This Week in Cardiology

Two studies on alcohol and AF incidence and an important paper on stable CAD are the topics John Mandrola discusses in this week’s podcast. https://www.medscape.com/twic 1 - COVID-19 New Vaccinations Increasing in COVID Hot Spots https://www.medscape.com/viewarticle/955680 2 - Alcohol - Moderate Drinking Protective After MI, Stroke in 'Flawed' Study https://www.medscape.com/viewarticle/955474 - Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation https://doi.org/10.1016/j.jacep.2021.05.013 - Can a Drink a Day Keep the Electrophysiologist Away? https://doi.org/10.1016/j.jacep.2021.06.010 - Association of alcohol consumption with morbidity and mortality in patients with cardiovascular disease: original data and meta-analysis of 48,423 men and women https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02040-2 3 - Coronary Artery Disease - CLARIFY Confirms Meds, Watchful Waiting in Angina, Stable CAD https://www.medscape.com/viewarticle/955313 - International Observational Analysis of Evolution and Outcomes of Chronic Stable Angina: The Multinational Observational CLARIFY Study https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.054567 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

COVID-19 messaging, coffee, CTA and statins, and Watchman problems are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1- COVID-19: - COVID-19 Cases in US Triple Over 2 Weeks Amid Misinformation https://www.medscape.com/viewarticle/955269 - Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant https://www.nejm.org/doi/full/10.1056/NEJMoa2108891 - What Really Happened With that Weird Yankees COVID Outbreak https://nymag.com/intelligencer/2021/05/what-really-happened-with-that-weird-yankees-covid-outbreak.html 2- Coffee: - Coffee Not Linked to Increased Arrhythmia Risk in New Study https://www.medscape.com/viewarticle/954992 - Coffee Consumption and Incident Tachyarrhythmias https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782015 - Another Cup of Coffee Without an Arrhythmia, Please https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782021 3- CTA and Statins: - CTA May Guide Primary Prevention Statins in Nonobstructive CAD https://www.medscape.com/viewarticle/955030 - Reduction of Myocardial Infarction and All-Cause Mortality Associated to Statins in Patients Without Obstructive CAD https://www.jacc.org/doi/full/10.1016/j.jcmg.2021.05.022 4- Left Atrial Appendage Closure: - Five Risk Factors May Predict Thrombus on LAA Occlusion Implants https://www.medscape.com/viewarticle/955131 - Predictors of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion https://www.jacc.org/doi/full/10.1016/j.jacc.2021.04.098 - Device-Related Thrombus After Left Atrial Appendage Occlusion https://www.jacc.org/doi/10.1016/j.jacc.2021.05.028 Features: - Does Coffee Make Your Heart Flutter? https://www.medscape.com/viewarticle/954996 - Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 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

COVID-19, Ivermectin, a dissolving pacer, clinician well-being, and finerenone are discussed this week. 1 COVID-19 US 'Losing Time' Against Delta Variant, NIH Chief Says https://www.medscape.com/viewarticle/954882 Ivermectin for COVID: How Do We Know What to Believe? https://www.medscape.com/viewarticle/954681 2 Dissolving Pacemaker Dissolving Pacemaker Impressive in Early Research https://www.medscape.com/viewarticle/954774 3 Clinician Well-being Global Heart Organizations Unite to Promote Clinician Well-Being https://www.medscape.com/viewarticle/954803 Clinician Well-Being: Addressing Global Needs for Improvements in the Health Care Field A Joint Opinion From the American College of Cardiology, American Heart Association, European Society of Cardiology, and the World Heart Federation https://www.jacc.org/toc/jacc/0/0 From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider https://www.annfammed.org/content/12/6/573.full Bullying in Academic Medicine Rife, Underreported https://www.medscape.com/viewarticle/954709 4 Finerenone FDA Approves Finerenone (Kerendia) for Slowing CKD in Type 2 Diabetes https://www.medscape.com/viewarticle/954606 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

COVID-19, mRNA-vaccine-induced myocarditis, type 2 diabetes in kids, optimal medical therapy for CAD, and Alcohol are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1-COVID - Fast-spreading Delta Variant, Vaccination Rates, Reintroduction of Indoor Masks: COVID-19 Global Weekly Highlights https://www.medscape.com/viewarticle/940446 - Health care 'breaking point': Cox confirms some Springfield COVID-19 patients transferred to St. Louis, Kansas City https://www.news-leader.com/story/news/local/ozarks/2021/06/29/springfield-covid-delta-variant-missouri-hospitals-cox-some-patients-transferred-vaccines/7787970002/ 2- COVID Vaccine-Induced Myocarditis - New Details of Myocarditis Linked to COVID Vaccines https://www.medscape.com/viewarticle/954061 - Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military https://jamanetwork.com/journals/jamacardiology/fullarticle/2781601 - Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination https://jamanetwork.com/journals/jamacardiology/fullarticle/2781602 3- Diabetes in the Clinic - 'Staggering' Doubling of Type 2 Diabetes in Kids During Pandemic https://www.medscape.com/viewarticle/953816 4- Optimal Medical Therapy - OMT 'Best Insurance' for Extended Survival After Revascularization https://www.medscape.com/viewarticle/953959 - Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization https://doi.org/10.1016/j.jacc.2021.04.087 - Defining the Proper SYNTAX for Long-Term Benefit of Myocardial Revascularization With Optimal Medical Therapy https://doi.org/10.1016/j.jacc.2021.04.088 - Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease. https://www.nejm.org/doi/full/10.1056/nejmoa0804626 - Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial https://doi.org/10.1016/S0140-6736(19)31997-X 5- Alcohol - The Sick-Quitter Effect: How Alcohol Can Seem Cardioprotective When It Isn't https://www.medscape.com/viewarticle/953696 Features: - Vaccine-Induced Myocarditis Concerns Demand Respect, Not Absolutism https://www.medscape.com/viewarticle/954038 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

Myocarditis and the COVID vaccine, lipid lowering guidelines, financial toxicity, and deprescribing statins are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1 – COVID Varied COVID Vaccination Rates May Lead to 'Two Americas' https://www.medscape.com/viewarticle/953658 Nearly All COVID Deaths in US Are Now Among Unvaccinated https://www.medscape.com/viewarticle/953703 2 - COVID Vaccine Myocarditis FDA to Add Myocarditis Warning to mRNA COVID-19 Vaccines https://www.medscape.com/viewarticle/953647 3 – Lipid Guidelines Clinicians Slow to Implement Lipid-Lowering Guidelines: GOULD Registry https://www.medscape.com/viewarticle/953688 - Use of Lipid-Lowering Therapies Over 2 Years in GOULD, a Registry of Patients With Atherosclerotic Cardiovascular Disease in the US https://jamanetwork.com/journals/jamacardiology/fullarticle/2780713 4 - Financial Toxicity Financial Burden Higher With CVD Than Cancer https://www.medscape.com/viewarticle/953687 - Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States https://www.jacc.org/doi/10.1016/j.jaccao.2021.02.006 5 - Deprescribing Statins Stopping Statins Linked to Death, CV Events in Elderly https://www.medscape.com/viewarticle/953545 - Cardiovascular Outcomes and Mortality Associated With Discontinuing Statins in Older Patients Receiving Polypharmacy https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780952 - Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61240-4/fulltext - Rosuvastatin in Older Patients with Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa0706201 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

COVID vaccine myocarditis, Christian Eriksen and sudden cardiac death, therapeutic hypothermia, and revascularization of stable CAD are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic 1- COVID-Vaccine-Myocarditis AHA: Don't Delay COVID Shot While CDC Reviews Myocarditis Cases https://www.medscape.com/viewarticle/953233 Myocarditis after BNT162b2 and mRNA-1273 Vaccination https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055913 2- Christian Eriksen Christian Eriksen: un survivant qui doit nous inspirer https://francais.medscape.com/voirarticle/3607279 Danish Soccer Player Suffered Cardiac Arrest During Euro Match https://www.webmd.com/news/20210614/danish-soccer-player-suffered-cardiac-arrest-during-euro-match Point/Counterpoint on Halting Implantation of the Subcutaneous ICD https://www.jacc.org/doi/10.1016/j.jacep.2021.03.006 3- Therapeutic Hypothermia Trial Supports Therapeutic Hypothermia in Nonshockable Cardiac Arrest https://www.medscape.com/viewarticle/919855 Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 PulmCrit – A history of hypothermia for cardiac arrest, 2002-2021 (RIP) https://emcrit.org/pulmcrit/ttm2/ 4 - Revascularization of Stable CAD Meta-analysis Muses Over ISCHEMIA Message Had Trial Lasted Longer https://www.medscape.com/viewarticle/951498 Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis https://doi.org/10.1093/eurheartj/ehab246 Impact of revascularisation on outcomes in chronic coronary syndromes: a new meta-analysis with the same old biases? https://doi.org/10.1093/eurheartj/ehab330 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

COVID vaccine myocarditis, AF post-stroke, semaglutide, and iPhones and cardiac devices are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-Vaccine-Myocarditis More Evidence Links COVID Vaccines to Rare Cases of Myocarditis in Youth https://www.medscape.com/viewarticle/952905 - Symptomatic Acute Myocarditis in Seven Adolescents Following the Pfizer-BioNTech COVID-19 Vaccination https://pediatrics.aappublications.org/content/early/2021/06/04/peds.2021-052478 - At Least 18 Cases of Apparent Heart Problems in Young People in CT After COVID-19 Vaccine https://www.nbcconnecticut.com/news/coronavirus/connecticut-confirms-at-least-18-cases-of-apparent-heart-problems-in-young-people-after-covid-19-vaccination/2494534/ - C.D.C. Is Investigating a Heart Problem in a Few Young Vaccine Recipients https://www.nytimes.com/2021/05/22/health/cdc-heart-teens-vaccination.html - EMA Statement: https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-3-6-may-2021 - Is the Second Shot Giving Young Men a Dangerous Heart Condition? https://nymag.com/intelligencer/2021/06/israel-detects-link-between-myocarditis-and-covid-vaccine.html - Report to FDA https://www.fda.gov/media/150054/download AF and Stroke Evidence Mounts for Implantable AF Monitoring After Stroke https://www.medscape.com/viewarticle/952325 - The STROKE-AF Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2780490 - The PER DIEM Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2780491 Obesity FDA Approves 'Game Changer' Semaglutide for Weight Loss https://www.medscape.com/viewarticle/952441 iPhone 12 and Cardiac Device Evidence Builds for iPhone 12 Interference With Cardiac Devices https://www.medscape.com/viewarticle/952780 - Magnetic Interference on Cardiac Implantable Electronic Devices From Apple iPhone MagSafe Technology https://www.ahajournals.org/doi/10.1161/JAHA.121.020818 - Letter to the Editor—Lifesaving therapy inhibition by phones containing magnets https://www.heartrhythmjournal.com/article/S1547-5271(20)31227-3/fulltext - Smart wearable device accessories may interfere with implantable cardiac devices https://www.heartrhythmcasereports.com/article/S2214-0271(20)30274-8/fulltext Features: Feb 26, 2021 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/946476 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

John Mandrola, MD, presents an ACC 2021 recap. https://www.medscape.com/twic ACC 2021 Reveiw I -- Left Atrial Appendage Closure LAAOS III: Surgical LAA Closure Cuts AF Stroke Risk by One Third https://www.medscape.com/viewarticle/951232 - Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 Watchman Registry: 1-Year Stroke Estimates Reassuringly Low https://www.medscape.com/viewarticle/951235 II - Angiotensin-Neprilysin Inhibition PARADISE-MI: Sacubitril/Valsartan Can't Beat Ramipril in Patients With Acute MI https://www.medscape.com/viewarticle/951236 Life Trial Rationale Paper: https://doi.org/10.1016/j.jchf.2020.05.005 III - Renal Denervation Ultrasound Renal Denervation Drops BP in Patients on Triple Therapy https://www.medscape.com/viewarticle/951248 IV -- Clopidogrel vs ASA post Stent HOST-EXAM: Clopidogrel Beats Aspirin as Monotherapy After Stenting https://www.medscape.com/viewarticle/951294 - Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial https://doi.org/10.1016/S0140-6736(21)01063-1 V -- AF Ablation in HF RAFT-AF, Despite Itself, Hints at Advantage for Ablation Rhythm Control in Heart Failure With AF. https://www.medscape.com/viewarticle/951326 VI -- Rivaroxaban in COVID-19 – ACTION Trial Therapeutic Rivaroxaban Dose: Risk Outweighs Benefit in Stable COVID https://www.medscape.com/viewarticle/951475 VII -- REHAB-HF Trial Novel Rehab Program Fights Frailty, Boosts Capacity in Advanced HF https://www.medscape.com/viewarticle/951244 - Physical Rehabilitation for Older Patients Hospitalized for Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2026141 VIII – ASA 81 vs 325 – ADAPTABLE Trial ADAPTABLE: Low-Dose Aspirin as Good as High-Dose in CHD? https://www.medscape.com/viewarticle/951230 - Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2102137 Perspectives: Eight Things to Know About the Surgical Left Atrial Appendage Occlusion (LAAOS III) Trial https://www.medscape.com/viewarticle/951229 PARADISE-MI Makes Me Question the Benefits of Sacubitril/Valsartan https://www.medscape.com/viewarticle/951239 Sacubitril/Valsartan: Trending Toward PARADISE Post MI https://www.medscape.com/viewarticle/950300 Renal Denervation for Resistant Hypertension Is Not Back on Track https://www.medscape.com/viewarticle/951497 Acute Alcohol Consumption Raises Risk for Atrial Fibrillation https://www.medscape.com/viewarticle/950938 Does ADAPTABLE Inform Aspirin Dosing for Secondary Prevention? https://www.medscape.com/viewarticle/950969 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

The upcoming ACC meeting, polypharmacy, finerenone, and ethics and professionalism are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic ACC Preview: ACC.21 Looks to Repeat Success Despite Pandemic Headwinds https://www.medscape.com/viewarticle/950836 - Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/31050775/ Polypharmacy Hypertension Worsened by Commonly Used Prescription Meds https://www.medscape.com/viewarticle/950724 Finerenone Finerenone Scores Second Pivotal-Trial Success in Diabetic Kidney Disease https://www.medscape.com/viewarticle/951027 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 Ethics and Professionalism AHA/ACC Guidance on Ethics, Professionalism in Cardiovascular Care https://www.medscape.com/viewarticle/951018 - 2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report https://www.ahajournals.org/doi/10.1161/CIR.0000000000000963 Features: Mandrola Previews the 2021 (Virtual) American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/950797 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

COVID-19 and BMI, TAVR vs SAVR, subcutaneous ICD, SGLT2 inhibitors, and physician-Moms are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 COVID-19 Severity Starts in Normal BMI Range, Especially in Young https://www.medscape.com/viewarticle/950568 - Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00089-9/fulltext TAVR vs SAVR VARC-3 Sets Goalpost for Future Aortic Valve Trials https://www.medscape.com/viewarticle/950012 - Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa799/6237954 TAVR Availability Patchy Growth of TAVR Programs Leaves Poorer Communities Behind https://www.medscape.com/viewarticle/950316 S-ICD Trade-offs Between Subcutaneous, Transvenous ICDs on Display in EFFORTLESS https://www.medscape.com/viewarticle/950328 - Implant and Midterm Outcomes of the Subcutaneous Implantable Cardioverter-Defibrillator Registry: The EFFORTLESS Study https://doi.org/10.1016/j.jacc.2017.06.040 - Reduction in Inappropriate Therapy and Mortality through ICD Programming https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 - Low inappropriate shock rates in patients with single- and dual/triple-chamber implantable cardioverter-defibrillators using a novel suite of detection algorithms: PainFree SST trial primary results https://doi.org/10.1016/j.hrthm.2015.01.017 Dapagliflozin and CKD FDA Approves Dapagliflozin (Farxiga) for Chronic Kidney Disease https://www.medscape.com/viewarticle/950329 Features New Physician Moms Need More Resources and Less Guilt in the Workplace https://www.medscape.com/viewarticle/949765 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