277. The Rounds Table- Top Papers from the 2025 American College of Cardiology (ACC) Session
Apr 3, 2025
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In a rapid-fire session, experts discuss groundbreaking findings from the 2025 American College of Cardiology conference. They dive into the efficacy of reduced-dose apixaban for cancer-related blood clots, highlighting its potential advantages. The DAPA-TAVI trial sheds light on the promising role of SGLT2 inhibitors in heart failure management. Additionally, the cardiovascular benefits of oral semaglutide in high-risk diabetes patients are explored, revealing significant reductions in adverse events. A sprinkle of humor is added with a mention of a new comedy series.
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Quick takeaways
The study on reduced-dose apixaban in cancer patients showed lower bleeding risks while maintaining efficacy in preventing thromboembolic events.
The DAPA-TAVI trial highlighted dapagliflozin's potential to significantly reduce death or worsening heart failure post-aortic valve implantation despite adverse effect concerns.
Deep dives
Extended Reduced Dose Apixaban for Cancer-Associated VTE
The study on extended reduced dose apixaban focuses on patients with cancer-associated venous thromboembolism and aims to determine if this treatment approach improves outcomes regarding recurrent thromboembolic events while reducing bleeding risks. Conducted as a double-blind, randomized control trial, the research included approximately 1,700 patients with active cancer who had previously completed at least six months of anticoagulation treatment. The results indicated that the reduced dose group experienced a recurrent or fatal VTE rate of 2.1% compared to 2.8% in the full dose group, suggesting that the lower dose was non-inferior. Furthermore, the bleeding risk was lower in the reduced dose group, pointing to a potentially significant shift in treatment protocols for these high-risk patients.
Dapagliflozin's Impact on Heart Failure Post-TAVI
The DAPA-TAVI trial investigates whether dapagliflozin effectively reduces the risk of death or worsening heart failure in patients undergoing transcatheter aortic valve implantation. This pragmatic, randomized trial involved over 1,200 patients with severe aortic stenosis who also had heart failure. The primary outcome showed a 5% absolute risk reduction in death or worsening heart failure for the dapagliflozin group compared to the standard care group, indicating that the medication could provide significant benefits for these patients. Despite some increased rates of adverse effects like genital infections, the trial's findings highlight the potential for dapagliflozin to be incorporated into post-TAVI management.
Oral Semaglutide and Cardiovascular Outcomes in Type 2 Diabetes
A large-scale study examined the cardiovascular efficacy of oral semaglutide in adults with type 2 diabetes and a history of atherosclerotic cardiovascular disease or chronic kidney disease. The trial included nearly 10,000 patients and found a 12% occurrence of major adverse cardiovascular events in the semaglutide group versus 13.8% in the placebo group, demonstrating a meaningful hazard ratio suggesting potential cardiovascular benefits. While there were concerns regarding the cost-effectiveness and limitations like not achieving some secondary outcomes, the data indicates oral semaglutide may improve cardiovascular outcomes in this population. As such, it may eventually alter prescribing practices for high-risk diabetes patients.
Episode 112 - Top Papers from the 2025 American College of Cardiology (ACC) Session
Welcome back Rounds Table Listeners! We are back today with a special Rapid Fire Podcast! This week, Drs. Mike and John Fralick discuss top papers from the 2025 American College of Cardiology (ACC) Annual Scientific Session. Hot off the presses, here we go!