This Week in Cardiology

Coronary calcium, cardiac arrest survival, Factor XI drug findings, APCs and a potential new board certification in cardiology 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 Coronary Artery Calcium - CONFIRM Registry - https://doi.org/10.1016/j.jcmg.2023.03.008 - CURE -- https://www.nejm.org/doi/full/10.1056/nejmoa010746 II Cardiac Arrest Cardiac Arrest Centers No Benefit in OHCA Without STEMI https://www.medscape.com/viewarticle/995885 - Cycling coverage https://velo.outsideonline.com/road/road-racing/nathan-van-hooydonck-forced-to-end-to-racing-career-due-to-heart-condition/ - ARREST https://doi.org/10.1016/S0140-6736(23)01351-X - SCD in Athletes Bob Harrington and Manesh Patel https://www.medscape.com/viewarticle/995575 III Factor XI Trial Halted for Bleeding Reduction With Abelacimab vs Rivaroxaban in AF https://www.medscape.com/viewarticle/996587 - Press Release - https://anthostherapeutics.com/wp-content/uploads/2023/09/2023-09-18-Anthos-Press-Release-final.pdf - Abelacimab, a Factor XI Inhibitor, Prevents VTE With Low Bleeding Risk in Knee Replacement - NEJM proof-of-concept https://www.nejm.org/doi/full/10.1056/NEJMoa2105872 - OCEANIC-AF https://classic.clinicaltrials.gov/ct2/show/NCT05643573 - Will Factor XI Be the Goldilocks Anticoagulant Target? https://www.medscape.com/viewarticle/979634 IV APC Care NPs and PAs Handling Increasingly More Primary Care Visits: New Studies https://www.medscape.com/viewarticle/996709 BMJ paper -- https://www.bmj.com/content/382/bmj-2022-073933 V Possible Cardiology Board Certification Changes - Heart Societies Ready to Split From ABIM Over MOC Disputes https://www.medscape.com/viewarticle/996747 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

Topics discussed include reader feedback, imaging in the cath lab, AF ablation to relieve anxiety, and the potential use of aldosterone as a drug target in hypertension. The hosts analyze two trials on imaging in the cath lab and compare OCT-guided PCI with angiography alone. They also explore the psychological effects of AFib and the impact of AFib ablation. Additionally, they discuss cathodorablation, AFiblation, and new anti-hypertensive drugs.

In this podcast, John Mandrola, MD discusses trials in cardiology including ECLS-SHOCK, FIRE, MULTISTARS-AMI, HEART FID, and DANPACE II. The ECLS-SHOCK trial found that ECMO for shock in acute MI may do more harm than good. The FIRE trial showed that physiology-guided MI complete revascularization benefits older patients. The MULTISTARS-AMI trial found parity between prompt and staged STEMI complete revascularization. The HEART-FID trial revealed modest benefits of IV iron supplementation in heart failure. The podcast also explores pacing and sick sinus syndrome.

This podcast covers a range of interesting topics including obesity, heart failure, atrial fibrillation, frailty, evidence translation, and catheter ablation. The speaker discusses the recent ESC wrap-up meeting and their experiences in Amsterdam. They also delve into findings from studies like the FRAIL AF study, STEP HEF PEPF study, NOAA AF Net Six Trial, and the Advent Trial comparing PFA and thermal ablation for treating AFib.

GLP-1 agonists in HFpEF, DOACs for subclinical AF, renal denervation, and the matter of remaining in the profession are discussed in this week’s podcast for healthcare professionals. Topics include the obesity and HFpEF, DOAC for subclinical AF, renal denervation, and the ongoing debate on maintenance of certification.

Cardiologist John Mandrola discusses ICD generator changes, less is more in VT management, comorbidity in HF, and SGLT2i after AF ablation. Topics include patient perspectives on generator exchanges, ischemia testing and monomorphic VT storm, hospital admissions in the last year of life of HF patients, and the impact of SGLT2 inhibitors on AFib recurrence.

Observational studies, another defense of digoxin, CTO-PCI, BP measurement, and a possible revolution in cardiovascular protection 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. Observational Research Yeh; Credibility in Observational Research https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064645 Hernan; Causal Language in Observational Research https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304337 Wang; RCT Duplicate Initiative https://jamanetwork.com/journals/jama/fullarticle/2804067 II. Defense of Digoxin Brophy; Beta Blockers, Digoxin, or Both https://doi.org/10.1016/j.cjca.2023.06.009 Dorian editorial https://doi.org/10.1016/j.cjca.2023.07.013 Ziff Digoxin Meta-analysis https://www.bmj.com/content/351/bmj.h4451.long DIG trial https://www.nejm.org/doi/full/10.1056/nejm199702203360801 Davila Analysis of DIG Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801940/ Kotecha Meta-analysis of Beta Blockers https://pubmed.ncbi.nlm.nih.gov/25193873/ RATE-AF https://jamanetwork.com/journals/jama/fullarticle/2774407 III. CTO-PCI PCI of Chronic Total Occlusions Improves Angina, Quality of Life in Trials https://www.medscape.com/viewarticle/994739 JAMA Network Open Meta-analysis IV. BP Measurement One Size Doesn't Fit All in Blood Pressure Measurement https://www.medscape.com/viewarticle/995216 Ishigami Blood Pressure Measurement Comparison https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2807853 V. GLP-1 SELECT Trial Semaglutide Cuts Cardiovascular Events in Landmark Trial https://www.medscape.com/viewarticle/995270 SELECT Protocol Paper 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

Listener feedback re observational studies, surgeons' dissent from recent guidelines, aspirin for primary prevention, and fish oil 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. Heart Surgeons Dissent Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 New Revascularization Guidelines: Key Points and Navigating Controversies https://www.medscape.com/viewarticle/972014 - AHA Guidelines - https://doi.org/10.1161/CIR.0000000000001168 - AATS statement 2023 https://doi.org/10.1016/j.jtcvs.2023.03.001 - Yusef and colleagues 1994 Meta-analysis - https://doi.org/10.1016/S0140-6736(94)91963-1 - 10-year SYNTAXES https://doi.org/10.1016/S0140-6736(19)31997-X - Surgeons' argument 2021 https://doi.org/10.1016/j.athoracsur.2021.12.003 - FAME 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 - Gaudino Meta-analysis of Medical Therapy vs CABG https://doi.org/10.1016/j.jtcvs.2022.06.003 - NOBLE https://doi.org/10.1016/S0140-6736(19)32972-1 - EXCEL 5 years https://www.nejm.org/doi/full/10.1056/nejmoa1909406 II. ASA for Primary Prevention Daily Aspirin Challenged in Primary Stroke Prevention: ASPREE https://www.medscape.com/viewarticle/994963 - ASPREE – All-cause mortality - ASPREE (MACE and Bleeding) https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - ASPREE (disability) https://www.nejm.org/doi/full/10.1056/NEJMoa1800722 - JAMA Network Open Subanalysis https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807630 III. Fish Oil - OMEMI Substudy https://doi.org/10.1016/j.clnu.2023.07.002 - Gencer and colleagues Meta-analysis - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 - OMEMI Main Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.052209 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

Antiarrhythmic drugs in patients with CAD, observational studies, GLP-1 agonists, and the subcutaneous ICD 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. AAD in Patients with CAD - The Feasibility and Safety of Flecainide Use Among Patients With Varying Degrees of Coronary Disease https://doi.org/10.1016/j.jacep.2022.12.021 - Three Questions for Evidence-Based Cardiac Electrophysiology https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 - The Cardiac Arrhythmia Suppression Trial (CAST) https://www.nejm.org/doi/full/10.1056/nejm198908103210608 II. GLP-1 Agonists Tirzepatide Powers Weight Loss in Two More Pivotal Trials https://www.medscape.com/viewarticle/994889 Semaglutide Use Surges in US Adults With Type 2 Diabetes https://www.medscape.com/viewarticle/994873 - Tirzepatide Once Weekly for the Treatment of Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 - Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(23)01200-X III. S-ICD S-ICD Shows Virtues, Limits in 'Real World' Postmarket Study https://www.medscape.com/viewarticle/994851 - Postapproval Study of a Subcutaneous Implantable Cardioverter-Defibrillator System https://doi.org/10.1016/j.jacc.2023.05.034 - Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 - Letter to the Editor https://www.nejm.org/doi/full/10.1056/NEJMc2034917 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

Listener feedback, conduction system pacing, eating fish vs fish pills, exercise, and an RCT for diet 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. Listener Feedback Monitor HF and AHA Jun 02, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/992678 - Link to the ACC Email -- https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/07/18/17/21/monitor-hf - Tweet From Anthony Pearson https://twitter.com/skepcard/status/1681288604990189574 II. Conduction System Pacing - Clinical Outcomes in Conduction System Pacing Compared to Right Ventricular Pacing in Bradycardia https://doi.org/10.1016/j.jacep.2022.10.016 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://www.acpjournals.org/doi/abs/10.7326/0003-4819-117-12-1016 III. Fish Oil Omega-3s and AF: No Added Risk From Eating Fish but High-Dose Supplement Questions Persist https://www.medscape.com/viewarticle/994559 - Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation https://www.jacc.org/doi/full/10.1016/j.jacc.2023.05.024 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 IV. Exercise Even Exercise by 'Weekend Warriors' Can Cut CV Risk https://www.medscape.com/viewarticle/994617 - Accelerometer-Derived "Weekend Warrior" Physical Activity and Incident Cardiovascular Disease https://jamanetwork.com/journals/jama/article-abstract/2807286 V. Diet Cognitive Benefit of Highly Touted MIND Diet Questioned https://www.medscape.com/viewarticle/994550 - Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons https://www.nejm.org/doi/full/10.1056/NEJMoa2302368 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