Dec 19 2025 This Week in Cardiology

The limits of knowing coronary artery disease anatomy, fish oil and AF risk, a new drug for PSVT, and maybe I was wrong about a drug for AF conversion (the RAFF4 trial). These 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 Prediction of CAD is hard — even if you have anatomy CCTA in Prediction of First Coronary Events https://jamanetwork.com/journals/jama/fullarticle/2841255 II Fish Oil and AF (and as a bonus we learn again about analytic flexibility) Are Fish Oils on the Hook for AF Risk? https://www.medscape.com/viewarticle/995290 Omega-3 and Fish Oil Use With Risk of AF  https://www.ahajournals.org/doi/full/10.1161/JAHA.125.043031 Effect of Long-Term Marine Omega-3 Fatty Acids on the Risk of AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 RESPECT-EPA Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065520 Association Between Omega-3 Fatty Acids and AF: Meta Analysis https://link.springer.com/article/10.1007/s10557-021-07204-z Fish Oil Supplements and Risk of AF https://academic.oup.com/eurjpc/article/29/14/1911/6679610 Editorial: Fish Oil Supplements and AF Risk https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057464 III A New Drug for PSVT FDA Approval https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-type-abnormally-fast-heart-rhythm RAPID trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00776-6/fulltext IV AF Conversion with Vernakalant RAFF4 Trial https://www.bmj.com/content/391/bmj-2025-085632.long Editorial: Rapid Cardioversion for Acute AF https://www.bmj.com/content/391/bmj.r2264 VI A Quick Note on HFpEF Med Op-Ed: Avalanche Survival, HFpEF Skepticism, and More https://www.medscape.com/viewarticle/med-op-ed-avalanche-survival-hfpef-skepticism-and-more-2026a1000012 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

9 Jan 28min

An elegant study in post-TAVI atrioventricular block, a PSA for my structural colleagues, revascularization in women, and a CTO PCI trial 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 AV Block After TAVR Heart Blocks During vs After TAVR Show Distinct Patterns https://www.medscape.com/viewarticle/heart-blocks-during-vs-after-tavr-show-distinct-patterns-2025a1000ypp Mechanisms Underlying Alterations in Cardiac Conduction After TAVR https://jamanetwork.com/journals/jamacardiology/fullarticle/2842748 II Related PSA Announcement to My Structural Colleagues III Revascularization Strategies in Women with Severe Chronic CAD Women With Chronic Severe CAD Fare Better With CABG vs PCI https://www.medscape.com/viewarticle/women-chronic-severe-cad-fare-better-cabg-vs-pci-2025a1000ygd PCI vs CABG in Women With Chronic CAD https://doi.org/10.1093/eurheartj/ehaf806 PCI vs CABG - Meta-Analysis of 4 RCTs https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02334-5/abstract CABG vs Drug-Eluting Stent Implantation for CAD - Meta-Analysis https://www.jacc.org/doi/10.1016/j.jcin.2016.10.008 RECHARGE trial https://therechargetrial.com/ IV A CTO PCI RCT – But don't get your hopes up Early vs Late-Staged PCI After Subintimal Tracking and Re-entry for CTO https://doi.org/10.1016/j.jacc.2025.09.1598 DECISION CTO trial https://pubmed.ncbi.nlm.nih.gov/30813758/ National Inpatient Sample Database PCI CTO Associated With Higher Mortality https://pubmed.ncbi.nlm.nih.gov/37356643/ V Mandrola's Top 10 Stories 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

12 Des 202527min

Less is more after PCI, the TARGET-FIRST trial, a negative blood pressure trial that is actually positive, aspirin vs OAC for bleeding, AEDs, and Factor XI is not dead yet are the topics discussed by John Mandrola, MD, on 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 Less is More: TARGET-FIRST TARGET-FIRST Trial https://www.nejm.org/doi/10.1056/NEJMoa2508808 STOPDAPT-2 ACS Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2789701 II A Negative Trial That Is Actually Positive The RETREAT-FRAIL Study https://www.nejm.org/doi/full/10.1056/NEJMoa2508157 III Major Bleeding With Aspirin vs Apixaban Subanalysis of ARTESiA https://jamanetwork.com/journals/jamacardiology/fullarticle/2841075 ARTESiA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 AVERROES Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1007432 IV High Value Interventions – The AED Experts Call for AED Placement on All Commercial Aircraft https://www.medscape.com/viewarticle/experts-call-aed-placement-all-commercial-aircraft-2025a1000xzf In-Flight Sudden Cardiac Arrest and AED Use 10.1016/j.cjca.2025.10.010 External Link V Factor XI Inhibitors – OCEANIC STROKE trial Bayer Press Release on Asundexian https://www.bayer.com/en/us/news-stories/oceanic-stroke 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

5 Des 202529min

Listener feedback, huge news in the world of carotid disease with the CREST-2 publication, prasugrel beats ticagrelor again, and a big coffee trial 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 Complete Revascularization for Acute MI Meta-analysis  https://doi.org/10.1016/S0140-6736(25)02170-1 II A Sea Change in the Treatment of Carotid Artery Disease — CREST-2 Published ECST-2 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00107-3/fulltext SPACE-2 https://pubmed.ncbi.nlm.nih.gov/36115360/ CREST-2 Trial www.nejm.org/doi/full/10.1056/NEJMoa2508800 CREST Protocol paper https://pmc.ncbi.nlm.nih.gov/articles/PMC5987521/ III Prasugrel Beats Ticagrelor in High-Risk Patients With Diabetes After PCI https://www.medscape.com/viewarticle/prasugrel-beats-ticagrelor-high-risk-patients-diabetes-after-2025a1000wbt PLATO trial https://www.nejm.org/doi/full/10.1056/NEJMoa0904327 Ticagrelor or prasugrel vs clopidogrel in PCI https://eurointervention.pcronline.com/article/ticagrelor-or-prasugrel-versus-clopidogrel-in-patients-undergoing-percutaneous-coronary-intervention-for-chronic-coronary-syndromes ISAR-REACT 5 trial https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 IV Another Coffee and AF study Can Coffee Cut the Risk for Atrial Fibrillation? https://www.medscape.com/viewarticle/can-coffee-cut-risk-atrial-fibrillation-2025a1000w11 A Coffee a Day to Keep the AFib Away? The DECAF Trial Discussed https://www.medscape.com/viewarticle/coffee-day-keep-afib-away-decaf-trial-discussed-2025a1000v5z DECAF trial https://jamanetwork.com/journals/jama/fullarticle/2841253 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

21 Nov 202529min

Listener feedback on the PISCES trial, AHA news (including a big PCSK9i trial), beta-blockers post MI, LAAC, and post-AF ablation OAC use 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 Why I Believe Fish Oil's Big CV Benefit in Dialysis Patients https://www.medscape.com/viewarticle/why-i-believe-fish-oils-big-cv-benefit-dialysis-patients-2025a1000uzg PISCES trial https://www.nejm.org/doi/full/10.1056/NEJMoa2513032 II PCSK9 Inhibitor News In Global Trial, PCSK9 Inhibitor Provides Major Protection Against First CV Event https://www.medscape.com/viewarticle/global-trial-pcsk9-inhibitor-provides-major-protection-2025a1000uzp VESALIUS-CV trial https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 ODYSSEY trial https://www.nejm.org/doi/full/10.1056/NEJMoa1801174 FOURIER https://www.nejm.org/doi/full/10.1056/NEJMoa1615664 Anish Koka Tweet on LDL-lowering https://x.com/anish_koka/status/1987280506937909326?s=20 III Beta-Blockers After MI and John Cleland Beta-Blockers after MI with normal EF https://www.nejm.org/doi/full/10.1056/NEJMoa2512686 REBOOT-CNIC trial https://www.nejm.org/doi/full/10.1056/NEJMoa2504735 REDUCE AMI trial https://academic.oup.com/ehjcvp/article/9/2/192/6895544?login=false ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 CAPITAL RCT trial https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199347 Beta-Blockers after MI with mildly reduced EF https://pubmed.ncbi.nlm.nih.gov/40897190/ John Cleland Clinical Outlook https://www.nature.com/articles/s41569-025-01228-w IV Left Atrial Appendage Closure – The CLOSURE-AF trial Percutaneous LAAC in AF Falls Short Again in CLOSURE-AF https://www.medscape.com/viewarticle/percutaneous-left-atrial-appendage-closure-af-falls-short-2025a1000uzu Prague-17 Trial https://www.jacc.org/doi/10.1016/j.jacc.2020.04.067 OPTION trial https://www.nejm.org/doi/full/10.1056/NEJMoa2408308 V Oral AC after AF ablation – the OCEAN Trial Anticoagulation After AF Ablation: The OCEAN Trial Still Leaves Questions https://www.medscape.com/viewarticle/anticoagulation-after-af-ablation-ocean-trial-still-leaves-2025a1000v4t OCEAN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509688 ALONE-AF trial https://jamanetwork.com/journals/jama/fullarticle/2838294 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

14 Nov 202536min

Listener feedback on non-culprit PCI in STEMI, a major cardiac result in patients on hemodialysis, news on GLP-1 agonists, a dubious stroke trial, and an AHA preview 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 Meta-analysis of MI as a surrogate https://pubmed.ncbi.nlm.nih.gov/34694318/ Compare Acute Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1701067 DANAMI-3–PRIMULTI 10.1016/S0140-6736(15)60648-1 External Link CULPRIT-SHOCK https://www.nejm.org/doi/full/10.1056/NEJMoa1710261   II  Huge Cardiac News for Patients with ESRD PISCES article EMBARGOED Till 1130 AM EST PISCES Trial www.nejm.org/doi/full/10.1056/NEJMoa2513032 REDUCE-IT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1812792 STRENGTH Trial https://jamanetwork.com/journals/jama/fullarticle/2773120 FISH trial https://jamanetwork.com/journals/jama/fullarticle/1150094 III Obesity Agents White House announces deal with Lilly and Novo on GLP-1 drugs https://www.reuters.com/business/healthcare-pharmaceuticals/novo-lilly-shares-rise-trump-obesity-drug-deal-nears-2025-11-06/ Amylin Agonists Amylin Analog Eloralintide Reduces Weight in Phase 2 Trial https://www.medscape.com/viewarticle/amylin-analog-eloralintide-reduces-weight-phase-2-trial-2025a1000uqf Eloralintide Phase 2 Study https://doi.org/10.1016/S0140-6736(25)02155-5 GLP-1 Comparisons SURMOUNT-5 Trial https://www.nejm.org/doi/10.1056/NEJMoa2416394 Tirzepatide vs Semaglutide in 10-year CVD Risk Reduction https://doi.org/10.1093/ehjopen/oeaf117 IV A Problematic Trial in Stroke Care LAMP trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2840370 V AHA Preview AHA 2025: Mandrola's Four Trials to Look For https://www.medscape.com/viewarticle/aha-2025-mandrolas-four-trials-look-2025a1000u80 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

7 Nov 202532min

Four pillars of cardiology today, stable coronary artery disease, severe aortic stenosis, the evaluation of chest pain, and best therapies for atrial fibrillation 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 Stable CAD Complete vs culprit-only revascularization at time of STEMI iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918 PRAMI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1305520 COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149 PCI Revascularization Strategies After MI https://www.jacc.org/doi/10.1016/j.jacc.2024.04.051 CULPRIT SHOCK Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1710261 How a Meta-Analysis Can Mislead https://www.sensible-med.com/p/how-a-meta-analysis-can-misleadthe II SEVERE Aortic Senosis 7-Year PARTNER 3 Results – TAVI vs SAVR 7-year results PARTNER 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2509766 PARTNER 3 at 1 year https://www.nejm.org/doi/10.1056/NEJMoa1814052 PARTNER 3 at 5 years https://www.nejm.org/doi/10.1056/NEJMoa2307447 III Functional vs Anatomic Assessment in Suspected CAD 10-year follow-up of PROMISE trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2838118 PROMISE Trial https://www.nejm.org/doi/10.1056/NEJMoa1415516 CCTA vs Functional Stress Test – Meta-Analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 IV ARREST AF ARREST AF trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2840225 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

31 Okt 202531min