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In the November 19, 2024, issue of JACC, Dr. Valentin Fuster discusses four groundbreaking studies that could shape the future of cardiovascular care. Topics include the impact of atrial fibrillation screening on stroke prevention, risk factors in Brugada syndrome, new methods to reduce heart block after congenital heart disease surgery, and genetic insights into arrhythmogenic triggers of atrial fibrillation, alongside a review of a decade of leadless cardiac pacing technology.
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In this episode, Dr. Valentin Fuster discusses the Garter AF trial, which evaluates the impact of screening for undiagnosed atrial fibrillation (AF) in older adults using a 14-day ECG monitor to reduce stroke risk. While the study found a marginal increase in AF diagnoses, it suggests that AI could play a crucial role in identifying high-risk patients who would benefit most from such screenings, highlighting the need for a more targeted approach in future trials.
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In this episode, Dr. Valentin Fuster discusses a groundbreaking study on Brugada Syndrome, exploring how non-modifiable risk factors—such as male sex, SCN 5A mutations, and polygenic risk scores—can predict life-threatening arrhythmic events in patients. The research, published in JACC (November 2024), offers new insights into personalized risk assessment for this inherited arrhythmia syndrome, though its clinical implications remain limited for now.
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In this podcast, Dr. Valentin Fuster reviews a groundbreaking study on intraoperative conduction mapping to prevent postoperative atrioventricular block (AVB) in children with complex congenital heart disease. The study highlights how mapping the His bundle during surgery significantly reduces the need for pacemakers, particularly in high-risk populations like those with Heterotaxy syndrome and non-Transposed Great Arteries, offering a promising tool to improve long-term outcomes for these patients.
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In this episode, Dr. Valentin Fuster discusses a groundbreaking study on the embryological origins of atrial fibrillation triggers, which could help refine treatment strategies for the condition. The research highlights how genetic factors linked to specific atrial regions, like the sinus venosus and primitive atrium, influence arrhythmia recurrence after ablation, potentially paving the way for more personalized, effective treatments.
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In this episode, Dr. Valentin Fuster explores the evolution of leadless cardiac pacing over the past decade, highlighting its safety, efficacy, and growing role in treating heart patients. He reviews key advancements, including single and dual-chamber leadless pacemakers, ongoing innovations, and future developments, emphasizing their potential to replace traditional pacemakers and improve patient outcomes.
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In this episode, Dr. Valentin Fuster discusses groundbreaking research on SGLT2 inhibitors and their impact on heart failure, highlighting the validation of mechanistic proteomic signatures from a major clinical trial. The study reveals how empagliflozin influences over 2,000 proteins, promoting autophagy, enhancing mitochondrial health, and normalizing kidney function, offering new insights into therapeutic strategies for heart failure management.
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In this episode, Dr. Valentin Fuster discusses groundbreaking research on hypertrophic cardiomyopathy (HCM), revealing dysregulated signaling pathways through comprehensive proteomic profiling of human myocardial tissue. The study identifies novel therapeutic targets, including the Ras MAPK pathway and the ubiquitin-proteasome system, while emphasizing the need for further exploration beyond obstructive cases to better understand the disease's molecular mechanisms.
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In this episode, Dr. Valentin Fuster discusses a pivotal study on revascularization strategies in older patients with myocardial infarction, comparing complete versus culprit-only approaches. The findings suggest that physiology-guided complete revascularization significantly reduces adverse outcomes in both STEMI and non-STEMI patients, emphasizing its potential benefits across a diverse patient population.
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In this episode, Dr. Valentin Fuster reviews two pivotal phase three trials from China assessing the efficacy of the new monoclonal antibody, Katisha, for treating non-familial hypercholesterolemia. With significant reductions in LDL cholesterol and a long-acting, flexible dosing regimen, these studies promise a novel therapeutic option for patients struggling with cholesterol management and adherence to traditional treatments.
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In this episode, Dr. Valentin Fuster reviews two pivotal phase three trials from China assessing the efficacy of the new monoclonal antibody, Katisha, for treating non-familial hypercholesterolemia. With significant reductions in LDL cholesterol and a long-acting, flexible dosing regimen, these studies promise a novel therapeutic option for patients struggling with cholesterol management and adherence to traditional treatments.
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In this episode, Dr. Valentin Fuster delves into the transformative potential of artificial intelligence (AI) in cardiovascular clinical trials, guided by a comprehensive review from leading experts. Highlighting both innovative applications and regulatory challenges, the discussion emphasizes AI's role in trial design, patient recruitment, and data analysis, while cautioning against risks like bias and data privacy concerns.
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In this episode, Dr. Valentin Fuster highlights the groundbreaking studies featured in the November 12, 2024 issue of the JACC, focusing on the emerging role of proteomics in understanding heart failure and hypertrophic cardiomyopathy. He discusses key findings on SGLT2 inhibitors, the efficacy of complete revascularization in myocardial infarction patients, and novel treatments for hypercholesterolemia, emphasizing the transformative potential of these insights for cardiovascular care.
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Author Robert W. Yeh, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss the results of the TARGET-IV NA trial. In the trial, 1720 patients with stable or acute coronary syndromes were randomized to undergo PCI with a BP-SES or any commonly used 2nd generation DES. At 12 months, BP-SES was non-inferior to control DES for the primary endpoint of Target Lesion Failure (cardiac death, target vessel-related myocardial infarction (MI), or ischemia-driven target lesion revascularization) which occurred in 3.4% of the BP-SES arm versus 3.3% in the control arm; p-value for non-inferiority. Secondary endpoints were also similar between groups.
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In this episode of JACC, Author Suzanne Arnold, MD and JACC Associate Editor Dennis T. Ko, MD, discusses groundbreaking findings from the Tricatin-2 trial, the first clinical study on transcatheter tricuspid valve replacement. The results reveal significant improvements in quality of life for patients, particularly those with severe tricuspid regurgitation, highlighting the transformative potential of this procedure compared to traditional medical therapy.
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Author Shao-Liang Chen, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss patients with simple and true coronary bifurcation lesions undergoing provisional stenting. Main vessel stenting with a DCB for the compromised side branch resulted in a lower 1-year rate of the composite outcome compared with an NCB intervention for the side branch. The high rates of periprocedural myocardial infarction, which occurred early and did not lead to revascularization, are of unclear clinical significance.
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Author Nicolas M. Van Mieghem, MD, PhD, FACC, and JACC: Executive Associate Editor Aakriti Gupta, MD, FACC, discuss the TAVR UNLOAD trial, which focused on patients with moderate aortic stenosis (AS) and reduced ejection fraction (HFrEF). The trial found no significant difference in the primary endpoint (composite of mortality, stroke, and hospitalizations) between the TAVR and clinical surveillance groups. However, patients who underwent TAVR showed a significant improvement in quality of life at one year. The conversation highlighted the need for individualized treatment approaches, emphasizing patient selection, while also considering trial limitations, including slow enrollment and study size.
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In the November 5, 2024 issue of JACC, Dr. Valentin Fuster summarizes the November 5, 2024 issue of the JACC, which focuses exclusively on hypertrophic cardiomyopathy (HCM). Highlighting six original research papers, the discussion emphasizes the groundbreaking impact of the cardiac myosin inhibitor Aficamten on health outcomes, symptom burden, and cardiac structure in patients with obstructive HCM, while also exploring genetic screening implications for affected families.
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In this episode, Dr. Valentin Fuster delves into the latest research on hypertrophic cardiomyopathy, highlighting the significant health status improvements achieved with the new cardiac myosin inhibitor, Aficamten, compared to placebo. The findings from the Sequoia HCM study reveal that Aficamten markedly enhances patients' quality of life and alleviates symptoms like chest pain and shortness of breath, paving the way for more effective treatments in this challenging condition.
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In this episode, Dr. Valentin Fuster explores groundbreaking research on hypertrophic cardiomyopathy, focusing on the effects of the drug aficamten on cardiac structure and function. Highlighting significant findings from the Sequoia HCM trial, the discussion underscores the potential of aficamten to induce favorable cardiac remodeling and improve patient outcomes, signaling a transformative era in the management of this condition.
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