This Week in Cardiology

Screening echo, multivitamins, wasteful research, another PA sensor for HF, vascular closure devices, and GLP-1 marketing as science research 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. Screening for Valvular HD in the Elderly

• EHJ-CV Imaging Paper https://doi.org/10.1093/ehjci/jeae127

II. Vitamins and Wasteful Research

Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https:// www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv

May 10, 2024 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1000772

• Multivitamin Paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820369
• Physicians Health Study II https://jamanetwork.com/journals/jama/fullarticle/1389615

III. FDA Has Approved Another PA Sensor

• Link to slides https://c212.net/c/link/?t=0&l=en&o=4104690-1&h=4197477262&u=https%3A%2F%2Fendotronix.com%2FEndotronix-PROACTIVE-HF-LBCT-THT-2024.pdf&a=here

IV. Vascular Closure Devices in Electrophysiology.

• Vascular Closure Devices Study https://onlinelibrary.wiley.com/doi/full/10.1111/jce.16345

V. SURMOUNT-OSA

• SURMOUNT OSA Paper https://www.nejm.org/doi/full/10.1056/NEJMoa2404881
• SELECT https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
• June 21, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001237
• JAMA Systematic Review and Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2643307
• SAVE https://www.nejm.org/doi/full/10.1056/NEJMoa1606599
• Norwegian study https://doi.org/10.1016/j.hrthm.2022.06.016

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MRAs in HF with renal dysfunction, coronary autoregulation, the hubris of US doctors, NSTEMI in older patients, survival after STEMI, and new leaders at JACC are discussed by John Mandrola, MD.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

• Combined analysis (Matsumoto)

II Coronary artery autoregulation with increasing stenosis

• NEJM Paper https://www.nejm.org/doi/full/10.1056/NEJMc2402216

III RECOVER IV Trial

• Gregg Stone, MD Tweet https://x.com/GreggWStone/status/1803583552354742416
• DANGER-Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572
• Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659

IV NSTEMI Elderly

• Main Paper
• Datamethods https://discourse.datamethods.org/t/random-vs-fixed-effects-meta-analysis/7361
• O'Fee Paper https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

V MI Survival

Danish Paper https://doi.org/10.1016/j.jacc.2024.04.025

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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:

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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)

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Cannabis and CV outcomes, post-CABG AF, embolic protection devices, emulation of randomization, and a preview heterogenous treatment effects 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:

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I. Cannabis

It Sure Looks Like Cannabis Is Bad for the Heart, Doesn't It?

https://www.medscape.com/viewarticle/1000250

Cannabis Use Tied to Increased Cardiovascular Risk

https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk

https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk-2024a10000sc

• Cannabis for Chronic Pain and CV Safety https://doi.org/10.1093/eurheartj/ehad834
• Editorial https://academic.oup.com/eurheartj/article/45/6/485/7500073
• Response to Letter https://doi.org/10.1093/eurheartj/ehae314
• UCLA paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819559
• Lifetime Cannabis Use and Mortality https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819635

II. Post Cardiac Surgery AF

• Meta-analysis https://doi.org/10.1093/eurheartj/ehae267

III. Embolic Protection devices

Clear Stroke Benefit Eludes Embolic Protection: PROTECTED TAVR

https://www.medscape.com/viewarticle/980978

• Embolic Protection and Stroke Prevention With TAVR https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697
• PROTECTED TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2204961

IV. Preview of HTE

Paper https://doi.org/10.1016/j.ahj.2024.04.020

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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:

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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

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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:

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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

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An Impella update, another TAVI vs SAVR trial, two studies on angina and PCI, another null substudy from REVIVED-BCIS, and semaglutide 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:

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I. Impella Update

• CHRIP BCIS 3 https://classic.clinicaltrials.gov/ct2/show/NCT05003817
• Danger-Shock Podcast https://www.medscape.com/viewarticle/1000675

II. TAVI vs SAVR

• Notion 2 Trial EHJ https://doi.org/10.1093/eurheartj/ehae331
• DEDICATE-DZHK6

III. Angina and PCI

• Orbita 2 Sub-analysis
• Orbita Star https://www.jacc.org/doi/10.1016/j.jacc.2024.04.001

IV. Complete Revascularization

• Main REVIVED trial https://www.nejm.org/doi/full/10.1056/NEJMoa2206606
• JACC Substudy https://www.jacc.org/doi/10.1016/j.jacc.2024.04.043

V. Semaglutide

Semaglutide CV Benefits Irrespective of Weight Loss: 4-Year SELECT Data

https://www.medscape.com/viewarticle/semaglutide-cv-benefits-irrespective-weight-loss-4-year-2024a100095z

• Nature Med substudy https://www.nature.com/articles/s41591-024-02996-7
• SELECT Main paper https://www.nejm.org/doi/full/10.1056/NEJMoa2307563

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Inclisiran, sodium-channel blocker safety, analytic flexibility, the work-up of patients with HF, and BP in older patients 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:

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I. Inclisiran Update

• ORION 4 https://classic.clinicaltrials.gov/ct2/show/NCT03705234

II. Sodium-Channel AADs

• UPenn Paper https://doi.org/10.1016/j.jacep.2024.01.021
• Three Questions Editorial https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381
• EAST Post-hoc Review https://doi.org/10.1093/europace/euae121

III. Analytic Flexibility

Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat

https://www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv

• Specification Curve Analysis of Red Meat Data https://doi.org/10.1016/j.jclinepi.2024.111278

IV. The Work-up of Patients With HF

• Durstenfeld and colleagues, UCSF https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010800
• REVIVED BCIS2 https://www.nejm.org/doi/full/10.1056/NEJMoa2206606

V. BP Therapy in Older Patients

• Haring and colleagues; Women's Health Initiative BP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067302
• SPRINT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1511939

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The DEDICATE trial of TAVR vs SAVR, more on renal denervation, inclisiran, and marketing disguised as science are the topics John Mandrola, MD, discusses in today's podcast.

This podcast is intended for healthcare professionals only.

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I. TAVR vs SAVR

TAVI Comparable With SAVR in Lower-Risk Aortic Stenosis

https://www.medscape.com/viewarticle/tavi-comparable-savr-lower-risk-aortic-stenosis-2024a100074o?form=fpf

• DEDICATE https://www.nejm.org/doi/full/10.1056/NEJMoa2400685
• Partner 3 https://www.nejm.org/doi/full/10.1056/NEJMoa1814052
• Evolut Low Risk https://www.nejm.org/doi/full/10.1056/NEJMoa1816885
• Barili meta-analysis https://doi.org/10.1093/ejcts/ezab516

II. Renal Denervation

Alcohol-Mediated Renal Denervation Promising in Hypertension

https://www.medscape.com/viewarticle/alcohol-mediated-renal-denervation-promising-hypertension-2024a10007eg

• TARGET 1 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.069291

III. Inclisiran

Earlier Inclisiran Gives Better Long-Term LDL Reductions

https://www.medscape.com/viewarticle/earlier-inclisiran-gives-better-long-term-ldl-reductions-2024a10007d6

• VICTORIAN INITIATE Trial https://www.jacc.org/doi/10.1016/j.jacc.2024.03.382

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A listener defends colored boxes in guidelines; mysteries of non-culprit coronary lesions during PCI, and of AF ablation; and surrogate markers 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:

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I. Mystery of What to Do in the Cath Lab after Fixing the Culprit Lesion – The FULL REVASC Trial

Complete Revascularization Not Superior to Culprit-Only PCI After MI

https://www.medscape.com/viewarticle/complete-revascularization-not-superior-culprit-only-pci-2024a10007ik

• FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
• FIRE Trial https://www.nejm.org/doi/10.1056/NEJMoa2300468
• COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
• Cohen Tweet on FULL REVASC https://x.com/djc795/status/1781361606238085532

II. AF Ablation Mysteries

New Expert Consensus on Ablation Strategies for AF

https://www.medscape.com/viewarticle/new-expert-consensus-ablation-strategies-af-2024a1000851

• Bern Study of Remapping https://doi.org/10.1016/j.jacep.2024.02.026
• Natural History of SCAF https://doi.org/10.1016/j.jacc.2019.09.050
• Liverpool Study: Thermal PV Isolation in Persistent AF https://doi.org/10.1016/j.hrthm.2024.04.061

III. Surrogate Markers

• JAMA: Surrugate Markers and Clinical Outcomes https://jamanetwork.com/journals/jama/fullarticle/2817850
• BP Surrogate Meta-analysis https://doi.org/10.1016/S0140-6736(21)00590-0
• JAMA: Nonfatal MI as Surrogate for Mortality https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

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