This Week in Cardiology

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Sep 06 2024 This Week in Cardiology Sep 06, 2024

Show notes

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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Aug 30 2024 This Week in Cardiology Aug 30, 2024

Show notes

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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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Aug 23 2024 This Week in Cardiology Aug 23, 2024

Show notes

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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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Aug 16 2024 This Week in Cardiology Aug 16, 2024

Show notes

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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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Aug 09 2024 This Week in Cardiology Aug 09, 2024

Show notes

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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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Aug 02 2024 This Week in Cardiology Aug 02, 2024

Show notes

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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Jul 26, 2024 This Week in Cardiology Podcast Jul 26, 2024

Show notes

Health and income, high BP in the hospital, and more on subclinical AF and when to use anticoagulants 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. Health and Income

A Cash Giveaway to Improve Health

https://www.medscape.com/viewarticle/cash-giveaway-improve-health-2024a1000dhf?form=fpf

JAMA RCT https://jamanetwork.com/journals/jama/fullarticle/2821454
NBER RCT https://www.nber.org/papers/w32711
Have We Missed the Hidden Cause of Medical Overuse? https://www.medscape.com/viewarticle/908309
Mar 17, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/989775

Other References

Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120
Rand Link https://www.rand.org/pubs/reports/R3055.html
The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/
Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576
Full Coverage for Preventive Medications after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmsa1107913
Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial InfarctionThe ARTEMIS Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2720024

II. Elevated BP in the hospital

JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821364

III. Short-duration Subclinical AF

Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA

https://www.medscape.com/viewarticle/998379

ARTESiA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234
ARTESiA CHADSVASC Subgroup https://www.jacc.org/doi/10.1016/j.jacc.2024.05.002
NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062
EHJ NOAH subanalysis https://doi.org/10.1093/eurheartj/ehae225
Stroke: Prolonged Heart Rhythm Monitoring After Stroke https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.045843
EHRA Analysis https://esc365.escardio.org/EHRA-Congress/sessions/10668

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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Jul 19 2024 This Week in Cardiology Jul 19, 2024

Show notes

Vulnerable plaque and scientific method; industry payments to trainees; tirzepatide or semaglutide; trial interpretation; and PFA 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. Non-invasive Imaging for Vulnerable Plaque

PET Imaging Finds Vulnerable Plaques That Cause MI

https://www.medscape.com/viewarticle/pet-imaging-finds-vulnerable-plaques-cause-mi-2024a1000cm2

JACC paper https://doi.org/10.1016/j.jacc.2024.03.419
Original JAMA-Card paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2806690

II. Industry Payments to Fellows

JAMA Network Letter https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821267

III. GLP-1a Class Effect?

Semaglutide Significantly Improves Chronic Kidney Disease

https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9

Mounjaro Beats Ozempic, So Why Isn't It More Popular?

https://www.medscape.com/viewarticle/mounjaro-beats-ozempic-so-why-isnt-it-more-popular-2024a1000ckd

JAMA-Internal Medicine: Semaglutide vs Tirzepatide https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080
SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
FLOW trial https://www.nejm.org/doi/full/10.1056/NEJMoa2403347
SURPASS-CVOT – Rationale https://doi.org/10.1016/j.ahj.2023.09.007

IV. Colchicine and Trial Interpretation in the Lancet

CONVINCE https://doi.org/10.1016/S0140-6736(24)00968-1

V. PFA

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

You may also like:

The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Jul 12 2024 This Week in Cardiology Jul 12, 2024

Show notes

Venous closure devices, GLP1-s linked to blindness and cancer, resisting the urge to do an ECG, and transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation are the topics discussed 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

Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study https://doi.org/10.1093/europace/euae105

II GLP1-s and Blindness

Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255
Locke Twitter https://x.com/doc_BLocke/status/1808972226655629610
When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808

III GLP1-s and Cancer

Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820833

IV Screening ECG

Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adultshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820721
Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP) https://doi.org/10.1016/S0140-6736(21)01637-8
Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study) https://doi.org/10.1016/S0140-6736(21)01698-6

IV TEER for Secondary Mitral Regurgitation

Randomized investigation of the MitraClip device in heart failure: Design and rationale of the RESHAPE-HF2 trial design https://doi.org/10.1002/ejhf.3247
Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure: Baseline characteristics of patients in the RESHAPE-HF2 trial and comparison to COAPT and MITRA-FR trials https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3286
Jun 21, 2024 This Week in Cardiology Podcast
https://www.medscape.com/viewarticle/1001237
Stats Blog https://www.r-bloggers.com/2023/07/the-benjamini-hochberg-procedure-fdr-and-p-value-adjusted-explained/

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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Jun 28 2024 This Week in Cardiology Jun 28, 2024

Show notes

Screening echo, multivitamins, wasteful research, another PA sensor for HF, vascular closure devices, and GLP-1 marketing as science research are the topics John Mandrola, MD, discusses 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. Screening for Valvular HD in the Elderly

EHJ-CV Imaging Paper https://doi.org/10.1093/ehjci/jeae127

II. Vitamins and Wasteful Research

Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https:// www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv

May 10, 2024 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1000772

Multivitamin Paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820369
Physicians Health Study II https://jamanetwork.com/journals/jama/fullarticle/1389615

III. FDA Has Approved Another PA Sensor

Link to slides https://c212.net/c/link/?t=0&l=en&o=4104690-1&h=4197477262&u=https%3A%2F%2Fendotronix.com%2FEndotronix-PROACTIVE-HF-LBCT-THT-2024.pdf&a=here

IV. Vascular Closure Devices in Electrophysiology.

Vascular Closure Devices Study https://onlinelibrary.wiley.com/doi/full/10.1111/jce.16345

V. SURMOUNT-OSA

SURMOUNT OSA Paper https://www.nejm.org/doi/full/10.1056/NEJMoa2404881
SELECT https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
June 21, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001237
JAMA Systematic Review and Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2643307
SAVE https://www.nejm.org/doi/full/10.1056/NEJMoa1606599
Norwegian study https://doi.org/10.1016/j.hrthm.2022.06.016

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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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