Aug 24, 2018 This Week in Cardiology Podcast

A non-significant but wonderful trial in AF, smoking and HF, vitamins, and pre-op risk screening are the topics discussed by John Mandrola, MD, 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 – DECAAF II Trial DECAAF II: AF, Fibrosis Ablation Technique Falls Short, but Signs of Hope https://www.medscape.com/viewarticle/957469 • Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/article-abstract/2793452 • Association of Atrial Tissue Fibrosis Identified by Delayed Enhancement MRI and Atrial Fibrillation Catheter Ablation https://jamanetwork.com/journals/jama/fullarticle/1820433 II – Smoking and HF Cigarettes Linked to HF With Preserved or Reduced EF https://www.medscape.com/viewarticle/976066?src= • Cigarette Smoking, Cessation, and Risk of Heart Failure With Preserved and Reduced Ejection Fraction https://www.jacc.org/doi/full/10.1016/j.jacc.2022.03.377 III – Vitamins Evidence Still Lacking That Vitamins Prevent CVD, Cancer: USPSTF https://www.medscape.com/viewarticle/975965 • Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2793446 IV – Pre-Op Risk Add Atrial Fibrillation to Pre-Noncardiac Surgery Risk Evaluation: New Support https://www.medscape.com/viewarticle/975926 • Preoperative Atrial Fibrillation and Cardiovascular Outcomes After Noncardiac Surgery https://doi.org/10.1016/j.jacc.2022.04.021 • Patterns and Determinants of Low-Value Preoperative Testing in Michigan https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2779744 • Coronary-Artery Revascularization before Elective Major Vascular Surgery https://www.nejm.org/doi/full/10.1056/nejmoa041905 • Stress testing before abdominal aortic aneurysm repair does not lead to a reduction in perioperative cardiac events https://doi.org/10.1016/j.jvs.2021.02.032 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

24 Jun 202220min

Statin Intolerance, external validity of trials, contrast shortage, and expansion of cardiology into diabetes and nephrology 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 - Statin Intolerance - New National Lipid Association Statement on Statin Intolerance https://www.medscape.com/viewarticle/975674 - What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. https://academic.oup.com/eurjpc/article/21/4/464/5926070 - Unblinded and Blinded N-of-1 Trials Versus Usual Care: A Randomized Controlled Trial to Increase Statin Uptake in Primary Care. https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.120.007793 - Role of Blinding in N-of-1 Trials https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.122.008914 - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 II - External Validity - Is Paxlovid, the Covid Pill, Reaching Those Who Most Need It? The Government Won't Say https://www.medscape.com/viewarticle/973906 - Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2118542 - PFE Press Release on EPIC SR https://www.pfizer.com/news/press-release/press-release-detail/pfizer-reports-additional-data-paxlovidtm-supporting III - Contrast Shortage - Global Contrast Media Shortage Blamed on COVID Lockdown in China https://www.medscape.com/viewarticle/973810 IV - Cardiology Expands - Experts Elevate New Drugs for Diabetic Kidney Disease https://www.medscape.com/viewarticle/975724 - SGLT2 Inhibitors Cut AFib Risk in Real-Word Analysis https://www.medscape.com/viewarticle/975542 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 - Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/nejmoa2110956 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

17 Jun 202221min

More ISCHEMIA controversy, health Insurance and CV outcomes, testosterone, and flawed observational studies are the topics discussed by John Mandrola, MD 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 – More Ischemia Controversy - Data Concerns Mount Despite ISCHEMIA Substudy Correction https://www.medscape.com/viewarticle/974974 - ISCHEMIA Substudy Data Just Don't Add Up, Cardiac Surgeons Say https://www.medscape.com/viewarticle/974107 - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 - Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049755 - Link to Bakaeen and Sabik Second letter (agree to terms to download the letter): https://protect-us.mimecast.com/s/nfDdCwp5G6HLjLO9GHV9Cnm?domain=wetransfer.com II – Health Insurance and CV outcomes - Medicaid Expansion: Good First Step, but No Panacea for CV Care https://www.medscape.com/viewarticle/975141 - 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 III – Testosterone - Jury Still Out on Cardiovascular Safety of Testosterone https://www.medscape.com/viewarticle/975273 - Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis https://doi.org/10.1016/S2666-7568(22)00096-4 - Adverse events associated with testosterone administration. https://www.nejm.org/doi/full/10.1056/NEJMoa1000485 IV – Voting and Mortality - Blue Counties Enjoy Dramatic Mortality Edge https://www.medscape.com/viewarticle/975217 - Political environment and mortality rates in the United States, 2001-19: population based cross sectional analysis https://www.bmj.com/content/377/bmj-2021-069308 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

10 Jun 202224min

Devices for HF, Twitter for disseminating science, HDL levels, and dubious post-hoc studies 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 – Interatrial Shunts for HF - Interatrial Shunt in HF Hints at Heart Structural, Functional Benefits https://www.medscape.com/viewarticle/974776 - Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00016-2 - Reducing Lung CongestIon Symptoms in Advanced Heart Failure (RELIEVE-HF) https://clinicaltrials.gov/ct2/show/NCT03499236 II – Twitter for Science Communication - Twitter Promotion Boosts Visibility, Citation for CV Research https://www.medscape.com/viewarticle/974653 - Twitter promotion is associated with higher citation rates of cardiovascular articles: the ESC Journals Randomized Study https://doi.org/10.1093/eurheartj/ehac150 - A Randomized Trial of Social Media From Circulation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.013509 III – HDL Level - Very High HDL-C: Too Much of a Good Thing? https://www.medscape.com/viewarticle/974651 - Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations https://jamanetwork.com/journals/jamacardiology/article-abstract/2792282 - Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889017/ IV – Dubious Sub-Studies: Omecamtiv Mecarbil - Myosin Inhibitor May Benefit Data-Deprived Patients With Heart Failure and Low Blood Pressure https://www.medscape.com/viewarticle/974960 - Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2025797 - METEORIC-HF: Omecamtiv Mecarbil Does Not Improve Exercise Capacity in HFrEF Patients https://www.acc.org/Latest-in-Cardiology/Articles/2022/04/02/13/22/Sun-945am-METEORIC-HF-acc-2022 - Effects of Omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac293/6590348 You might also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

3 Jun 202223min

Ischemia vs anatomic testing for CAD, UK-TAVI trial, TAVI for AR? and post-PCI anti-thrombotics 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 – Ischemic vs Anatomic Evaluation for CAD - ISCHEMIA Substudy Data Just Don't Add Up, Cardiac Surgeons Say https://www.medscape.com/viewarticle/974107 - Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.049755 - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 - Forget Ischemia: It's All About the Plaque https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054102 - Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.743963 - Baseline stress myocardial perfusion imaging results and outcomes in patients with stable ischemic heart disease randomized to optimal medical therapy with or without percutaneous coronary intervention https://doi.org/10.1016/j.ahj.2012.05.018 - Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease https://www.nejm.org/doi/full/10.1056/nejmoa1415516 - Coronary CT Angiography and 5-Year Risk of Myocardial Infarction https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 - Five Reasons I Don't Believe an Imaging Test Improves Outcomes https://www.medscape.com/viewarticle/901204 II – UK-TAVI Trial - UK TAVI: Similar Outcomes to Surgery in Real World https://www.medscape.com/viewarticle/927729 - Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis https://jamanetwork.com/journals/jama/fullarticle/2792251 III – TAVI for AI? - JenaValve Trilogy Takes Another Step Forward in Severe AR https://www.medscape.com/viewarticle/974304 IV – Post PCI DAPT - One-Month DAPT Enough for Complex PCI if Bleeding Risk High https://www.medscape.com/viewarticle/974224 - Duration of Antiplatelet Therapy After Complex Percutaneous Coronary Intervention In Patients at High Bleeding Risk: a MASTER DAPT trial sub-analysis https://doi.org/10.1093/eurheartj/ehac284 - Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2108749 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

20 Mai 202224min

Obstructive hypertrophic cardiomyopathy and mavacamten, SGLT2 inhibitors, the triple whammy, espresso, and clinician burnout 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 – Mavacamten - FDA Clears Mavacamten (Camzyos) for Obstructive Hypertrophic Cardiomyopathy https://www.medscape.com/viewarticle/972945 - Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(20)31792-X - FDA approves new drug to improve heart function in adults with rare heart condition https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-new-drug-improve-heart-function-adults-rare-heart-condition II – Dapagliflozin in HFpEF - Positive Topline Results for Dapagliflozin in HFpEF: DELIVER https://www.medscape.com/viewarticle/973490 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 III – Triple Whammy for AKI - Mixing BP Meds With NSAID May Be 'Triple Whammy' for Kidneys https://www.medscape.com/viewarticle/973885 IV – Espresso - Espresso Coffee Associated With Increased Total Cholesterol https://www.medscape.com/viewarticle/973819 - Association between espresso coffee and serum total cholesterol: the Tromsø Study 2015–2016 https://openheart.bmj.com/content/9/1/e001946 - Is everything we eat associated with cancer? A systematic cookbook review https://pubmed.ncbi.nlm.nih.gov/23193004/ - Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 V – Clinician Burnout - Administrative Hassle Hacks: Strategies to Curb Physician Stress https://www.medscape.com/viewarticle/973597 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

13 Mai 202218min

HRS meeting presentations: conduction system pacing, AF in the ED, a possible new treatment for vagal bradycardia, and women in EP 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 – HRS Comments II – Conduction System Pacing Conduction System Disease Recast as Preventive Therapy Target https://www.medscape.com/viewarticle/973488 • Rescue Left Bundle Branch Area Pacing in Coronary Venous Lead Failure or Non-response to Biventricular Pacing: Results From International LBBAP Collaborative Study Group https://doi.org/10.1016/j.hrthm.2022.04.024 • Clinical Outcomes Of Conduction System Pacing Compared To Biventricular Pacing In Patients Requiring Cardiac Resynchronization Therapy https://doi.org/10.1016/j.hrthm.2022.04.023 III – Emergency Triage of AF Early Arrhythmia-Specialist Consult, Ordered in the ER, a Boon to AF Outcomes: ER2EP Study https://www.medscape.com/viewarticle/973250 • ClinicalTrials.gov Reference https://clinicaltrials.gov/ct2/show/NCT04476524 • George Bernard Shaw Reference: https://jamanetwork.com/journals/jama/fullarticle/2623628 IV – Cardioneural Ablation Can Ablation Abolish Vasovagal Syncope? Early Series Promising https://www.medscape.com/viewarticle/973346 V – Women in EP Why Are Numbers of Women, Minorities So Low in Cardiac EP? https://www.medscape.com/viewarticle/972968 • Temporal and geographical trends in women operators of electrophysiology procedures in the United States https://doi.org/10.1016/j.hrthm.2022.02.015 • Quantification of Female and Underrepresented Minority Applicants to Clinical Cardiac Electrophysiology Fellowship https://www.jacc.org/doi/full/10.1016/j.jacep.2022.04.001 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

6 Mai 202221min

Aspirin for primary prevention, time-restricted feeding, renal denervation, and a potential new obesity drug 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 – ASA for Primary Prevention: - USPSTF Final Recommendation on Aspirin for Primary CV Prevention https://www.medscape.com/viewarticle/972761 - Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2791399 - Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/10.1056/NEJMoa1805819 - Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1803955 II – Time Restricted Feeding - Is There a Benefit to Fasting Plus Calorie Counting? https://www.medscape.com/viewarticle/972579 - Calorie Restriction with or without Time-Restricted Eating in Weight Loss https://www.nejm.org/doi/full/10.1056/NEJMoa2114833 - Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity. The TREAT Randomized Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 III – Renal Denervation - Renal Denervation BP Benefits Remain at 3 Years: SPYRAL HTN-ON https://www.medscape.com/viewarticle/971883 - Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00455-X IV – Tirzepatide for Obesity - Tirzepatide Excites in Obesity Now Too, Says Lilly https://www.medscape.com/viewarticle/972936 - Lilly's tirzepatide delivered up to 22.5% weight loss in adults with obesity or overweight in SURMOUNT-1 https://www.prnewswire.com/news-releases/lillys-tirzepatide-delivered-up-to-22-5-weight-loss-in-adults-with-obesity-or-overweight-in-surmount-1--301534871.html You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

29 Apr 202221min