Surgical clearance, NICM assessment, dueling perspectives on PCI as first-line therapy for angina, GDMT in HFrEF 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. New ACC Peri-operative Guidelines Released

• ACC Guideline document https://www.jacc.org/doi/10.1016/j.jacc.2024.06.013
• J Vasc Surg https://www.jvascsurg.org/article/S0741-5214(21)00335-9/fulltext
• McFalls and colleagues; CARP https://www.nejm.org/doi/full/10.1056/NEJMoa041905

II. NICM – We may be doing it wrong in Selecting ICDs

• JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/
• German CMR ICD Trial https://www.clinicaltrials.gov/study/NCT04558723
• BRITISH CMR trial https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/britishusing-cmr-scar-as-risk-indication-tool-in-nicm-and-severe-lvsd/

III. When Should PCI be Used in Chronic Stable CAD?

• Rajkumar and Al-Lamee; PCI First https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011201

• Boden and De Caterina; Meds First https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011268
• ORBITA 10.1016/S0140-6736(17)32714-9
• ORBITA 2 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2310610

IV. GDMT Underuse in HFrEF

• Greene and colleagues https://doi.org/10.1016/j.jchf.2024.08.002
• DAPA HF https://www.nejm.org/doi/full/10.1056/NEJMoa1911303
• RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001

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

Listener feedback, K levels post cardiac surgery, cardiac device safety, disparities in preventive care, stopping trials early, and a SHAM-PVI update 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. Listener Feedback

Sep 13, 2024 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1001596

• Sripal Bangalore Tweet on Yusef Meta-analysis https://x.com/SripalBangalore/status/1750116964893094125

II. Post Cardiac Surgery AF

• TIGHT K Trial https://jamanetwork.com/journals/jama/fullarticle/2823246

III. Evidence Base for New Cardiac Devices

• Annals of IM Survey Observational Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724

IV. Disparities in Care

• JAMA Network Open Paper on Insurer Denials of Preventive Care https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823677

V. Stopping Trials Early

• Kaul and Butler; Insights on Recent CKD Trials https://doi.org/10.1016/j.jacc.2024.07.026
• Bassler Systematic Review https://jamanetwork.com/journals/jama/fullarticle/185591

VI. Sham PVI

AF Ablation Works…But: The Positive SHAM-PVI Trial

https://www.medscape.com/viewarticle/af-ablation-works-positive-sham-pvi-trial-2024a1000gzl?&icd=login_success_email_match_fpf

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

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

Feedback on ABYSS and beta-blockers, more ESC recap, including SHAM-PVI, FINEARTS-HF, and RESHAPE HF2 trials are the topics John Mandrola, MD, discusses in today’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. Feedback on ABYSS

Setbacks After Stopping Beta-Blockers

https://www.medscape.com/viewarticle/setbacks-after-stopping-beta-blockers-2024a1000fv7

Beta-Blockers Post-MI? No for Me, Even After the ABYSS Trial

https://www.medscape.com/viewarticle/beta-blockers-post-mi-no-me-even-after-abyss-trial-2024a1000fva

• ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204
• REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479
• QOL paper REDUCE AMI https://doi.org/10.1093/ehjcvp/pvae062
• Atenolol ED paper 10.1016/j.ehj.2003.08.016

II. SHAM-PVI

• JAMA SHAM-PVI paper https://jamanetwork.com/journals/jama/article-abstract/2823283
• Gupta QOL paper https://pubmed.ncbi.nlm.nih.gov/33952593/

III. FINEARTS HF

Finerenone Benefits Heart Failure With Preserved EF

https://www.medscape.com/viewarticle/finerenone-benefits-heart-failure-preserved-ef-2024a1000fza

Topline Finerenone Results Point to Advance in Heart Failure

https://www.medscape.com/viewarticle/topline-finerenone-results-point-advance-heart-failure-2024a1000fq2

• FINEHEARTS -HF NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2407107
• FIDELIO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2025845
• FIGARO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2110956
• Why Have We Not Been Able to Demonstrate Reduced Mortality in Patients With HFmrEF/HFpEF? https://doi.org/10.1016/j.jacc.2024.08.033

IV. RESHAPE HF

TEER in Functional MR: Data Deluge, but No Easy Answers

https://www.medscape.com/viewarticle/teer-functional-mr-data-deluge-no-easy-answers-2024a1000fvg

• Mitra FR https://www.nejm.org/doi/full/10.1056/NEJMoa1805374
• COAPT https://www.nejm.org/doi/full/10.1056/NEJMoa1806640
• RESHAPE- HF2 https://www.nejm.org/doi/full/10.1056/NEJMoa2314328
• RESHAPE Subgroup paper https://doi.org/10.1016/j.jacc.2024.08.027

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

From ESC: post-MI beta blockers, a new therapy for ATTR-CM, holding RASi before non-cardiac surgery, good news in HFpEF, and an ESC preview 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. ABYSS

• ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204
• REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479

II. ATTR -CM HELIOS B

Positive Top Line Results for Vutrisiran in Cardiac Amyloidosis

https://www.medscape.com/viewarticle/positive-top-line-results-vutrisiran-cardiac-amyloidosis-2024a1000cjj

• HELIOS A https://www.tandfonline.com/doi/full/10.1080/13506129.2022.2091985
• HELIOS B https://www.nejm.org/doi/full/10.1056/NEJMoa2409134

III. STOP or NOT Trial

• Observational Study Showing Benefits of Holding RASi https://doi.org/10.1097/ALN.0000000000001404
• STOP or NOT Protocol Paper -- https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3247-1
• JAMA STOP or NOT https://jamanetwork.com/journals/jama/fullarticle/2823118

IV. GLP1a in HFpEF

The GLP-1 Agonist Semaglutide in HFpEF Cleared a Low Bar https://www.medscape.com/viewarticle/995872

• STEP-HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963
• STEP-HFpEF-DM https://www.nejm.org/doi/full/10.1056/NEJMoa2313917
• SELECT https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
• FLOW https://www.nejm.org/doi/full/10.1056/NEJMoa2403347
• Lancet Meta-analysis https://doi.org/10.1016/S0140-6736(24)01643-X

V. ESC Preview

Mandrola's Five Big Trials to Look for at ESC 2024

https://www.medscape.com/viewarticle/mandrolas-five-big-trials-look-esc-2024-2024a1000fkt

Topline Finerenone Results Point to Advance in Heart Failure

https://www.medscape.com/viewarticle/topline-finerenone-results-point-advance-heart-failure-2024a1000fq2

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

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

Prediction models vs clinical judgement, CCTA quantification of atherosclerosis, AF ablation plus LAAO, atrial shunt devices, and HF medical therapy are 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.Clinical Prediction Models vs Clinical Judgement

Did Statin Decision-Making Just Get Harder?

https://www.medscape.com/viewarticle/did-statin-decision-making-just-get-harder-2024a1000egl

• Colunga-Lozano and colleagues
• https://doi.org/10.1016/j.jclinepi.2023.10.016
• Aug 02, 2024 This Week in Cardiology Podcast
• https://www.medscape.com/viewarticle/1001429

II. CCTA Quantification of Atherosclerosis

• Atherosclerosis Quantification and Cardiovascular Risk: the ISCHEMIA Trial https://doi.org/10.1093/eurheartj/ehae471
• Circulation ISCHEMIA sub study 2021 – Severity of CAD and Outcomes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049755
• ISCHEMIA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1915922

III. Combined AF Ablation and LAAO

• Review from Mills and colleagues https://doi.org/10.1016/j.tcm.2023.11.003
• Link to CMS Rule on AF Ablation and LAAO https://hrs2.informz.net/z/cjUucD9taT05MjU3ODgyJnA9MSZ1PTkwMDQ2MTk4MCZsaT04NTU1OTQxMg/index.html

IV. Atrial Shunt Devices

No Net HF Benefit for Interatrial Shunt Device

https://www.medscape.com/viewarticle/no-net-hf-benefit-interarterial-shunt-device-2024a10006kk

• Original REDUCE-LAP-HF-II https://doi.org/10.1016/S0140-6736(22)00016-2
• Two-year results of REDUCE-LAP-HF-II https://doi.org/10.1016/j.jchf.2024.04.011
• Apr 19, 2024 This Week in Cardiology Podcast

V. Optimal HF Therapy

• Rao and colleagues; CHAMP HF https://doi.org/10.1016/j.jchf.2024.05.026

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