May 7, 2021 This Week in Cardiology Podcast

Renal denervation, the obesity paradox, JACC and the FINEARTS trial of finerenone in HFpEF, a setback for a PFA system, and coffee are the topics Jon 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. RDN CMS https://www.cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=318 Messerli https://doi.org/10.1016/j.jacc.2024.09.1244 Filippone https://doi.org/10.1016/j.amjmed.2023.05.010 II. Finerenone 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 Regional Variation TOPCAT https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 Time from WHF Subanalysis https://doi.org/10.1016/j.jacc.2024.09.004 REDEFINE - https://clinicaltrials.gov/study/NCT06008197 Health status paper https://doi.org/10.1016/j.jacc.2024.09.023 Obesity subanalysis https://doi.org/10.1016/j.jacc.2024.10.111 Kidney outcomes https://www.sciencedirect.com/science/article/pii/S0735109724102525 Kidney outcomes 2 https://doi.org/10.1016/j.jacc.2024.11.020 Kaul editorial https://doi.org/10.1016/j.jacc.2024.11.024 III. PFA Setback J&J Halts Varipulse Field Ablation for AFib https://www.medscape.com/viewarticle/j-j-halts-varipulse-field-ablation-afib-2025a10000j8 IV. Coffee Stop the Coffee Studies https://www.medscape.com/viewarticle/883709 Coffee drinking timing and mortality in US adults  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 Questions or feedback, please contact news@medscape.net

17 Tammi 202531min

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 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 Questions or feedback, please contact news@medscape.net

10 Tammi 202530min

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 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 Questions or feedback, please contact news@medscape.net

20 Joulu 202436min

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 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 Questions or feedback, please contact news@medscape.net

13 Joulu 202429min

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 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 Questions or feedback, please contact news@medscape.net

6 Joulu 202427min

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 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 Questions or feedback, please contact news@medscape.net

22 Marras 202432min

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/ 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 Questions or feedback, please contact news@medscape.net

15 Marras 202428min

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 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 Questions or feedback, please contact news@medscape.net

8 Marras 202432min