This Week in Cardiology

More from ESC: the SCOFF trial and fasting before cardiac cath, MATTERHORN, humbling data with AI, plus a reflection on the work of being a patient 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. Fasting Before Cardiac Procedures The SCOFF Trial https://doi.org/10.1093/eurheartj/ehae573 II. MV repair for Functional MR Large Trials Support Mitral Valve Repair in Heart Failure MATTERHORN https://www.nejm.org/doi/full/10.1056/NEJMoa2408739 III. AI in Medicine Rapidx AI Project https://healthtranslationsa.org.au/project/rapid-x-ai/ PROTEUS Trial Rationale paper https://pubmed.ncbi.nlm.nih.gov/37192698/ IV. Time Toxicity Time Toxicity https://link.springer.com/article/10.1007/s00520-024-08844-1 Thread X https://x.com/EnriqueSoto8/status/1833587144256065859 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this engaging discussion, John Mandrola, MD, a cardiology expert, dives into recent groundbreaking clinical trials. He shares insights on the ABYSS trial, questioning the role of beta-blockers post-myocardial infarction. The conversation also touches on the SHAM-PVI trial for AFib ablation and its implications for practice. Mandrola highlights the FINEARTS HF trial, emphasizing the benefits of finerenone for heart failure with preserved ejection fraction. This episode is a treasure trove of valuable information for healthcare professionals!

Dr. John Mandrola, a prominent cardiologist, shares insights from the European Society of Cardiology meeting. He discusses the implications of beta blockers post-myocardial infarction and introduces a promising new therapy for ATTR cardiomyopathy. Mandrola also highlights the importance of temporarily halting RAS inhibitors before non-cardiac surgery and presents encouraging developments in managing heart failure with preserved ejection fraction. The episode further examines the significance of placebo effects in cardiology trials and their influence on patient quality of life.

Suicidal ideation and GLP-1 agonists, a repeat of PARADIGM HF in Chagas CM, CASTLE HTx critical appraisal, and primary prevention of SCD in HF 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. Suicidal ideation with GLP-1 Signal of Suicidality With GLP-1 RA Semaglutide, but Experts Urge Caution https://www.medscape.com/viewarticle/signal-suicidality-glp-1-ra-semaglutide-experts-urge-caution-2024a1000fa7 Disproportionality Analysis from World Health Organization Data on Semaglutide, Liraglutide, and Suicidality   Variability in Disproportionality paper https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.668765/full II. PARACHUTE HF: Repeating the Mistakes in PARADIGM HF PARACHUTE HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 SOLVD https://www.nejm.org/doi/full/10.1056/NEJM199108013250501 CONSENSUS trial https://www.nejm.org/doi/full/10.1056/NEJM198706043162301 Meta-analysis of Low vs High Dose ACE/ARB https://doi.org/10.1161/CIRCHEARTFAILURE.117.003956 Meta-analysis of Sac/Val vs ARB/ACE Inhibitors https://link.springer.com/article/10.1007/s00228-024-03686-6 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508 III. CASTLE HTx Critical Appraisal Critical Appraisal of CASTLE HTx https://doi.org/10.1016/j.jacc.2024.06.020 CASTLE HTx https://www.nejm.org/doi/10.1056/NEJMoa2306037 CASTLE AF https://www.nejm.org/doi/full/10.1056/NEJMoa1707855 IV. More Data Suggesting Modest Benefits of the Primary Prevention ICD First and Recurrent ICD Shocks: JICE Paper from Denmark https://link.springer.com/article/10.1007/s10840-024-01873-0 HF trialists https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 PROFID Trial https://profid-project.eu/ DANISH  https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 SCD-HeFT https://www.nejm.org/doi/full/10.1056/NEJMoa043399 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Diuretic therapy in HFrEF, AF ablation, TACT 2 and the story of subgroups, and SGLT2 inhibitor underuse 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. Diuretic Therapy in HF Dapa vs Metolazone Trial https://doi.org/10.1093/eurheartj/ehad341 ADVOR https://www.nejm.org/doi/10.1056/NEJMoa2203094 II. Rapid Medication Titration for Acute HF ACC Decision Pathway https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002 III. SGLT2 Inhibitor Use in the US Shin and Colleagues; JACC  https://www.sciencedirect.com/science/article/abs/pii/S0735109724076332 Editorial  https://doi.org/10.1016/j.jacc.2024.07.001 IV. AF Ablation: General Anesthesia vs Conscious Sedation Da Riis-Vestergaard and Colleagues  https://doi.org/10.1093/europace/euae203 V. TACT 2 Published TACT 1 https://jamanetwork.com/journals/jama/fullarticle/1672238 TACT 1 DM https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.113.000663 TACT 2 https://jamanetwork.com/journals/jama/fullarticle/2822472 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

John Mandrola, MD, a leading cardiologist, dives into critical cardiology topics this week. He discusses the tug-of-war between clinical prediction models and personal judgment in patient care. The conversation also covers the intricacies of CCTA quantification of atherosclerosis and its implications for cardiovascular risk. Mandrola examines the combined approach of AF ablation with LAAO, along with the efficacy of atrial shunt devices, highlighting recent studies that question their overall benefits for heart failure patients.

Two downsides of PFA including autonomic tone and hemolysis, a bad surrogate in AF care, and controversies in defining cardiac risk are the topics John Mandrola, MD, covers 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.PFA and Its (lack of) Effect on Autonomic Tone Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed? https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v Autonomic Tone Paper https://doi.org/10.1016/j.jacep.2024.05.005 ADVENT https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 II. Second PFA Study JACC-EP—on Hemolysis   Hemolysis study https://doi.org/10.1016/j.jacep.2024.05.001 MANIFEST 17K https://www.nature.com/articles/s41591-024-03114-3 Defaye Editorial https://www.jacc.org/doi/abs/10.1016/j.jacep.2024.06.007 III. A Self-serving Surrogate Marker:  Diagnosis to Ablation Time. CAPLA Study https://jamanetwork.com/journals/jama/fullarticle/2800186 CAPLA Substudy https://doi.org/10.1016/j.jacep.2024.05.031 EHJ RCT Early vs Late https://doi.org/10.1093/eurheartj/ehad247 LOOP; Diederichsen and colleagues  10.1016/j.jacc.2019.09.050 Groningen and Maastricht Group study https://heart.bmj.com/content/109/3/186 IV. Future Cardiac Risk Diao and colleagues Study of AHA PREVENT Risk Equations https://jamanetwork.com/journals/jama/fullarticle/2821624 JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821542 Another JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821628 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this discussion, John Mandrola, MD, delves into the intricate ties between health and income, reviewing fascinating studies on cash giveaways and their health impacts. He also navigates the challenges of managing elevated blood pressure in hospitals with a six-step strategy, emphasizing personalized care. Lastly, he explores subclinical atrial fibrillation management, shedding light on anticoagulant therapy and the significance of CHADS-VASC scores, all while confronting the uncertainties in treatment decisions.

This podcast discusses vulnerable plaques and the scientific method, industry payments to trainees, comparison between tirzepatide and semaglutide, trial interpretation, and PFA. It also explores the use of PET imaging to detect vulnerable plaques, the impact of profit motives on medical advancements, and the significant cardiovascular benefits of semaglutide in treating heart disease.

This week's podcast dives into topics like venous closure devices, GLP1-s linked to blindness and cancer, resisting ECG urges, and transcatheter edge-to-edge repair for secondary mitral regurgitation. Healthcare professionals share insights on these complex issues.