.nejm.org/doi/10.1056/NEJMoa2306037 CASTLE AF https://www.nejm.org/doi/full/10.1056/NEJMoa1707855

    IV. More Data Suggesting Modest Benefits of the Primary Prevention ICD

    First and Recurrent ICD Shocks: JICE Paper from Denmark https://link.springer.com/article/10.1007/s10840-024-01873-0 HF trialists https://www.nejm.org/doi/full/10.1056/NEJMoa1609758
    PROFID Trial https://profid-project.eu/ DANISH https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 SCD-HeFT https://www.nejm.org/doi/full/10.1056/NEJMoa043399

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  • Diuretic therapy in HFrEF, AF ablation, TACT 2 and the story of subgroups, and SGLT2 inhibitor underuse 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. Diuretic Therapy in HF

    Dapa vs Metolazone Trial https://doi.org/10.1093/eurheartj/ehad341
    ADVOR https://www.nejm.org/doi/10.1056/NEJMoa2203094

    II. Rapid Medication Titration for Acute HF

    ACC Decision Pathway https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002

    III. SGLT2 Inhibitor Use in the US

    Shin and Colleagues; JACC https://www.sciencedirect.com/science/article/abs/pii/S0735109724076332 Editorial https://doi.org/10.1016/j.jacc.2024.07.001

    IV. AF Ablation: General Anesthesia vs Conscious Sedation

    Da Riis-Vestergaard and Colleagues https://doi.org/10.1093/europace/euae203

    V. TACT 2 Published

    TACT 1 https://jamanetwork.com/journals/jama/fullarticle/1672238 TACT 1 DM https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.113.000663 TACT 2 https://jamanetwork.com/journals/jama/fullarticle/2822472

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  • Prediction models vs clinical judgement, CCTA quantification of atherosclerosis, AF ablation plus LAAO, atrial shunt devices, and HF medical therapy are topics John Mandrola, MD, covers this week.

    This podcast is intended for healthcare professionals only.

    To read a partial transcript or to comment, visit:

    https://www.medscape.com/twic

    I.Clinical Prediction Models vs Clinical Judgement

    Did Statin Decision-Making Just Get Harder?

    https://www.medscape.com/viewarticle/did-statin-decision-making-just-get-harder-2024a1000egl

    Colunga-Lozano and colleagues https://doi.org/10.1016/j.jclinepi.2023.10.016 Aug 02, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001429

    II. CCTA Quantification of Atherosclerosis

    Atherosclerosis Quantification and Cardiovascular Risk: the ISCHEMIA Trial https://doi.org/10.1093/eurheartj/ehae471 Circulation ISCHEMIA sub study 2021 – Severity of CAD and Outcomes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049755 ISCHEMIA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1915922

    III. Combined AF Ablation and LAAO

    Review from Mills and colleagues https://doi.org/10.1016/j.tcm.2023.11.003 Link to CMS Rule on AF Ablation and LAAO https://hrs2.informz.net/z/cjUucD9taT05MjU3ODgyJnA9MSZ1PTkwMDQ2MTk4MCZsaT04NTU1OTQxMg/index.html

    IV. Atrial Shunt Devices

    No Net HF Benefit for Interatrial Shunt Device

    https://www.medscape.com/viewarticle/no-net-hf-benefit-interarterial-shunt-device-2024a10006kk

    Original REDUCE-LAP-HF-II https://doi.org/10.1016/S0140-6736(22)00016-2 Two-year results of REDUCE-LAP-HF-II https://doi.org/10.1016/j.jchf.2024.04.011 Apr 19, 2024 This Week in Cardiology Podcast

    V. Optimal HF Therapy

    Rao and colleagues; CHAMP HF https://doi.org/10.1016/j.jchf.2024.05.026

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  • Two downsides of PFA including autonomic tone and hemolysis, a bad surrogate in AF care, and controversies in defining cardiac risk 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 and Its (lack of) Effect on Autonomic Tone

    Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed?

    https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v

    Autonomic Tone Paper https://doi.org/10.1016/j.jacep.2024.05.005 ADVENT https://www.nejm.org/doi/full/10.1056/NEJMoa2307291

    II. Second PFA Study JACC-EP—on Hemolysis

    Hemolysis study https://doi.org/10.1016/j.jacep.2024.05.001 MANIFEST 17K https://www.nature.com/articles/s41591-024-03114-3 Defaye Editorial https://www.jacc.org/doi/abs/10.1016/j.jacep.2024.06.007

    III. A Self-serving Surrogate Marker: Diagnosis to Ablation Time.

    CAPLA Study https://jamanetwork.com/journals/jama/fullarticle/2800186 CAPLA Substudy https://doi.org/10.1016/j.jacep.2024.05.031 EHJ RCT Early vs Late https://doi.org/10.1093/eurheartj/ehad247 LOOP; Diederichsen and colleagues 10.1016/j.jacc.2019.09.050 Groningen and Maastricht Group study https://heart.bmj.com/content/109/3/186

    IV. Future Cardiac Risk

    Diao and colleagues Study of AHA PREVENT Risk Equations https://jamanetwork.com/journals/jama/fullarticle/2821624 JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821542 Another JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821628

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