This Week in Cardiology

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

COVID-19 and global vaccinations, AF screening, conduction-system pacing, FDA ban on menthol tobacco, and a heartfelt essay are the topics John Mandrola, MD, discusses in this week's podcast. https://www.medscape.com/twic COVID-19 Indians Rush for COVID-19 Vaccines as Death Toll Passes 200,000 https://www.medscape.com/viewarticle/950095 - Vaccine Breakthrough Infections with SARS-CoV-2 Variants https://www.nejm.org/doi/full/10.1056/NEJMoa2105000 AF Screening: Modest Clinical Gain for AF Screening of Asymptomatic Elderly: STROKESTOP https://www.medscape.com/viewarticle/949950 - Mass Screening for Untreated Atrial Fibrillation The STROKESTOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.014343 - Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials https://pubmed.ncbi.nlm.nih.gov/25596211/ - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350 Conduction System Pacing Keeping Pace: His-Bundle CRT for Heart Failure Impresses in Second Randomized Trial https://www.medscape.com/viewarticle/950037 - A Randomized Trial of His pacing versus Biventricular pacing in Symptomatic Heart Failure Patients with left bundle branch block (His-Alternative) https://www.jacc.org/doi/10.1016/j.jacep.2021.04.003 - His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure https://www.jacc.org/doi/full/10.1016/j.jacc.2019.04.026 FDA FDA Moves to Ban Menthol in Tobacco Products https://www.medscape.com/viewarticle/950223 Features: Losing Both Parents During COVID: A Physician's 'Unwitnessed Grief' https://www.medscape.com/viewarticle/949490 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

Cardiac status post COVID-19 in athletes, AF ablation, and bias against procedural doctors are the topics covered by John Mandrola, MD, in this week's podcast https://www.medscape.com/twic COVID-19 COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e2.htm Professor Zeynep Tufekci Newsletter: https://www.theinsight.org/p/facts-are-pieces-of-a-puzzle-not Post-COVID-19 Cardiac Involvement in NCAA athletes SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054824 AF and Durable PV isolation Paroxysmal AF Can Recur but Burden Plunges After 'Durable' Ablation https://www.medscape.com/viewarticle/949566 Radiofrequency vs. Cryoballoon Catheter Ablation for Paroxysmal Atrial Fibrillation: Durability of Pulmonary Vein Isolation and Effect on AF Burden: The RACE-AF Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009573 Bias Against Procedures: Apr 9, 2021 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/949000 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 vaccine-related clotting, vitamin D, anticoagulation strategies before PCI, and a good intervention at end of life are the topics John Mandrola, MD, discusses in this week's podcast. https://www.medscape.com/twic COVID-19: How Some COVID-19 Vaccines Could Cause Rare Blood Clots https://www.medscape.com/viewarticle/949262 FAQ: What to Know About the J&J Vaccine Pause https://www.medscape.com/viewarticle/949231 Vitamin D Screening: Don't Screen for Vitamin D in General Population, Says US Task Force https://www.medscape.com/viewarticle/949167 Pre-PCI AC Decisions: Parity Whether Anticoagulation Is Halted or Not for Unplanned Cath https://www.medscape.com/viewarticle/949064 Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention https://doi.org/10.1016/j.jcin.2021.01.022 Pacemaker or Defibrillator Surgery without Interruption of Anticoagulation https://www.nejm.org/doi/full/10.1056/nejmoa1302946 Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to high risk of arterial thrombo-embolic events (BRUISE CONTROL-2) https://doi.org/10.1093/eurheartj/ehy413 A Superb Intervention at End of Life: Use of Comfort Care Increasing After Stroke, May Reduce Costs https://www.medscape.com/viewarticle/949297 Decade‐Long Nationwide Trends and Disparities in Use of Comfort Care Interventions for Patients With Ischemic Stroke https://doi.org/10.1161/JAHA.120.019785 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, COVID-19 vaccines, hybrid AF ablation TAVR and who gets to be called a doctor are the topics by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 UK Regulators to Offer Under-30s Alternative to AZ COVID Vaccine https://www.medscape.com/viewarticle/948934 - News - Communicating the potential benefits and harms of the Astra-Zeneca COVID-19 vaccine https://wintoncentre.maths.cam.ac.uk/news/communicating-potential-benefits-and-harms-astra-zeneca-covid-19-vaccine/ Hybrid Ablation for Persistent AF - Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288 - Converge trial Rationale Paper https://doi.org/10.1016/j.ahj.2020.02.016 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350/ TAVR - TAVR Feasible, Comparable to Surgery in Rheumatic Heart Disease https://www.medscape.com/viewarticle/948832 - Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis https://doi.org/10.1016/j.jacc.2021.02.032 - Upsides, Downsides for TAVR, Minimally Invasive AVR https://www.medscape.com/viewarticle/946104 - Minimally invasive surgery versus transcatheter aortic valve replacement: a systematic review and meta-analysis https://openheart.bmj.com/content/8/1/e001535#ref-9 Who Should Get to Be Called 'Doctor'? https://www.medscape.com/viewarticle/948887 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, long-COVID, the language of medicine, childhood obesity, and open notes are the topics covered by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 AstraZeneca COVID Vaccine: Clotting Disorder Mechanism Revealed? https://www.medscape.com/viewarticle/948560 Long COVID Long COVID Brings Welcome Attention to POTS https://www.medscape.com/viewarticle/948174 Keep Both 'Renal' and 'Nephro' in Glossary of Kidney Disease https://www.medscape.com/viewarticle/948451 'Striking' Increase in Childhood Obesity During Pandemic https://www.medscape.com/viewarticle/948350 COVID-19 and Changes in Child Obesity. https://pediatrics.aappublications.org/content/early/2021/03/01/peds.2021-050123 Starting Monday, Patients Can Read Your Notes: 5 Key Things https://www.medscape.com/viewarticle/948508 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, AF detection post stroke, new measures of heart function, and structural racism in quality measures are the topics covered by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 NIH Rebukes AstraZeneca Vaccine Interim Data: 'Incomplete' https://www.medscape.com/viewarticle/947954 Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination https://jamanetwork.com/journals/jama/fullarticle/2777898 AF and Stroke Insertable Cardiac Monitors Improve AF Detection After Stroke https://www.medscape.com/viewarticle/947986 Perfection in LV Function Measurement Adding Strain Measure to LVEF Better Predicts Later HF https://www.medscape.com/viewarticle/948114 Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life https://jamanetwork.com/journals/jamacardiology/fullarticle/2777414 Is the Left Ventricular Ejection Fraction Measurement Still Preeminent?—New Measures to Quantify Subclinical Systolic Dysfunction https://jamanetwork.com/journals/jamacardiology/fullarticle/2777412 Structural Racism in Pay for Performance Association Between the Proportion of Black Patients Cared for at Hospitals and Financial Penalties Under Value-Based Payment Programs https://jamanetwork.com/journals/jama/fullarticle/2777701 Twitter Thread from Rishi Wadhera https://twitter.com/rkwadhera/status/1374380385560186883 References: Sowell, Thomas A Conflict of Visions https://en.wikipedia.org/wiki/A_Conflict_of_Visions 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, Fish Oil and AF risk, SGLT2 inhibitors and renal outcomes, and TAVR vs SAVR are the topics discussed by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 EMA Launches Review of Clot Risk With AstraZeneca COVID Vaccine https://www.medscape.com/viewarticle/947393 AZ Vaccine Safe Overall but Questions Remain over Unusual Clots https://www.medscape.com/viewarticle/947733 Fish Oil and AF Dose-Related AF Risk With Omega-3 Fatty Acids? https://www.medscape.com/viewarticle/947542 Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777469 Omega-3 Fatty Acids and Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777450 SGLT2i and Renal Outcomes Ertugliflozin: Renal Benefits in Additional VERTIS CV Analyses https://www.medscape.com/viewarticle/947668 Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2004967 Effects of ertugliflozin on kidney composite outcomes, renal function and albuminuria in patients with type 2 diabetes mellitus: an analysis from the randomised VERTIS CV trial https://link.springer.com/article/10.1007/s00125-021-05407-5 TAVR vs SAVR TAVR vs SAVR in Low-Risk Patients: What We Do and Don't Know https://www.medscape.com/viewarticle/946173 Mortality in trials on transcatheter aortic valve implantation versus surgical aortic valve replacement: a pooled meta-analysis of Kaplan-Meier-derived individual patient data https://pubmed.ncbi.nlm.nih.gov/32236543/ Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk https://www.jacc.org/doi/full/10.1016/j.jacc.2020.12.052 Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement https://www.nejm.org/doi/full/10.1056/NEJMoa1910555 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