This Week in Cardiology

COVID-19 vaccine-related clotting, vitamin D, anticoagulation strategies before PCI, and a good intervention at end of life are the topics John Mandrola, MD, discusses in this week's podcast. https://www.medscape.com/twic

COVID-19:

How Some COVID-19 Vaccines Could Cause Rare Blood Clots https://www.medscape.com/viewarticle/949262

FAQ: What to Know About the J&J Vaccine Pause https://www.medscape.com/viewarticle/949231

Vitamin D Screening:

Don't Screen for Vitamin D in General Population, Says US Task Force https://www.medscape.com/viewarticle/949167

Pre-PCI AC Decisions:

Parity Whether Anticoagulation Is Halted or Not for Unplanned Cath https://www.medscape.com/viewarticle/949064

Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention https://doi.org/10.1016/j.jcin.2021.01.022

Pacemaker or Defibrillator Surgery without Interruption of Anticoagulation https://www.nejm.org/doi/full/10.1056/nejmoa1302946

Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to high risk of arterial thrombo-embolic events (BRUISE CONTROL-2) https://doi.org/10.1093/eurheartj/ehy413

A Superb Intervention at End of Life:

Use of Comfort Care Increasing After Stroke, May Reduce Costs https://www.medscape.com/viewarticle/949297

Decade‐Long Nationwide Trends and Disparities in Use of Comfort Care Interventions for Patients With Ischemic Stroke https://doi.org/10.1161/JAHA.120.019785

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COVID-19, COVID-19 vaccines, hybrid AF ablation TAVR and who gets to be called a doctor are the topics by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic

COVID-19

UK Regulators to Offer Under-30s Alternative to AZ COVID Vaccine https://www.medscape.com/viewarticle/948934

- News - Communicating the potential benefits and harms of the Astra-Zeneca COVID-19 vaccine https://wintoncentre.maths.cam.ac.uk/news/communicating-potential-benefits-and-harms-astra-zeneca-covid-19-vaccine/

Hybrid Ablation for Persistent AF

- Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288

- Converge trial Rationale Paper https://doi.org/10.1016/j.ahj.2020.02.016

- Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288

- Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350/

TAVR

- TAVR Feasible, Comparable to Surgery in Rheumatic Heart Disease https://www.medscape.com/viewarticle/948832

- Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis https://doi.org/10.1016/j.jacc.2021.02.032

- Upsides, Downsides for TAVR, Minimally Invasive AVR https://www.medscape.com/viewarticle/946104

- Minimally invasive surgery versus transcatheter aortic valve replacement: a systematic review and meta-analysis https://openheart.bmj.com/content/8/1/e001535#ref-9

Who Should Get to Be Called 'Doctor'? https://www.medscape.com/viewarticle/948887

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COVID-19, long-COVID, the language of medicine, childhood obesity, and open notes are the topics covered by John Mandrola, MD, in this week's podcast.

https://www.medscape.com/twic

COVID-19

AstraZeneca COVID Vaccine: Clotting Disorder Mechanism Revealed?

https://www.medscape.com/viewarticle/948560

Long COVID

Long COVID Brings Welcome Attention to POTS

https://www.medscape.com/viewarticle/948174

Keep Both 'Renal' and 'Nephro' in Glossary of Kidney Disease

https://www.medscape.com/viewarticle/948451

'Striking' Increase in Childhood Obesity During Pandemic

https://www.medscape.com/viewarticle/948350

COVID-19 and Changes in Child Obesity. https://pediatrics.aappublications.org/content/early/2021/03/01/peds.2021-050123

Starting Monday, Patients Can Read Your Notes:

5 Key Things https://www.medscape.com/viewarticle/948508

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https://www.medscape.com/author/bob-harrington

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[email protected]

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COVID-19, AF detection post stroke, new measures of heart function, and structural racism in quality measures are the topics covered by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic

COVID-19

NIH Rebukes AstraZeneca Vaccine Interim Data: 'Incomplete' https://www.medscape.com/viewarticle/947954

Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination https://jamanetwork.com/journals/jama/fullarticle/2777898

AF and Stroke

Insertable Cardiac Monitors Improve AF Detection After Stroke https://www.medscape.com/viewarticle/947986

Perfection in LV Function Measurement

Adding Strain Measure to LVEF Better Predicts Later HF https://www.medscape.com/viewarticle/948114

Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life https://jamanetwork.com/journals/jamacardiology/fullarticle/2777414

Is the Left Ventricular Ejection Fraction Measurement Still Preeminent?—New Measures to Quantify Subclinical Systolic Dysfunction https://jamanetwork.com/journals/jamacardiology/fullarticle/2777412

Structural Racism in Pay for Performance

Association Between the Proportion of Black Patients Cared for at Hospitals and Financial Penalties Under Value-Based Payment Programs https://jamanetwork.com/journals/jama/fullarticle/2777701

Twitter Thread from Rishi Wadhera https://twitter.com/rkwadhera/status/1374380385560186883

References:

Sowell, Thomas A Conflict of Visions https://en.wikipedia.org/wiki/A_Conflict_of_Visions

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COVID-19, Fish Oil and AF risk, SGLT2 inhibitors and renal outcomes, and TAVR vs SAVR are the topics discussed by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic

COVID-19

EMA Launches Review of Clot Risk With AstraZeneca COVID Vaccine https://www.medscape.com/viewarticle/947393

AZ Vaccine Safe Overall but Questions Remain over Unusual Clots https://www.medscape.com/viewarticle/947733

Fish Oil and AF

Dose-Related AF Risk With Omega-3 Fatty Acids? https://www.medscape.com/viewarticle/947542

Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777469

Omega-3 Fatty Acids and Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777450

SGLT2i and Renal Outcomes

Ertugliflozin: Renal Benefits in Additional VERTIS CV Analyses https://www.medscape.com/viewarticle/947668

Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2004967

Effects of ertugliflozin on kidney composite outcomes, renal function and albuminuria in patients with type 2 diabetes mellitus: an analysis from the randomised VERTIS CV trial https://link.springer.com/article/10.1007/s00125-021-05407-5

TAVR vs SAVR

TAVR vs SAVR in Low-Risk Patients: What We Do and Don't Know https://www.medscape.com/viewarticle/946173

Mortality in trials on transcatheter aortic valve implantation versus surgical aortic valve replacement: a pooled meta-analysis of Kaplan-Meier-derived individual patient data https://pubmed.ncbi.nlm.nih.gov/32236543/

Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk https://www.jacc.org/doi/full/10.1016/j.jacc.2020.12.052

Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement https://www.nejm.org/doi/full/10.1056/NEJMoa1910555

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[email protected]

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COVID-19, heart failure classifications, DOAC after bioprosthetic valves, and Medicare spending in the pandemic year Are the topics discussed by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic

I. COVID-19 Vaccination in Israel

COVID-19 Vaccination Linked to Less Mechanical Ventilation https://www.medscape.com/viewarticle/946568

BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

II. Heart Failure Classification

Heart Failure Redefined With New Classifications, Staging https://www.medscape.com/viewarticle/947048

Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure https://doi.org/10.1016/j.cardfail.2021.01.022

Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655

Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.044586

III. DOACs In Bioprosthetic Valves --

DOACs Offered After Heart Valve Surgery Despite Absence of Data https://www.medscape.com/viewarticle/947193

Off-label Use of Direct Oral Anticoagulants in Patients Receiving Surgical Mechanical and Bioprosthetic Heart Valves https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777141

Dabigatran versus Warfarin in Patients with Mechanical Heart Valves https://www.nejm.org/doi/full/10.1056/nejmoa1300615

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document.... https://academic.oup.com/europace/article/19/11/1757/4098134

IV. Pandemic Slices Medicare Physician Spending in First Half of 2020: AMA https://www.medscape.com/viewarticle/946984

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Cardiac studies in professional athletes after COVID-19 infection, percutaneous valve repair, AF screening, and social media are the topics discussed by John Mandrola, MD, in this week's podcast. To read a partial transcript or to comment https://www.medscape.com/twic

COVID and the Athletic Heart

Incidence of Cardiac Pathology Post-COVID in Pro Athletes

Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening https://jamanetwork.com/journals/jamacardiology/fullarticle/2777308

Percutaneous Valve Repair

Delirium Common, Costly After Mitral, Tricuspid Valve Repair https://www.medscape.com/viewarticle/946736

Prevalence and Impact of Post-Procedural Delirium After Percutaneous Repair of Mitral and Tricuspid Valves https://www.jacc.org/doi/full/10.1016/j.jcin.2020.11.031

AF Screening

AF Screening in Asymptomatic Older Individuals Shows Promise https://www.medscape.com/viewarticle/946844

Screening for Atrial Fibrillation in the Older Population A Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2776728

Social Media

JAMA Podcast on Racism in Medicine Faces Backlash https://www.webmd.com/sex-relationships/news/20210304/jama-podcast-on-racism-in-medicine-faces-backlash

Time's Up Founder Choo Accused in Harassment Mishandling https://www.medscape.com/viewarticle/946678

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Risk factors for COVID-19, CMR after COVID-19, and two important obesity studies are discussed in this week's podcast. To read a partial transcript or to comment https://www.medscape.com/twic

Cardiometabolic Conditions and COVID19

Most Severe COVID Tied to Four Cardiometabolic Conditions https://www.medscape.com/viewarticle/946488

Coronavirus Disease 2019 Hospitalizations Attributable to Cardiometabolic Conditions in the United States: A Comparative Risk Assessment Analysis https://www.ahajournals.org/doi/10.1161/JAHA.120.019259

CMR after COVID19

Myocardial Injury Seen on MRI in 54% of Recovered COVID https://www.medscape.com/viewarticle/946287

Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance https://doi.org/10.1093/eurheartj/ehab075

Obesity Trials

Semaglutide for Weight Loss? A Good First STEP, With Caveats https://www.medscape.com/viewarticle/945630

Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

Major Breakthrough in Weight Loss With Semaglutide? https://www.medscape.com/viewarticle/940841

Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity https://jamanetwork.com/journals/jama/fullarticle/2777025

Features

Fired for Good Judgment a Sign of Physicians' Lost Respect https://www.medscape.com/viewarticle/946286

A Tribute to Bernard Lown https://www.medscape.com/viewarticle/946447

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Bernard Lown, Type 2 MI, Sacubitril/Valsartan and COVID19 anticoagulation are discussed in this week's podcast. To read a partial transcript or to comment https://www.medscape.com/twic

COVID

Israeli Study Finds Pfizer Vaccine 95% Effective Against COVID-19 https://www.medscape.com/viewarticle/945962

Bernard Lown

Cardiologist, Antiwar Activist Bernard Lown Dies at 99 https://www.medscape.com/viewarticle/945966

Type 2 MI

New Light Cast on Type-2 MI Aims to Sharpen Diagnosis, Therapy https://www.medscape.com/viewarticle/946075

Early AC in COVID19

More Evidence Supports Early Anticoagulation in COVID-19 https://www.medscape.com/viewarticle/945902

Sacubitril/Valsartan

FDA Expands Sacubitril/Valsartan Indication to Embrace Some HFpEF https://www.medscape.com/viewarticle/945936

Five Reasons Sacubitril/Valsartan Should NOT Be Approved for HFpEF https://www.medscape.com/viewarticle/944168

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Questions or feedback, please contact [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Prediabetes, AI and ECGs, HFpEF, and observational studies are the topics discussed by John Mandrola, MD in this week's podcast. To read a partial transcript or to comment http://www.medscape.com/twic

Pre-diabetes

'Prediabetes' Unlikely to Progress to Diabetes in Older Adults https://www.medscape.com/viewarticle/945511

Mobile QT Interval Measurement

Using AI, Mobile ECG Aims to Expand QTc Screening Horizons https://www.medscape.com/viewarticle/945484 Giudicessi JR et al.

Artificial Intelligence-Enabled Assessment of the Heart Rate Corrected QT Interval Using a Mobile Electrocardiogram Device | Circulation (ahajournals.org) https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.120.050231

HFpEF

Exercise Quandary in HFpEF: Training Regimens Fall Short in Trial https://www.medscape.com/viewarticle/945621

Observational Study Follies

Statins Linked to Reduced Postop Adhesions, Bowel Obstruction https://www.medscape.com/viewarticle/945686

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Questions or feedback, please contact [email protected]

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.