Apr 13, 2018 This Week in Cardiology

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 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

26 Apr 202428min

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 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

19 Apr 202428min

ACC Recap #1: DanGer Shock (plus a sobering JAMA research letter on Impella use), REDUCE-AMI, PREVENT, and EMPACT-MI 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. DanGer-Shock Trial Impella CP Improves Survival in STEMI, Cardiogenic Shock https://www.medscape.com/viewarticle/impella-cp-improves-survival-stemi-cardiogenic-shock-2024a10006kz Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 Published DanGer Shock Study https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 JAMA Research letter https://jamanetwork.com/journals/jama/article-abstract/2817457 II. REDUCE-AMI Trial New Data Question Beta-Blockers Post-MI With Preserved EF https://www.medscape.com/viewarticle/new-data-question-beta-blockers-post-mi-preserved-ef-2024a10006y8 Beta-Blockers Post-MI Past Their Expiration Date: REDUCE-AMI https://www.medscape.com/viewarticle/1000663 REDUCE-AMI paper https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 Meta-analysis: Beta Blockers for MI https://doi.org/10.1016/j.amjmed.2014.05.032 III. PREVENT Trial Preventive PCI for Vulnerable Plaques Reduces Cardiac Events https://www.medscape.com/viewarticle/preventive-pci-vulnerable-plaques-reduces-cardiac-events-2024a10006tc Preventive Coronary Stents: Not There Yet https://www.medscape.com/viewarticle/preventive-coronary-stents-not-there-yet-2024a10006yr PREVENT https://doi.org/10.1016/S0140-6736(24)00413-6 IV. EMPACT MI trial of Empagliflozin in the Post-MI setting Empagliflozin Fails to Reduce Events After Acute MI https://www.medscape.com/viewarticle/empagliflozin-fails-reduce-events-after-acute-mi-2024a10006kn EMPACT-MI: Another SGLT2 Inhibitor Miss in Post-MI Care https://www.medscape.com/viewarticle/1000684 EMPACT MI https://www.nejm.org/doi/10.1056/NEJMoa2314051 DAPA MI https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300286 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508 Kaul thread https://x.com/kaulcsmc/status/1776611935842165029 Kaul paper https://www.ahajournals.org/doi/full/10.1161/circulationaha.116.022537 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 Apr 202429min

Statins and diabetes, AAD in patients with heart disease, tricuspid valve interventions, and an ACC 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. Statins and Diabetes Meta-analysis in Lancet-Diabetes https://doi.org/10.1016/S2213-8587(24)00040-8 Editorial https://doi.org/10.1016/S2213-8587(24)00059-7 NEJM Paper on Gene Variants and DM https://www.nejm.org/doi/full/10.1056/nejmoa1604304 JAMA Paper on Gene Variants and DM https://jamanetwork.com/journals/jama/fullarticle/2565289 II. Anti-arrhythmic Drugs in Patients With Serious Heart Disease UPenn Paper on AADs for PVC Suppression https://doi.org/10.1016/j.jacep.2024.01.021 Three Questions for Evidence-Based Cardiac EP https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 CAST trial https://www.nejm.org/doi/full/10.1056/NEJM199103213241201 III. Tricuspid Valve Interventions FDA Clears TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-clears-triclip-tricuspid-regurgitation-2024a100068o FDA Panel in Favor of TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-panel-favor-triclip-tricuspid-regurgitation-2024a100037n Slides for Trisend II TRILUMINATE https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 IV. ACC Preview Mandrola's Three Trials to Look for at the 2024 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/1000613 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 Apr 202426min

Intermittent fasting, anticoagulation decisions, heterogenous treatment effects, frailty in HF, the importance of the ECG, and industry conflicts 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. Intermittent Fasting No, Intermittent Fasting Won't Kill You https://www.medscape.com/viewarticle/1000544 NEJM Paper on Time-Restricted Eating  https://www.nejm.org/doi/full/10.1056/NEJMoa2114833 JAMA TREAT Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 II. Stroke Prevention with OAC Shah Meta analysis of Vitamin K Agonists in AF https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010269 III. Heterogenous Treatment Effects in Trials Pivotal CV Trials May Not Apply to Complex Patients https://www.medscape.com/viewarticle/989129 Analysis of 8 Trials of Multimorbidity and Treatment Response https://doi.org/10.1016/j.amjmed.2024.01.028 IV. Frailty and HF Circulation Outcomes: Multidomain Frailty and Mode of Death in HF  https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010416 V. ECG in LBBB JAMA Cardiology: Revised Definition of LBBB  https://jamanetwork.com/journals/jamacardiology/fullarticle/2816973 VI. Industry Payments to Doctors JAMA: Payments to US Physicians by Specialty https://jamanetwork.com/journals/jama/fullarticle/2816900 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

29 Mars 202428min

p>Obesity drugs as ASCVD-modifiers, HR monitors, when journals publish obvious facts, and effect scores and sorting out signals from RCTs 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. Denmark Notes II. FDA approval of Semaglutide FDA Approves Semaglutide for Cardiovascular Risk Reduction https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix Select Trial III. PPG Monitor Accuracy Research Letter https://doi.org/10.1016/j.jacc.2024.01.024 IV. AAD and Bradycardia Anti-arrhythmic Drugs Linked to Bradycardia in Patients With AF https://www.medscape.com/viewarticle/anti-arrhythmic-drugs-linked-bradycardia-patients-af-2024a10004vw JACC paper on AAD Adverse Effects https://doi.org/10.1016/j.jacc.2024.01.013 V. Finding Signals in RCTs   JAMA paper on Treatment Effects of Oxygen Targets DANISH trial https://www.nejm.org/doi/full/10.1056/nejmoa1608029 LAFFLIN et al. Scoring System to Assess Generalizability of Trial Results https://doi.org/10.1177/2047487318815967 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 Mars 202426min

Plastics and heart disease, MINT trial letters-to-the-editor and Bayes theorem, and Brugada syndrome 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. Plastics and Heart Disease Plastic Particles in Carotid Plaques Linked to CV Events https://www.medscape.com/viewarticle/plastic-particles-carotid-plaques-linked-cv-events-2024a10004ge Plastics and ASCVD Study https://www.nejm.org/doi/full/10.1056/NEJMoa2309822 Review https://www.nejm.org/doi/full/10.1056/NEJMra2300476 Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2400683 II. MINT trial LTE and Bayes Theorem In MI With Anemia, Results May Favor Liberal Transfusion: MINT https://www.medscape.com/viewarticle/998376 The MINT Study https://www.nejm.org/doi/full/10.1056/NEJMoa2307983 Letter-to-the-Editor https://www.nejm.org/doi/full/10.1056/NEJMc2400982 Likelihood Ratio https://www.cebm.ox.ac.uk/resources/ebm-tools/likelihood-ratios III. Brugada Syndrome The EHJ paper: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehae133/7623123 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 Mars 202426min

The Western AF meeting, aspirin, cannabis use, LVEF in athletes, and shared decision making before ICD implantation 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. ASA in Primary Prevention Campbell Meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065420 Swedish Observational study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.028321 ASPREE https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 II. Cannabis Cannabis Use Tied to Increased Cardiovascular Risk https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr It Sure Looks Like Cannabis Is Bad for the Heart, Doesn't It? https://www.medscape.com/viewarticle/1000250 Journal of the AHA Observational Study https://www.ahajournals.org/doi/full/10.1161/JAHA.123.030178 III. Low EF in Athletes Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.063777 IV. ICDs and Shared Decision-Making Association of a Medicare Mandate for Shared Decision-Making With Cardiac Device Utilization https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2815017 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

1 Mars 202428min