Dec 13 2024 This Week in Cardiology

Dec 13, 2024

Delve into the controversies surrounding ticagrelor and clopidogrel, with new research shaking up established beliefs in cardiology. Explore the debate on physician compensation and the impact of electronic health records on heart failure treatment. Discover why clopidogrel edges out aspirin even in high bleeding risk situations and unpack the nuances of holding antiplatelet medications for non-cardiac surgeries. The discussion challenges norms while shedding light on the evolving landscape of cardiovascular care.

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Challenges in Heart Failure Treatment and U.S. Physician Compensation

00:00 • 7min

Navigating Controversies in Cardiology: Ticagrelor, Clopidogrel, and Aspirin

06:52 • 22min

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

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