This Week in Cardiology

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Nov 22 2024 This Week in Cardiology Nov 22, 2024

Show notes

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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Nov 15 2024 This Week in Cardiology Nov 15, 2024

Show notes

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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Nov 08 2024 This Week in Cardiology Nov 08, 2024

Show notes

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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Oct 25 2024 This Week in Cardiology Oct 25, 2024

Show notes

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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Oct 18 2024 This Week in Cardiology Oct 18, 2024

Show notes

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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Oct 11 2024 This Week in Cardiology Oct 11, 2024

Show notes

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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Oct 04 2024 This Week in Cardiology Oct 04, 2024

Show notes

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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Sep 27 2024 This Week in Cardiology Sep 27, 2024

Show notes

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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Sep 20 2024 This Week in Cardiology Sep 20, 2024

Show notes

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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Sep 13 2024 This Week in Cardiology Sep 13, 2024

Show notes

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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