The small blood vessels in the heart, called the coronary microvasculature, carry most of the blood flow to the heart muscle, delivering oxygen. These blood vessels can become unhealthy when there is damage to their inner lining. There can also be plaque buildup in the larger coronary arteries that does not narrow them but can contribute to abnormal blood flow.    Over time, this leads to abnormal widening or narrowing of the small vessels in response to exercise or stress, which can cause problems with the blood supply to the heart, causing chest pain, shortness of breath, heart attack, and heart failure.  In this interview, C. Noel Bairey Merz MD, FACC, FAHA, FESC, and Purvi Parwani MBBS, MPH, FACC, discuss Management of INOCA and MINOCA: What Do We Know and How Are We Doing?   Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

ACCEL Lite: Management of INOCA and MINOCA: What Do We Know and How Are We Doing?

The American College of Cardiology offers select interviews and summaries of cardiology’s most interesting research areas from ACCEL’s renowned library, hosted by ACCEL Editor-in-Chief Alison L. Bailey, MD, FACC, FAACPVR.

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 In this interview, Leslie Cho, MD, FACC, and Steven E. Nissen MD, MACC explore the nuances of estrogen and testosterone replacement: who benefits, when to consider it, and how long it should last.          Subscribe to ACCEL  

The Hormone Puzzle: Decoding the what, when and how long of hormone replacement therapy in women

Ticagrelor monotherapy following one month of dual antiplatelet therapy (DAPT) outperforms 12-month DAPT (aspirin and ticagrelor) post PCI for reducing clinically meaningful bleeding with no increased thrombotic risk. In this interview, Gregg W Stone MD, FACC and Anthony N. DeMaria MD, MACC discuss principal results from the Ultimate DAPT Trial.  Subscribe to ACCEL Lite Other ACC resources on DAPT and bleeding risk:  1.      One-Month Ticagrelor Monotherapy After PCI in Acute Coronary Syndromes - IVUS-ACS/ULTIMATE-DAPT  2.      Study Suggests Most Patients with Acute Coronary Syndromes Can Safely Stop Aspirin One Month After Percutaneous Coronary Intervention  3.      ACC.24 Presentation Slides | ULTIMATE-DAPT

Ultimate DAPT Trial Principal Results - Ticagrelor monotherapy following one month of dual antiplatelet therapy (DAPT) outperforms 12-month DAPT (aspirin and ticagrelor) post PCI for reducing clinical

 The Be Active trial demonstrates the efficacy of scalable interventions, incorporating remote monitoring and behavioral economics, in boosting physical activity among high-risk cardiovascular patients. Lasting effects were observed even six months post-intervention. While additional data may be warranted for some stakeholders, these interventions hold promise as integral components of exercise-based prevention strategies for cardiovascular disease.    In this interview, Alexander Fanaroff, MD, MHS and Glenn A. Hirsch MD, MHS, FACC discuss results from the Be Active RCT.        Subscribe on Apple Podcasts |    

Be Active RCT: Gamification & Financial Incentives to Increase Physical Activity

 The VICTORION-INIATATE study demonstrated that initiating inclisiran, a highly potent lipid-lowering therapy, upon failure to achieve lipid targets with statins, yielded superior outcomes compared to standard care. This approach facilitated a greater proportion of patients in reaching LDL-C targets recommended by current guidelines. Presently, the conventional management of cholesterol disorders in the US routinely falls short of attaining treatment goals for the majority of patients.    In this interview, Michael J. Koren, MD, FACC, and C. Noel Bairey Merz, MD, FACC discuss results from the VICTORION-INITIATE randomized trial.  

Statin Intolerance, Inclisarin, and the VICTORION-INITIATE Trial

 Heart failure is an increasingly recognized complication in chronic diabetes that may be caused by a number of processes including direct effects of hyperglycemia on the heart muscle. So-called diabetic cardiomyopathy may affect up to 20% of people with chronic diabetes and represents a unique target for treatment.     In this interview, James Januzzi, MD, FACC, and Alison L. Bailey, MD FACC discuss the primary results from the ARISE-HF study: Selective Aldose Reductase Inhibitor  For Diabetic Cardiomyopathy.     Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL  

ACCEL Lite: Management of INOCA and MINOCA: What Do We Know and How Are We Doing?

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