In this interview, Amit R. Patel, MD, FACC and Alison L. Bailey, MD FACC, discuss the Top Cardiovascular Imaging Takeaways from 2025 including myocardial fibroblast activation, photon-counting detector CT, the newly published ACC/AHA CT Advanced Training Statement, and more.

Suggested Materials:

1. Nijveldt R, Maeng M, Beijnink CWH, et al. Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction. N Engl J Med. Published online October 28, 2025. doi:10.1056/NEJMoa2512918

2. Barton AK, Craig NJ, Loganath K, et al. Myocardial Fibroblast Activation After Acute Myocardial Infarction: A Positron Emission Tomography and Magnetic Resonance Study. J Am Coll Cardiol. 2025;85(6):578-591. doi:10.1016/j.jacc.2024.10.103

3. Sakai K, Shin D, Singh M, et al. Diagnostic Performance and Clinical Impact of Photon-Counting Detector Computed Tomography in Coronary Artery Disease. J Am Coll Cardiol. 2025;85(4):339-348. doi:10.1016/j.jacc.2024.10.069

4. Baldassarre LA, Mendes LA, Blankstein R, et al. 2025 ACC/AHA/ASE/ASNC/SCCT/SCMR Advanced Training Statement on Advanced Cardiovascular Imaging: A Report of the ACC Competency Management Committee. J Am Coll Cardiol. Published online November 18, 2025. doi:10.1016/j.jacc.2025.07.036

5. Sahashi Y, Ieki H, Yuan V, et al. Artificial Intelligence Automation of Echocardiographic Measurements. J Am Coll Cardiol. 2025;86(13):964-978. doi:10.1016/j.jacc.2025.07.053

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Inflammation is a key contributor to cardiovascular disease (CVD), influencing both its onset and progression. High-sensitivity C-reactive protein (hsCRP) serves as a reliable biomarker for detecting systemic inflammation and assessing cardiovascular risk. Recognizing the role of inflammation helps refine risk stratification and guide preventive strategies in the general population.

In this interview, Nanette Kass Wenger MD, MACC and Prof. Dr. Florian Kahles, MD discuss "C-Reactive Protein and CV Risk in the General Population".

SUGGESTED MATERIALS:

1. Amezcua-Castillo E, González-Pacheco H, Sáenz-San Martín A, et al. C-Reactive Protein: The Quintessential Marker of Systemic Inflammation in Coronary Artery Disease-Advancing toward Precision Medicine. Biomedicines. 2023;11(9):2444. Published 2023 Sep 2. doi:10.3390/biomedicines11092444

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The ALONE-AF study examined outcomes in atrial fibrillation (AF) patients who remained free of recurrence following catheter ablation. Researchers found that discontinuing oral anticoagulation (OAC) was associated with a lower risk of stroke, systemic embolism, or major bleeding compared to continued OAC. These findings, presented at the ESC Congress 2025, suggest that stopping OAC may offer a safer long-term strategy for select post-ablation AF patients. This could mark a meaningful shift in how clinicians approach anticoagulation management in this population.

In this interview, Dhanunjaya "DJ" Lakkireddy MBBS, FACC and Boyoung Joung, MD, PhD discuss "ALONE-AF: Discontinuing Long-Term Oral Anticoagulation After Successful AFib Ablation".

SUGGESTED MATERIALS:

1. New data on oral anticoagulation after successful ablation of atrial fibrillation (escardio.org website). 2025. Available at: https://www.escardio.org/The-ESC/Press-Office/Press-releases/New-data-on-oral-anticoagulation-after-successful-ablation-of-atrial-fibrillation#. Accessed 11/9/25.

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Imaging is a powerful tool in managing obesity, helping clinicians visualize fat distribution and detect complications like fatty liver disease or heart issues. Advanced techniques like magnetic resonance imaging (MRI) and computed tomography (CT) scans guide personalized treatment plans and monitor progress over time. Despite challenges with equipment limitations, innovations like artificial intelligence and specialized scanners are making imaging more accessible and accurate for patients with obesity.

In this interview, W. Douglas Weaver MD, MACC and Mouaz H. Al-Mallah, MD, FACC discuss "How Does Imaging Guide Management in Patients with Obesity?"

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In the TACSI trial, researchers evaluated ticagrelor plus aspirin versus aspirin alone in about 2,200 patients who underwent coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS). At 12 months, dual antiplatelet therapy (DAPT) did not reduce major adverse cardiac events compared to aspirin alone. However, it was associated with a higher risk of major bleeding. These findings do not support routine DAPT use post-CABG in ACS patients, though longer-term follow-up is still needed.

In this interview, Drs. Steven E. Nissen and Anders Jeppsson discuss "TACSI Trial: Dual or Single Antiplatelet Therapy After CABG in Patients With ACS".

SUGGESTED MATERIALS:

1. Jeppsson A, James S, Moller CH, et al. Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. N Engl J Med. Published online September 1, 2025. doi:10.1056/NEJMoa2508026

1. TACSI: Dual or single antiplatelet therapy after CABG in patients with acute coronary syndrome: Reported from ESC Congress 2025 (PCRonline website). 2025. Available at: https://www.pcronline.com/News/Whats-new-on-PCRonline/2025/ESC/TACSI-Dual-or-single-antiplatelet-therapy-after-CABG-in-patients-with-acute-coronary-syndrome. Accessed 10/31/25.

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Current clinical challenges in lipid control include achieving and maintaining target LDL-cholesterol levels in patients at high risk for atherosclerotic cardiovascular disease, especially those who do not respond adequately to standard therapies. The VICTORION-Difference trial demonstrated that an inclisiran-based treatment strategy significantly outperformed usual care in helping patients reach early and sustained LDL-C goals. This approach also resulted in fewer muscle-related side effects, a common barrier to adherence. Inclisiran offers a convenient, effective, and well-tolerated option for improving lipid management in these patients.

In this interview, Drs. Kim A. Williams and Ulf Landmesser discuss "VICTORION-Difference: Inclisiran-Based Strategy vs. Standard of Care."

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What if your genes could predict a life-threatening condition before symptoms ever appear? Explore how medical science uncovered the genetic roots of thoracic aortic aneurysm—and why that discovery changed everything. From famous historical figures to modern patients, the implications are profound: understanding the exact genetic mutation can guide treatment and safeguard entire families.

In this interview, Drs. Jeroen J. Bax and John A. Elefteriades discuss "Aortopathies: What A Cardiologist Needs to Know".

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Can a newer, more targeted pacing method revolutionize heart failure treatment? The PhysioSync-HF trial investigates conduction system pacing as a potentially more effective and affordable alternative to traditional cardiac resynchronization therapy. Explore the surprising differences between this study and prior research and hear firsthand what it was like to lead a nationwide, publicly funded clinical trial across Brazil. This episode dives deep into innovation, equity, and the future of heart care.

In this interview, Drs. Joseph Marine and André Zimerman discuss "PhysioSync-HF: Conduction System vs. Biventricular Pacing in Cardiac Resynchronization in HFrEF".

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The DAPT SHOCK AMI trial is the first major study to evaluate antiplatelet therapy specifically in patients with cardiogenic shock (CS) following acute myocardial infarction (AMI). It compares initial treatment strategies using cangrelor versus crushed ticagrelor. Early and potent platelet inhibition is critical for restoring microvascular reperfusion in this high-risk population. Previous randomized trials have excluded these patients, leaving a gap in evidence for optimal antiplatelet management in AMI-CS.

In this interview, Drs. Dipti Itchhaporia and Zuzana Motovska discuss "DAPT-SHOCK-AMI Trial: Cangrelor in Cardiogenic Shock".

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The ODYSSEY-HCM trial found that mavacamten did not significantly improve exercise capacity or patient-reported outcomes in individuals with symptomatic nonobstructive hypertrophic cardiomyopathy. Safety concerns emerged, including more frequent reductions in ejection fraction and treatment interruptions among those receiving mavacamten. The trial's limited diversity and short duration raise questions about the generalizability and long-term implications of the findings. Despite the lack of approved therapies for this patient group, the study underscores the complexity of using surrogate endpoints and the need for deeper exploration into disease mechanisms and treatment response.

In this interview, Matthew Martinez MD, FACC and Milind Y. Desai, MD, MBA, FACC discuss "ODYSSEY-HCM: Mavacamten in nHCM."

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