This Week in Cardiology

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Jun 21 2024 This Week in Cardiology Jun 21, 2024

Show notes

MRAs in HF with renal dysfunction, coronary autoregulation, the hubris of US doctors, NSTEMI in older patients, survival after STEMI, and new leaders at JACC are discussed by John Mandrola, MD.

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

Combined analysis (Matsumoto)

II Coronary artery autoregulation with increasing stenosis

NEJM Paper https://www.nejm.org/doi/full/10.1056/NEJMc2402216

III RECOVER IV Trial

Gregg Stone, MD Tweet https://x.com/GreggWStone/status/1803583552354742416
DANGER-Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572
Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659

IV NSTEMI Elderly

Main Paper
Datamethods https://discourse.datamethods.org/t/random-vs-fixed-effects-meta-analysis/7361
O'Fee Paper https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

V MI Survival

Danish Paper https://doi.org/10.1016/j.jacc.2024.04.025

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Jun 14 2024 This Week in Cardiology Jun 14, 2024

Show notes

Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF 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

ASPIRE AF https://classic.clinicaltrials.gov/ct2/show/NCT03968393
Butala paper: Stroke After TAVR With and Without EPD https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697
PROTECTED TAVR
Heuts meta-analysis: EPD During TAVR https://heart.bmj.com/content/110/11/757

II. Statin Eligibility

JAMA-IM: Data Analytic Choices and Predicting Vascular Events https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819821
Zeraatker Specification Analysis Paper https://doi.org/10.1016/j.jclinepi.2024.111278
PCE https://www.mdcalc.com/calc/3398/ascvd-atherosclerotic-cardiovascular-disease-2013-risk-calculator-aha-acc

III. Heterogenous Treatment Effect

Weisberg and Dailey-Higgs
DANISH

IV. Heart Failure and MRAs

RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001
EMPHASIS https://www.nejm.org/doi/full/10.1056/NEJMoa1009492
Combined analysis (Matsumoto)

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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 07 2024 This Week in Cardiology Jun 07, 2024

Show notes

Cannabis and CV outcomes, post-CABG AF, embolic protection devices, emulation of randomization, and a preview heterogenous treatment effects 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. Cannabis

It Sure Looks Like Cannabis Is Bad for the Heart, Doesn't It?

https://www.medscape.com/viewarticle/1000250

Cannabis Use Tied to Increased Cardiovascular Risk

https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk

https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk-2024a10000sc

Cannabis for Chronic Pain and CV Safety https://doi.org/10.1093/eurheartj/ehad834
Editorial https://academic.oup.com/eurheartj/article/45/6/485/7500073
Response to Letter https://doi.org/10.1093/eurheartj/ehae314
UCLA paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819559
Lifetime Cannabis Use and Mortality https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819635

II. Post Cardiac Surgery AF

Meta-analysis https://doi.org/10.1093/eurheartj/ehae267

III. Embolic Protection devices

Clear Stroke Benefit Eludes Embolic Protection: PROTECTED TAVR

https://www.medscape.com/viewarticle/980978

Embolic Protection and Stroke Prevention With TAVR https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697
PROTECTED TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2204961

IV. Preview of HTE

Paper https://doi.org/10.1016/j.ahj.2024.04.020

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May 31 2024 This Week in Cardiology May 31, 2024

Show notes

The FLOW trial of semaglutide, the DANCAVAS CV screening trial, non-invasive tests for chest pain, and conflicts of interest on social media 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. Semaglutide for CKD

Semaglutide Significantly Improves Chronic Kidney Disease

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

FLOW Trial

II. CV Screening

Judicious CVD Screening May Work in Men: DANCAVAS

https://www.medscape.com/viewarticle/980153

DANCAVAS 6-Year Outcomes https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004403
DANCAVAS Main Trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2208681

III. Non-invasive Cardiac Testing in Chest Pain

Circulation Outcomes Paper https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010457
Scot Heart https://www.nejm.org/doi/full/10.1056/NEJMoa1805971

IV. COI and Social Media

JAMA letter https://jamanetwork.com/journals/jama/fullarticle/2816900

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May 24 2024 This Week in Cardiology May 24, 2024

Show notes

Clues in SCAF, a DOAC antidote trial, another negative lytic trial in stroke, JAMA changes to observational studies, and BP in stroke care 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. ARTESIA Substudy

Sadly, ARTESIA Doesn't Answer a Common Question in Cardiology

https://www.medscape.com/viewarticle/998215

ARTESIA Substudy
NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062
ARTESIA https://www.nejm.org/doi/10.1056/NEJMoa2310234

II. DOAC Reversal

ANNEXA-1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2313040

III. Lytic Therapy in Acute Stroke

Thrombolysis Offers No Benefit for Mild Stroke

https://www.medscape.com/viewarticle/iv-thrombolysis-offers-no-benefit-mild-stroke-2024a10009p7

TEMPO-2 Trial https://doi.org/10.1016/S0140-6736(24)00921-8
The Case Against Thrombolytic Therapy in Stroke

IV. Observational Research

JAMA Special Communication https://jamanetwork.com/journals/jama/fullarticle/2818746
JAMA editors note https://jamanetwork.com/journals/jama/fullarticle/2818747

V. Aggressive BP Control in Stroke

Guidelines on Rapid BP Reduction in Acute Ischemic Stroke Challenged

https://www.medscape.com/viewarticle/guidelines-rapid-bp-reduction-acute-ischemic-stroke-2024a10009pe

TRUTH Trial https://doi.org/10.1016/S1474-4422(24)00177-7

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May 17 2024 This Week in Cardiology May 17, 2024

Show notes

An Impella update, another TAVI vs SAVR trial, two studies on angina and PCI, another null substudy from REVIVED-BCIS, and semaglutide 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. Impella Update

CHRIP BCIS 3 https://classic.clinicaltrials.gov/ct2/show/NCT05003817
Danger-Shock Podcast https://www.medscape.com/viewarticle/1000675

II. TAVI vs SAVR

Notion 2 Trial EHJ https://doi.org/10.1093/eurheartj/ehae331
DEDICATE-DZHK6

III. Angina and PCI

Orbita 2 Sub-analysis
Orbita Star https://www.jacc.org/doi/10.1016/j.jacc.2024.04.001

IV. Complete Revascularization

Main REVIVED trial https://www.nejm.org/doi/full/10.1056/NEJMoa2206606
JACC Substudy https://www.jacc.org/doi/10.1016/j.jacc.2024.04.043

V. Semaglutide

Semaglutide CV Benefits Irrespective of Weight Loss: 4-Year SELECT Data

https://www.medscape.com/viewarticle/semaglutide-cv-benefits-irrespective-weight-loss-4-year-2024a100095z

Nature Med substudy https://www.nature.com/articles/s41591-024-02996-7
SELECT Main paper https://www.nejm.org/doi/full/10.1056/NEJMoa2307563

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May 10 2024 This Week in Cardiology May 10, 2024

Show notes

Inclisiran, sodium-channel blocker safety, analytic flexibility, the work-up of patients with HF, and BP in older patients 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. Inclisiran Update

ORION 4 https://classic.clinicaltrials.gov/ct2/show/NCT03705234

II. Sodium-Channel AADs

UPenn Paper https://doi.org/10.1016/j.jacep.2024.01.021
Three Questions Editorial https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381
EAST Post-hoc Review https://doi.org/10.1093/europace/euae121

III. Analytic Flexibility

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

Specification Curve Analysis of Red Meat Data https://doi.org/10.1016/j.jclinepi.2024.111278

IV. The Work-up of Patients With HF

Durstenfeld and colleagues, UCSF https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010800
REVIVED BCIS2 https://www.nejm.org/doi/full/10.1056/NEJMoa2206606

V. BP Therapy in Older Patients

Haring and colleagues; Women's Health Initiative BP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067302
SPRINT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1511939

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May 03 2024 This Week in Cardiology May 03, 2024

Show notes

The DEDICATE trial of TAVR vs SAVR, more on renal denervation, inclisiran, and marketing disguised as science 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. TAVR vs SAVR

TAVI Comparable With SAVR in Lower-Risk Aortic Stenosis

https://www.medscape.com/viewarticle/tavi-comparable-savr-lower-risk-aortic-stenosis-2024a100074o?form=fpf

DEDICATE https://www.nejm.org/doi/full/10.1056/NEJMoa2400685
Partner 3 https://www.nejm.org/doi/full/10.1056/NEJMoa1814052
Evolut Low Risk https://www.nejm.org/doi/full/10.1056/NEJMoa1816885
Barili meta-analysis https://doi.org/10.1093/ejcts/ezab516

II. Renal Denervation

Alcohol-Mediated Renal Denervation Promising in Hypertension

https://www.medscape.com/viewarticle/alcohol-mediated-renal-denervation-promising-hypertension-2024a10007eg

TARGET 1 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.069291

III. Inclisiran

Earlier Inclisiran Gives Better Long-Term LDL Reductions

https://www.medscape.com/viewarticle/earlier-inclisiran-gives-better-long-term-ldl-reductions-2024a10007d6

VICTORIAN INITIATE Trial https://www.jacc.org/doi/10.1016/j.jacc.2024.03.382

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Apr 26 2024 This Week in Cardiology Apr 26, 2024

Show notes

A listener defends colored boxes in guidelines; mysteries of non-culprit coronary lesions during PCI, and of AF ablation; and surrogate markers 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. Mystery of What to Do in the Cath Lab after Fixing the Culprit Lesion – The FULL REVASC Trial

Complete Revascularization Not Superior to Culprit-Only PCI After MI

https://www.medscape.com/viewarticle/complete-revascularization-not-superior-culprit-only-pci-2024a10007ik

FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
FIRE Trial https://www.nejm.org/doi/10.1056/NEJMoa2300468
COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
Cohen Tweet on FULL REVASC https://x.com/djc795/status/1781361606238085532

II. AF Ablation Mysteries

New Expert Consensus on Ablation Strategies for AF

https://www.medscape.com/viewarticle/new-expert-consensus-ablation-strategies-af-2024a1000851

Bern Study of Remapping https://doi.org/10.1016/j.jacep.2024.02.026
Natural History of SCAF https://doi.org/10.1016/j.jacc.2019.09.050
Liverpool Study: Thermal PV Isolation in Persistent AF https://doi.org/10.1016/j.hrthm.2024.04.061

III. Surrogate Markers

JAMA: Surrugate Markers and Clinical Outcomes https://jamanetwork.com/journals/jama/fullarticle/2817850
BP Surrogate Meta-analysis https://doi.org/10.1016/S0140-6736(21)00590-0
JAMA: Nonfatal MI as Surrogate for Mortality https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

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Apr 19 2024 This Week in Cardiology Apr 19, 2024

Show notes

ACC Part 2: The TACT2 trial of chelation, inter-atrial shunts for HF, and triglyceride lowering; plus diltiazem and Factor Xa anticoagulants 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. TACT 2

Chelation Therapy Provides No Benefit Post-MI

https://www.medscape.com/viewarticle/chelation-therapy-provides-no-benefit-post-mi-2024a10006l5

Chelation Therapy and CV Risk: Why TACT2 Showed No Benefit https://www.medscape.com/viewarticle/chelation-therapy-and-cv-risk-why-tact2-showed-no-benefit-2024a1000761?src=

JAMA TACT 1 paper https://jamanetwork.com/journals/jama/fullarticle/1672238
Diabetes Subgroup paper https://pubmed.ncbi.nlm.nih.gov/24254885/
A New Look at P-values https://evidence.nejm.org/doi/abs/10.1056/EVIDoa2300003
PARAGON HF https://www.nejm.org/doi/full/10.1056/NEJMoa1908655

II. Interatrial Shunts for HF

No Net HF Benefit for Interarterial Shunt Device

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

REDUCE LAP HF II https://doi.org/10.1016/S0140-6736(22)00016-2

III. Triglyceride Lowering

Early Olezarsen Results Show 50% Reduction in Triglycerides

https://www.medscape.com/viewarticle/early-olezarsen-results-show-50-reduction-triglycerides-2024a10006oz

Is It Time to Stop Treating High Triglycerides?

https://www.medscape.com/viewarticle/990126

NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2402309

Substantial Triglyceride Reduction With Plozasiran

https://www.medscape.com/viewarticle/substantial-triglyceride-reduction-plozasiran-2024a10006wf?icd=login_success_email_match_norm

JAMA Cardiology https://jamanetwork.com/journals/jamacardiology/article-abstract/2817469

IV. Diltiazem and Factor Xa inhibitors

JAMA Vanderbilt University Paper https://jamanetwork.com/journals/jama/fullarticle/2817546

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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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