This Week in Cardiology

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.

Topics discussed include screening for valvular heart disease in the elderly, the efficacy of multivitamins, approval of another PA sensor for heart failure, the use of vascular closure devices in electrophysiology, and the marketing of GLP-1 as scientific research.

Cardiologist John Mandrola, MD, discusses MRAs in HF, coronary autoregulation, NSTEMI in older patients, survival after STEMI, and new leaders at JACC. Topics include renal dysfunction, hubris of US doctors, microvascular resistance, device approvals, outcomes of older vs conservative strategies, long-term outcomes of PCI in STEMI patients, limitations of composite endpoints, and well wishes to Dr. Harlan Crumholz and the new Jack Team.

Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF 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. Listener Feedback ASPIRE AF https://classic.clinicaltrials.gov/ct2/show/NCT03968393 Butala paper: Stroke After TAVR With and Without EPD https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697 PROTECTED TAVR Heuts meta-analysis: EPD During TAVR https://heart.bmj.com/content/110/11/757 II. Statin Eligibility JAMA-IM: Data Analytic Choices and Predicting Vascular Events https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819821 Zeraatker Specification Analysis Paper https://doi.org/10.1016/j.jclinepi.2024.111278 PCE https://www.mdcalc.com/calc/3398/ascvd-atherosclerotic-cardiovascular-disease-2013-risk-calculator-aha-acc III. Heterogenous Treatment Effect Weisberg and Dailey-Higgs DANISH IV. Heart Failure and MRAs RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001 EMPHASIS https://www.nejm.org/doi/full/10.1056/NEJMoa1009492 Combined analysis (Matsumoto) 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

Cardiologist John Mandrola discusses the impact of cannabis on cardiovascular risk, post-CABG AF, and embolic protection devices. Topics include cannabis use linked to arrhythmias, challenges in preventing post-surgery AFib, and the efficacy of embolic protection devices post-TAVI.

The FLOW trial of semaglutide, the DANCAVAS CV screening trial, non-invasive tests for chest pain, and conflicts of interest on social media are the topics John Mandrola, MD, discusses 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. Semaglutide for CKD Semaglutide Significantly Improves Chronic Kidney Disease https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9 FLOW Trial II. CV Screening Judicious CVD Screening May Work in Men: DANCAVAS https://www.medscape.com/viewarticle/980153 DANCAVAS 6-Year Outcomes https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004403 DANCAVAS Main Trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 III. Non-invasive Cardiac Testing in Chest Pain Circulation Outcomes Paper https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010457 Scot Heart https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 IV. COI and Social Media JAMA letter https://jamanetwork.com/journals/jama/fullarticle/2816900 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

Clues in SCAF, a DOAC antidote trial, another negative lytic trial in stroke, JAMA changes to observational studies, and BP in stroke care 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. ARTESIA Substudy Sadly, ARTESIA Doesn't Answer a Common Question in Cardiology https://www.medscape.com/viewarticle/998215 ARTESIA Substudy NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 ARTESIA https://www.nejm.org/doi/10.1056/NEJMoa2310234 II. DOAC Reversal ANNEXA-1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2313040 III. Lytic Therapy in Acute Stroke Thrombolysis Offers No Benefit for Mild Stroke https://www.medscape.com/viewarticle/iv-thrombolysis-offers-no-benefit-mild-stroke-2024a10009p7 TEMPO-2 Trial https://doi.org/10.1016/S0140-6736(24)00921-8 The Case Against Thrombolytic Therapy in Stroke IV. Observational Research JAMA Special Communication https://jamanetwork.com/journals/jama/fullarticle/2818746 JAMA editors note https://jamanetwork.com/journals/jama/fullarticle/2818747 V. Aggressive BP Control in Stroke Guidelines on Rapid BP Reduction in Acute Ischemic Stroke Challenged https://www.medscape.com/viewarticle/guidelines-rapid-bp-reduction-acute-ischemic-stroke-2024a10009pe TRUTH Trial https://doi.org/10.1016/S1474-4422(24)00177-7 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