Listener feedback on the c-statistic, atherosclerotic plaque imaging, WATCHMAN implant decisions in the US, and deprescribing 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.Listener Feedback Oct 11, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001735 Nancy Cook; C-statistic https://doi.org/10.1161/CIRCULATIONAHA.106.672402 II. Plaque Imaging New Evidence That Plaque Buildup Shouldn't Be Ignored https://www.medscape.com/viewarticle/new-evidence-plaque-buildup-shouldnt-be-ignored-2024a1000ihw Fuster and colleagues; Imaging vs CAC   III. WATCHMAN Decisions Zeitler and colleagues. Long-term Outcomes IV. Deprescribing Cognitive Decline and Antihypertensive Use: New Data https://www.medscape.com/viewarticle/cognitive-decline-and-antihypertensive-use-new-data-2024a1000isw?form=fpf Jing and colleagues. 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 [email protected]

Reader feedback on cardiac devices and PFA, a new paradigm in the language of MI, sudden cardiac death, and measuring blood pressure 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. Listener Feedback Sep 20, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001631 Cardiac Devices https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724 Impact of PFA on Intraluminal Esophageal Temperature https://onlinelibrary.wiley.com/doi/10.1111/jce.16096 II. Towards a New Classification of MI McLaren and colleagues; From STEMI to OMI https://doi.org/10.1016/j.jacadv.2024.101314 III. Sudden Death After MI. EHJ Paper; SCD After MI https://doi.org/10.1093/eurheartj/ehae326 Barsheshet and colleagues; Risk Score to Predict Benefit of ICD https://doi.org/10.1016/j.jacc.2012.02.036 Zegard and colleagues; Myocardial Fibrosis and SCD 10.1016/j.jacc.2020.10.046 MADIT RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 IV. BP Readings Poor Arm Position May Significantly Skew BP Readings https://www.medscape.com/viewarticle/poor-arm-position-may-significantly-skew-bp-readings-2024a1000icv?form=fpf ARMS Crossover RCT 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 [email protected]

Reader feedback on LGE pre-ICDs, PFA for AF ablation, CTO-PCI, endovascular ablation of the greater splanchnic nerve in HFpEF, and data sharing 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 Sept 27, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001666 JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/ II. Pulsed Field Ablation for AF Feb 02, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/999995 ADMIRE Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.070333 ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 III. PCI for CTO EuroCTO One Year SAQ Results https://doi.org/10.1093/eurheartj/ehy220 EuroCTO Hard Outcomes https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusions Faith Healing and Subtraction Anxiety https://doi.org/10.1161/CIRCOUTCOMES.118.004665 DECISION CTO trial https://doi.org/10.1161/CIRCULATIONAHA.118.031313 ISCHEMIA CTO Rationale and Design https://doi.org/10.1016/j.ahj.2022.11.016 IV. Greater Splanchnic Nerve Ablation for HFpEF REBALANCE HF https://jamanetwork.com/journals/jamacardiology/fullarticle/2823999 V. Data Sharing The Pros and Cons of Clinical Trial Data Sharing https://www.medscape.com/viewarticle/862815 Kramer and Nallamothu, Caution in Data Sharing https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.124.010257 Nosek, Variability in Analytic Methods https://journals.sagepub.com/doi/10.1177/2515245917747646 Zeraatker, Variability in Analytic Methods   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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

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 [email protected]

Two downsides of PFA including autonomic tone and hemolysis, a bad surrogate in AF care, and controversies in defining cardiac risk 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: https://www.medscape.com/twic I.PFA and Its (lack of) Effect on Autonomic Tone Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed? https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v Autonomic Tone Paper https://doi.org/10.1016/j.jacep.2024.05.005 ADVENT https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 II. Second PFA Study JACC-EP—on Hemolysis   Hemolysis study https://doi.org/10.1016/j.jacep.2024.05.001 MANIFEST 17K https://www.nature.com/articles/s41591-024-03114-3 Defaye Editorial https://www.jacc.org/doi/abs/10.1016/j.jacep.2024.06.007 III. A Self-serving Surrogate Marker:  Diagnosis to Ablation Time. CAPLA Study https://jamanetwork.com/journals/jama/fullarticle/2800186 CAPLA Substudy https://doi.org/10.1016/j.jacep.2024.05.031 EHJ RCT Early vs Late https://doi.org/10.1093/eurheartj/ehad247 LOOP; Diederichsen and colleagues  10.1016/j.jacc.2019.09.050 Groningen and Maastricht Group study https://heart.bmj.com/content/109/3/186 IV. Future Cardiac Risk Diao and colleagues Study of AHA PREVENT Risk Equations https://jamanetwork.com/journals/jama/fullarticle/2821624 JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821542 Another JAMA Editorial https://jamanetwork.com/journals/jama/fullarticle/2821628 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 [email protected]

Health and income, high BP in the hospital, and more on subclinical AF and when to use anticoagulants 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. Health and Income  A Cash Giveaway to Improve Health https://www.medscape.com/viewarticle/cash-giveaway-improve-health-2024a1000dhf?form=fpf JAMA RCT https://jamanetwork.com/journals/jama/fullarticle/2821454 NBER RCT https://www.nber.org/papers/w32711 Have We Missed the Hidden Cause of Medical Overuse? https://www.medscape.com/viewarticle/908309 Mar 17, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/989775 Other References  Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120 Rand Link https://www.rand.org/pubs/reports/R3055.html The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/ Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576 Full Coverage for Preventive Medications after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmsa1107913 Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial InfarctionThe ARTEMIS Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2720024 II. Elevated BP in the hospital JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821364 III. Short-duration Subclinical AF Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA https://www.medscape.com/viewarticle/998379 ARTESiA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 ARTESiA CHADSVASC Subgroup  https://www.jacc.org/doi/10.1016/j.jacc.2024.05.002 NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 EHJ NOAH subanalysis https://doi.org/10.1093/eurheartj/ehae225 Stroke: Prolonged Heart Rhythm Monitoring After Stroke https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.045843 EHRA Analysis https://esc365.escardio.org/EHRA-Congress/sessions/10668   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 [email protected]

Vulnerable plaque and scientific method; industry payments to trainees; tirzepatide or semaglutide; trial interpretation; and PFA are the topics John Mandrola, MD, covers 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. Non-invasive Imaging for Vulnerable Plaque   PET Imaging Finds Vulnerable Plaques That Cause MI https://www.medscape.com/viewarticle/pet-imaging-finds-vulnerable-plaques-cause-mi-2024a1000cm2 JACC paper https://doi.org/10.1016/j.jacc.2024.03.419 Original JAMA-Card paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2806690 II. Industry Payments to Fellows JAMA Network Letter https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821267 III. GLP-1a Class Effect? Semaglutide Significantly Improves Chronic Kidney Disease https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9 Mounjaro Beats Ozempic, So Why Isn’t It More Popular? https://www.medscape.com/viewarticle/mounjaro-beats-ozempic-so-why-isnt-it-more-popular-2024a1000ckd JAMA-Internal Medicine: Semaglutide vs Tirzepatide https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080  SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 FLOW trial https://www.nejm.org/doi/full/10.1056/NEJMoa2403347 SURPASS-CVOT – Rationale https://doi.org/10.1016/j.ahj.2023.09.007 IV. Colchicine and Trial Interpretation in the Lancet CONVINCE https://doi.org/10.1016/S0140-6736(24)00968-1 V. PFA Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed? https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v 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 [email protected]

Venous closure devices, GLP1-s linked to blindness and cancer, resisting the urge to do an ECG, and transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation are the topics discussed 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 Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study https://doi.org/10.1093/europace/euae105 II GLP1-s and Blindness Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255 Locke Twitter  https://x.com/doc_BLocke/status/1808972226655629610 When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808 III GLP1-s and Cancer Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820833 IV Screening ECG Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adultshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820721 Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP)  https://doi.org/10.1016/S0140-6736(21)01637-8 Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study) https://doi.org/10.1016/S0140-6736(21)01698-6 IV TEER for Secondary Mitral Regurgitation Randomized investigation of the MitraClip device in heart failure: Design and rationale of the RESHAPE-HF2 trial design https://doi.org/10.1002/ejhf.3247 Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure: Baseline characteristics of patients in the RESHAPE-HF2 trial and comparison to COAPT and MITRA-FR trials https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3286 Jun 21, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001237 Stats Blog https://www.r-bloggers.com/2023/07/the-benjamini-hochberg-procedure-fdr-and-p-value-adjusted-explained/ 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 [email protected]

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 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 [email protected]

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. To read a partial transcript or to comment, visit: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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) 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

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. To read a partial transcript or to comment, visit: https://www.medscape.com/twic 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 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 [email protected]

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: https://www.medscape.com/twic 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 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 [email protected]

ACC Part 2: The TACT2 trial of chelation, inter-atrial shunts for HF, and triglyceride lowering; plus diltiazem and Factor Xa anticoagulants 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. TACT 2 Chelation Therapy Provides No Benefit Post-MI https://www.medscape.com/viewarticle/chelation-therapy-provides-no-benefit-post-mi-2024a10006l5 Chelation Therapy and CV Risk: Why TACT2 Showed No Benefit https://www.medscape.com/viewarticle/chelation-therapy-and-cv-risk-why-tact2-showed-no-benefit-2024a1000761?src= JAMA TACT 1 paper https://jamanetwork.com/journals/jama/fullarticle/1672238 Diabetes Subgroup paper https://pubmed.ncbi.nlm.nih.gov/24254885/ A New Look at P-values https://evidence.nejm.org/doi/abs/10.1056/EVIDoa2300003 PARAGON HF https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 II. Interatrial Shunts for HF No Net HF Benefit for Interarterial Shunt Device https://www.medscape.com/viewarticle/no-net-hf-benefit-interarterial-shunt-device-2024a10006kk REDUCE LAP HF II https://doi.org/10.1016/S0140-6736(22)00016-2 III. Triglyceride Lowering Early Olezarsen Results Show 50% Reduction in Triglycerides https://www.medscape.com/viewarticle/early-olezarsen-results-show-50-reduction-triglycerides-2024a10006oz Is It Time to Stop Treating High Triglycerides? https://www.medscape.com/viewarticle/990126 NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2402309 Substantial Triglyceride Reduction With Plozasiran https://www.medscape.com/viewarticle/substantial-triglyceride-reduction-plozasiran-2024a10006wf?icd=login_success_email_match_norm JAMA Cardiology https://jamanetwork.com/journals/jamacardiology/article-abstract/2817469 IV. Diltiazem and Factor Xa inhibitors JAMA Vanderbilt University Paper https://jamanetwork.com/journals/jama/fullarticle/2817546 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 [email protected]

ACC Recap #1: DanGer Shock (plus a sobering JAMA research letter on Impella use), REDUCE-AMI, PREVENT, and EMPACT-MI 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: https://www.medscape.com/twic I. DanGer-Shock Trial Impella CP Improves Survival in STEMI, Cardiogenic Shock https://www.medscape.com/viewarticle/impella-cp-improves-survival-stemi-cardiogenic-shock-2024a10006kz Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 Published DanGer Shock Study  https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 JAMA Research letter https://jamanetwork.com/journals/jama/article-abstract/2817457 II. REDUCE-AMI Trial New Data Question Beta-Blockers Post-MI With Preserved EF https://www.medscape.com/viewarticle/new-data-question-beta-blockers-post-mi-preserved-ef-2024a10006y8 Beta-Blockers Post-MI Past Their Expiration Date: REDUCE-AMI https://www.medscape.com/viewarticle/1000663 REDUCE-AMI paper https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 Meta-analysis: Beta Blockers for MI https://doi.org/10.1016/j.amjmed.2014.05.032 III. PREVENT Trial Preventive PCI for Vulnerable Plaques Reduces Cardiac Events https://www.medscape.com/viewarticle/preventive-pci-vulnerable-plaques-reduces-cardiac-events-2024a10006tc Preventive Coronary Stents: Not There Yet https://www.medscape.com/viewarticle/preventive-coronary-stents-not-there-yet-2024a10006yr PREVENT https://doi.org/10.1016/S0140-6736(24)00413-6 IV. EMPACT MI trial of Empagliflozin in the Post-MI setting Empagliflozin Fails to Reduce Events After Acute MI https://www.medscape.com/viewarticle/empagliflozin-fails-reduce-events-after-acute-mi-2024a10006kn EMPACT-MI: Another SGLT2 Inhibitor Miss in Post-MI Care  https://www.medscape.com/viewarticle/1000684 EMPACT MI https://www.nejm.org/doi/10.1056/NEJMoa2314051 DAPA MI https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300286 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508 Kaul thread https://x.com/kaulcsmc/status/1776611935842165029 Kaul paper https://www.ahajournals.org/doi/full/10.1161/circulationaha.116.022537 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 [email protected]

Statins and diabetes, AAD in patients with heart disease, tricuspid valve interventions, and an ACC preview 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. Statins and Diabetes Meta-analysis in Lancet-Diabetes https://doi.org/10.1016/S2213-8587(24)00040-8 Editorial https://doi.org/10.1016/S2213-8587(24)00059-7 NEJM Paper on Gene Variants and DM https://www.nejm.org/doi/full/10.1056/nejmoa1604304 JAMA Paper on Gene Variants and DM https://jamanetwork.com/journals/jama/fullarticle/2565289 II. Anti-arrhythmic Drugs in Patients With Serious Heart Disease UPenn Paper on AADs for PVC Suppression https://doi.org/10.1016/j.jacep.2024.01.021 Three Questions for Evidence-Based Cardiac EP https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 CAST trial https://www.nejm.org/doi/full/10.1056/NEJM199103213241201 III. Tricuspid Valve Interventions FDA Clears TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-clears-triclip-tricuspid-regurgitation-2024a100068o FDA Panel in Favor of TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-panel-favor-triclip-tricuspid-regurgitation-2024a100037n Slides for Trisend II TRILUMINATE https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 IV. ACC Preview Mandrola's Three Trials to Look for at the 2024 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/1000613 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 [email protected]

Intermittent fasting, anticoagulation decisions, heterogenous treatment effects, frailty in HF, the importance of the ECG, and industry conflicts 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. Intermittent Fasting No, Intermittent Fasting Won't Kill You https://www.medscape.com/viewarticle/1000544 NEJM Paper on Time-Restricted Eating  https://www.nejm.org/doi/full/10.1056/NEJMoa2114833 JAMA TREAT Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 II. Stroke Prevention with OAC Shah Meta analysis of Vitamin K Agonists in AF https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010269 III. Heterogenous Treatment Effects in Trials Pivotal CV Trials May Not Apply to Complex Patients https://www.medscape.com/viewarticle/989129 Analysis of 8 Trials of Multimorbidity and Treatment Response https://doi.org/10.1016/j.amjmed.2024.01.028 IV. Frailty and HF Circulation Outcomes: Multidomain Frailty and Mode of Death in HF  https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010416 V. ECG in LBBB JAMA Cardiology: Revised Definition of LBBB  https://jamanetwork.com/journals/jamacardiology/fullarticle/2816973 VI. Industry Payments to Doctors JAMA: Payments to US Physicians by Specialty https://jamanetwork.com/journals/jama/fullarticle/2816900 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 [email protected]

p>Obesity drugs as ASCVD-modifiers, HR monitors, when journals publish obvious facts, and effect scores and sorting out signals from RCTs 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: https://www.medscape.com/twic I. Denmark Notes II. FDA approval of Semaglutide FDA Approves Semaglutide for Cardiovascular Risk Reduction https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix Select Trial III. PPG Monitor Accuracy Research Letter https://doi.org/10.1016/j.jacc.2024.01.024 IV. AAD and Bradycardia Anti-arrhythmic Drugs Linked to Bradycardia in Patients With AF https://www.medscape.com/viewarticle/anti-arrhythmic-drugs-linked-bradycardia-patients-af-2024a10004vw JACC paper on AAD Adverse Effects https://doi.org/10.1016/j.jacc.2024.01.013 V. Finding Signals in RCTs   JAMA paper on Treatment Effects of Oxygen Targets DANISH trial https://www.nejm.org/doi/full/10.1056/nejmoa1608029 LAFFLIN et al. Scoring System to Assess Generalizability of Trial Results https://doi.org/10.1177/2047487318815967 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 [email protected]

Plastics and heart disease, MINT trial letters-to-the-editor and Bayes theorem, and Brugada syndrome 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. Plastics and Heart Disease Plastic Particles in Carotid Plaques Linked to CV Events https://www.medscape.com/viewarticle/plastic-particles-carotid-plaques-linked-cv-events-2024a10004ge Plastics and ASCVD Study https://www.nejm.org/doi/full/10.1056/NEJMoa2309822 Review https://www.nejm.org/doi/full/10.1056/NEJMra2300476 Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2400683 II. MINT trial LTE and Bayes Theorem In MI With Anemia, Results May Favor Liberal Transfusion: MINT https://www.medscape.com/viewarticle/998376 The MINT Study https://www.nejm.org/doi/full/10.1056/NEJMoa2307983 Letter-to-the-Editor https://www.nejm.org/doi/full/10.1056/NEJMc2400982 Likelihood Ratio https://www.cebm.ox.ac.uk/resources/ebm-tools/likelihood-ratios III. Brugada Syndrome The EHJ paper: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehae133/7623123 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 [email protected]

The Western AF meeting, aspirin, cannabis use, LVEF in athletes, and shared decision making before ICD implantation 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. ASA in Primary Prevention Campbell Meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065420 Swedish Observational study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.028321 ASPREE https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 II. Cannabis Cannabis Use Tied to Increased Cardiovascular Risk https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr It Sure Looks Like Cannabis Is Bad for the Heart, Doesn’t It? https://www.medscape.com/viewarticle/1000250 Journal of the AHA Observational Study https://www.ahajournals.org/doi/full/10.1161/JAHA.123.030178 III. Low EF in Athletes Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.063777 IV. ICDs and Shared Decision-Making Association of a Medicare Mandate for Shared Decision-Making With Cardiac Device Utilization https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2815017 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 [email protected]

Reading incidental CAC on chest CT scans, exercise benefits in women vs men, PCI with or without imaging, and trial non-reporting 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. Incidental CAC on Chest CT Incidental CAC Tweet When Does a Calcium Score Equate to Secondary Prevention?: Insights From the Multinational CONFIRM Registry https://doi.org/10.1016/j.jcmg.2023.03.008 II. Exercise Health Gains of Exercise Greater in Women? https://www.medscape.com/viewarticle/health-gains-exercise-greater-women-2024a10003fv Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality III. PCI With or Without Imaging Intravascular Imaging in PCI: Time for a Guideline Update? https://www.medscape.com/viewarticle/995677  Meta-analysis paper Lancet https://doi.org/10.1016/S0140-6736(23)02454-6 Imaging uptake paper https://doi.org/10.1093/eurheartj/ehad430 IV. Trial Non-reporting The Ghost Research Haunting Nordic Medical Trials https://www.medscape.com/viewarticle/ghost-research-haunting-nordic-medical-trials-2024a10003gz Manuscript/preprint https://www.medrxiv.org/content/10.1101/2024.02.04.24301363v1#T10 Nissen (Rosiglitazone) https://www.nejm.org/doi/10.1056/NEJMoa072761 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 [email protected]

An update in trial interpretation, CI, and P-values; percutaneous tricuspid Interventions; and news on HDL and humility in Medicine 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: https://www.medscape.com/twic I. Evidence of Absence Is not Absence of Evidence Feb 09, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1000101 ARCADIA Trial https://jamanetwork.com/journals/jama/fullarticle/2814933 FOURIER Trial https://www.nejm.org/doi/full/10.1056/nejmoa1615664 Sample Size Calculator https://clincalc.com/stats/samplesize.aspx II. Tricuspid Valve Interventions FDA OKs First Transcatheter Tricuspid Valve Replacement https://www.medscape.com/viewarticle/fda-oks-first-transcatheter-tricuspid-valve-replacement-2024a10002dq FDA Panel in Favor of TriClip for Tricuspid Regurgitation https://www.medscape.com/viewarticle/fda-panel-favor-triclip-tricuspid-regurgitation-2024a100037n Cardiothoracic Surgical Trials Network Study https://www.nejm.org/doi/full/10.1056/NEJMoa2115961 TRILUMINATE https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 KAUL Tweet on ATTR Cardiomyopathy https://twitter.com/kaulcsmc/status/1753552603534016622?s=20 APOLLO B trial https://www.nejm.org/doi/full/10.1056/NEJMoa2300757 Al-Lamee Tweet on Sham Controls https://x.com/rallamee/status/1758236588570562736 III. HDL Cholesterol Rationale paper — AEGIS https://doi.org/10.1016/j.ahj.2020.10.052 Press Release AEGIS II https://www.prnewswire.com/news-releases/csl-announces-top-line-results-from-the-phase-3-aegis-ii-trial-evaluating-the-efficacy-and-safety-of-csl112-apolipoprotein-a-i-human-302059156.html 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 [email protected]

Beta-blocker withdrawal in HFpEF, the ARCADIA trial, food as medicine, and bariatric surgery 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. HFpEF and Heart Rate PRESERVE HF Substudy https://jamanetwork.com/journals/jamacardiology/fullarticle/2814596 PRESERVE HF Original https://doi.org/10.1016/j.jacc.2021.08.073 II. ARCADIA trial ARCADIA Main Paper: Apixaban vs ASA https://jamanetwork.com/journals/jama/fullarticle/2814933 KAMEL’s AF and Stroke Paper 10.1161/STROKEAHA.115.012004 AVERROES Substudy -- 10.1016/S1474-4422(12)70017-0 III. Food as Medicine Food-As-Medicine Trial results: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2812982 NPR Story https://www.npr.org/sections/thesalt/2017/05/08/526952657/fresh-food-by-prescription-this-health-care-firm-is-trimming-costs-and-waistline IV. Bariatric Surgery Weight Loss Surgery Yields Long-Term BP Control in Obesity https://www.medscape.com/viewarticle/weight-loss-surgery-yields-long-term-bp-control-obesity-2024a10002le Gateway RCT https://doi.org/10.1016/j.jacc.2023.11.032 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 [email protected]

FDA approves PFA for AF ablation, flawed comparisons of TEER vs MV surgery and PCI vs CABG, and cardiologists struggling with board exams 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: https://www.medscape.com/twic I. PFA FDA Okays Boston Scientific PFA System for Paroxysmal AF https://www.medscape.com/viewarticle/fda-okays-boston-scientific-pfa-system-paroxysmal-af-2024a1000275 Pulsed-Field Ablation for AF: The Promise and the Reality https://www.medscape.com/viewarticle/995675 ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 EU-PORIA Registry https://doi.org/10.1093/europace/euad185 Tomlinson/Mandrola Editorial https://www.jacc.org/doi/10.1016/j.jacc.2020.07.032 II. TEER vs MV Surgery EHJ Paper https://doi.org/10.1093/eurheartj/ehae046 III. ISCHEMIA Post-Hoc Studies JACC Post-Hoc ISCHEMIA Trialhttps://doi.org/10.1016/j.jacc.2023.11.002 Main ISCHEMIA paper https://www.nejm.org/doi/full/10.1056/nejmoa1915922 FAME 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 IV. Board Exams More Cardiologists Failing the Boards, Why and How to Fix? https://www.medscape.com/viewarticle/more-cardiologists-failing-boards-why-and-how-fix-2024a10001oi 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 [email protected]

LAAO, more evidence that stable CAD is stable, CRT benefit over the long-term, and AF monitoring after stroke 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: https://www.medscape.com/twic I. LAAO This Week in Cardiology Podcast, Dec 15, 2023 https://www.medscape.com/viewarticle/999282 European Heart Journal paper https://academic.oup.com/eurheartj/article/45/3/214/7471675 LAAOS 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 II. CAD after Transcatheter Aortic Valve Implantation Cleveland Clinic Observational study https://doi.org/10.1093/eurheartj/ehae019 ACTIVATION trial  https://doi.org/10.1016/j.jcin.2021.06.041 III. Cardiac Resynchronization Therapy Original RAFT 2010 https://www.nejm.org/doi/full/10.1056/nejmoa1009540 Long-term RAFT  https://www.nejm.org/doi/full/10.1056/NEJMoa2304542 Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2312419 IV. AF Monitoring After Stroke Japanese Observational Study https://www.ahajournals.org/doi/10.1161/JAHA.123.031508 ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 LOOP substudy https://jamanetwork.com/journals/jamaneurology/fullarticle/2795865 CRYSTAL AF https://www.nejm.org/doi/full/10.1056/nejmoa1313600 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 [email protected]

Listener feedback on antiplatelet therapy after PCI, bempedoic acid, off-Label PFO Closure, and palliative care 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. Listener Feedback on Antiplatelet Therapy After PCI Long-term Clopidogrel Has Advantages After Coronary Stenting https://www.medscape.com/viewarticle/long-term-clopidogrel-has-advantages-after-coronary-stenting-2024a10000c8 Host Exam Study;  Extended FU of Host-Exam https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062770 II. Bempedoic Acid This Week in Cardiology July 7, 2023 https://www.medscape.com/viewarticle/994089 NEJM: Bempedoic Acid and CV Outcomes JAMA: Primary Prevention Analysis https://jamanetwork.com/journals/jama/fullarticle/2806646 JAMA-Cardiology: Total Events Analysis https://jamanetwork.com/journals/jamacardiology/fullarticle/2813647/ III. Off-Label PFO Closure Circulation Outcomes Paperhttps://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010200 IV. Palliative Care JAMA: Palliative Care Consultation 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 [email protected]

GLP-1s and BaroStim Neo revisited, a new drug for transthyretin amyloid CM, clopidogrel vs ASA years after PCI and stent, and statins 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. GLP-1s and Obesity, BaroStim Neo Revisited FDA Expands Label for CVRx Barostim System in HF https://www.medscape.com/viewarticle/fda-expands-label-cvrx-barostim-system-hf-2023a1000wsx JAMA Cardiology Special Communication – BDP https://jamanetwork.com/journals/jamacardiology/fullarticle/2810726 II. ATTR Cardiomyopathy ATTRibute-CM NEJM paper https://www.nejm.org/doi/full/10.1056/NEJMoa2305434 Circulation Review of TTR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.078915 ATTR-ACT (Tafadimis) https://www.nejm.org/doi/10.1056/NEJMoa1805689 III. Clopidogrel vs ASA Years After PCI Long-term Clopidogrel Has Advantages After Coronary Stenting https://www.medscape.com/viewarticle/long-term-clopidogrel-has-advantages-after-coronary-stenting-2024a10000c8 Stop DAPT Original Trial STOP DAPT at 5 Years https://doi.org/10.1016/j.jacc.2023.10.013 Network Meta-analysis of P2Y12-I vs ASA https://doi.org/10.1016/j.jcin.2022.08.009 IV. Statin Use Statin Use Remains Low for At-Risk Patients https://www.medscape.com/viewarticle/999043 Annals of Internal Medicine Observational Study https://doi.org/10.7326/M23-1915 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 [email protected]

Neuro-modulation in HF, private equity owned hospitals, HCM, SCD and ICD re-evaluated, and peer review 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. Neuromodulation for HFrEF FDA Expands Label for CVRx Barostim System in HF https://www.medscape.com/viewarticle/fda-expands-label-cvrx-barostim-system-hf-2023a1000wsx BeAT HF trial https://doi.org/10.1016/j.jacc.2020.05.015 II. Private Equity Takeover of US Hospitals Hospital Adverse Events Rise After Private Equity Acquisition https://www.medscape.com/viewarticle/hospital-adverse-events-rise-after-private-equity-2023a1000wya Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition: https://jamanetwork.com/journals/jama/article-abstract/2813379 RSS audio: https://bi.medscape.com/pi/editorial/studio/audio/2024/core/999557.mp3 III. Hypertrophic Cardiomyopathy Positive Topline Results for SEQUOIA-HCM Trial in OHCM https://www.medscape.com/viewarticle/positive-topline-results-sequoia-hcm-trial-ohcm-2023a1000wu9 IV. The ICD gets a ReLook Study to Examine Routine ICD Implantation Post Heart Attack https://www.medscape.com/viewarticle/study-examine-routine-icd-implantation-post-heart-attack-2023a1000wmd PROFID Site https://profid-project.eu/profid-ehra-trial/ Declining Risk of Sudden Death in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 V. Peer Review Prevalence of Short Peer Reviews in 3 Leading General Medical Journals -- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812883 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 [email protected]

FDA approves PFA, breakthrough in PAH, residual leaks after percutaneous LAAO, OAC in low to intermediate risk people 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. FDA Approves PFA FDA Approves First Pulsed Field Ablation System for AF https://www.medscape.com/viewarticle/fda-approves-first-pulsed-field-ablation-system-af-2023a1000vit - PULSED AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064329 - ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 - MANIFEST https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064959 II. Pulmonary HTN Positive Topline Data for Sotatercept in PAH: STELLAR https://www.medscape.com/viewarticle/982407 - STELLAR https://www.nejm.org/doi/10.1056/NEJMoa2213558 - Editorial on STELLAR https://www.nejm.org/doi/full/10.1056/NEJMe2300324 III. Peri-Device Leaks - Greek Meta-analysis https://doi.org/10.1093/eurheartj/ehad828 IV. Intermediate Risk AF – Norwegian Study - Stroke and bleeding risk in atrial fibrillation with CHA2DS2-VASC risk score of one: the Norwegian AFNOR study AFNOR Study https://doi.org/10.1093/eurheartj/ehad659 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine 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 [email protected]

Three aspects of the recent AF guideline documents and a possible new treatment of POTS 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 AF Guidelines ACC/AHA Issue Updated Atrial Fibrillation Guideline https://www.medscape.com/viewarticle/998956 - Guideline doc: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 - CASTLE AF https://www.nejm.org/doi/full/10.1056/nejmoa1707855 - Analysis of US Inpatient Sample https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-73 - RAFT AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057095 - Beta Blockers in AF https://pubmed.ncbi.nlm.nih.gov/25193873/ Section 2 AF Guidelines – EARLY Rhythm Control Gets Emphasis - STOP AF https://www.nejm.org/doi/full/10.1056/NEJMoa2029554 - EARLY AF https://www.nejm.org/doi/full/10.1056/nejmoa2029980 - EAST https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 - Natural History of AF https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.09.050 Section 3 AF Guidelines – Dubious Upgrade of percutaneous LAAC - PROTECT and PREVAIL Meta-analysis 5-year https://doi.org/10.1016/j.jacc.2017.10.021 - PINNACLE FLX https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.050117 II. Postural Orthostatic tachycardia Syndrome Vagus Nerve Stimulation Promising In POTS https://www.medscape.com/viewarticle/998913 - Stavrakis et al. Noninvasive VNS for POTS https://doi.org/10.1016/j.jacep.2023.10.015 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine 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 [email protected]

More from AHA including SGLT2 inhibitors, blood transfusion after MI; cracks in the armor of Factor XI inhibitors; and renal denervation 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: https://www.medscape.com/twic I. DAPA MI Potential Dapagliflozin Benefit Post-MI Is Not a 'Mandate' https://www.medscape.com/s/viewarticle/998378 - NEJM Evidence: Dapagliflozin After MI https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300286 II. Blood Transfusion Strategy Post MI In MI With Anemia, Results May Favor Liberal Transfusion: MINT https://www.medscape.com/viewarticle/998376 - MINT NEJM -- https://www.nejm.org/doi/full/10.1056/NEJMoa2307983 - REALITY https://jamanetwork.com/journals/jama/fullarticle/2776201 - PROTECTED TAVR - https://www.nejm.org/doi/full/10.1056/NEJMoa2204961 III. FACTOR XI Impressive Bleeding Profile With Factor XI Inhibitor in AF: AZALEA https://www.medscape.com/viewarticle/998418 Asundexian Phase 3 AF Study Halted for Lack of Efficacy https://www.medscape.com/viewarticle/998665 - Abelacimab for VTE https://www.nejm.org/doi/full/10.1056/NEJMoa2105872 IV. Renal Denervation FDA Panel Split on Efficacy of Spyral Renal Denervation https://www.medscape.com/viewarticle/995800 FDA OKs Symplicity Renal Denervation System for Hypertension https://www.medscape.com/viewarticle/998664 - SPYRAL HTN OFF MED  -- https://doi.org/10.1016/S0140-6736(20)30554-7 - SPRYAL HTN On Meds (Pilot Lancet 2018 ) https://doi.org/10.1016/S0140-6736(18)30951-6 - SPRYAL HTN ON Meds (Expansion Pilot) https://doi.org/10.1016/j.jacc.2023.08.045 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine 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 [email protected]

An AHA Recap: SELECT, ORBITA2, and ARTESIA are the trials John Mandrola, MD, reviews 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 American Heart Association 2023 on theHeart.org | Medscape Cardiology https://www.medscape.com/viewcollection/37277 I. SELECT Trial Semaglutide 'A New Pathway' to CVD Risk Reduction: SELECT https://www.medscape.com/viewarticle/998373 Positive Results From SELECT Begins a New Era in Cardiology https://www.medscape.com/viewarticle/998217 Is It Time for Cardiologists to Treat Obesity? https://www.medscape.com/viewarticle/998391 - SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 - SUSTAIN 6 https://www.nejm.org/doi/full/10.1056/nejmoa1607141 II. ORBITA 2 Angioplasty Finally Proven Beneficial in Stable Angina: ORBITA-2 https://www.medscape.com/s/viewarticle/998375 ORBITA-2 Saves Interventional Cardiology and Challenges Current Guidance https://www.medscape.com/viewarticle/998213 PCI, the Antianginal 'Pill': ORBITA-2 in Detail https://www.medscape.com/viewarticle/997777 - ORBITA-2; NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 - ORBITA 1 https://doi.org/10.1016/S0140-6736(17)32714-9 III. ARTESIA Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA https://www.medscape.com/viewarticle/998379 Sadly, ARTESIA Doesn't Answer a Common Question in Cardiology https://www.medscape.com/viewarticle/998215 - NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 - ARTESIA https://www.nejm.org/doi/10.1056/NEJMoa2310234 - AVERROES https://www.nejm.org/doi/full/10.1056/NEJMoa1007432 - McIntyre Meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512 - TRENDS https://www.ahajournals.org/doi/10.1161/circep.109.849638 - ASSERT https://doi.org/10.1093/eurheartj/ehx042 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Renal denervation, a potential deadly decision in the ED, GLP-1 agonists, and an AHA preview 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. Renal Denervation FDA OKs Paradise Renal Denervation System for Hypertension https://www.medscape.com/viewarticle/998237 - Company Press Release https://www.recormedical.com/recor-medical-and-otsuka-medical-devices-announce-first-fda-approved-renal-denervation-system-for-the-treatment-of-hypertension/ - Six-month Meta-analysis of RDN Studies https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.123.066941 - March This Week in Cardiology with RDN Discussion https://www.medscape.com/viewarticle/989014 II. Potential Deadly Decisions in the ED Even One Night in the ED Raises Risk for Death https://www.medscape.com/viewarticle/998080 - JAMA Internal Medicine Study III. Tirzepatide Approval FDA Approves Tirzepatide for Treating Obesity https://www.medscape.com/viewarticle/998225 - SURMOUNT 2 https://doi.org/10.1016/S0140-6736(23)01200-X - SURMOUNT 1 https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 IV. AHA Preview Mandrola's Top Trials to Look for at AHA 2023 https://www.medscape.com/viewarticle/998123 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Tricuspid regurgitation therapy, two more left atrial appendage trials, and reflections on being too soft on medical science 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. Tricuspid Regurgitation Trilogy TAVR Safe, Effective in Aortic Regurgitation https://www.medscape.com/viewarticle/997782 The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? https://www.medscape.com/viewarticle/989105 Transcatheter Tricuspid Valve Repair Effective, Safe for Regurgitation: TRILUMINATE https://www.medscape.com/s/viewarticle/989103 - TRILUMINATE NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 II. LAA Occlusion Different Strengths for LAA Closure Devices? https://www.medscape.com/viewarticle/962893 - Swiss Apero – Original paper https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057859 - Swiss Apero – One-year https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067599 Peri-device Leaks After Watchman https://pubmed.ncbi.nlm.nih.gov/35902169/ TAVR With Left Atrial Appendage Occlusion Non-inferior to TAVR Plus Medical Therapy https://www.medscape.com/viewarticle/997725 - WATCH TAVR Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067312 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

More on the Million Hearts RCT, ENRICH AF, TAVI vs SAVR, the Partner 3 and Evolut-low-risk trials, and myocardial viability 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: https://www.medscape.com/twic I. Listener Feedback Million Hearts CMS 'Million Hearts' CVD Risk Reduction Model Works https://www.medscape.com/viewarticle/997551 -  RCT JAMA -    https://jamanetwork.com/journals/jama/fullarticle/2810696 AC in ICH - ENRICH AF Oral Anticoagulation in ICH Patients With AF: New Data https://www.medscape.com/viewarticle/997547 -  Lancet Neurology Meta-analysis https://doi.org/10.1016/S1474-4422(23)00315-0 -  ENRICH AF letter https://doi.org/10.1016/S0140-6736(23)02025-1 II.  TAVI vs SAVR Low-Risk TAVR Studies: Divergent Long-Term Results  https://www.medscape.com/viewarticle/997784 -  Partner 3 Main Results -  Partner 3 – Five Year -  Original EVOLUT -LR https://www.nejm.org/doi/10.1056/NEJMoa1816885 -  EVOLUT 3-year https://doi.org/10.1016/j.jacc.2023.02.017 -  EVOLUT -LR 4-year https://doi.org/10.1016/j.jacc.2023.09.813 III. Myocardial Viability Viability-Guided PCI Doubted in Stable Severe CAD: REVIVED-BCIS2 https://www.medscape.com/viewarticle/989101 -  Revived BCIS – Original paper  https://www.nejm.org/doi/10.1056/NEJMoa2206606 -  JAMA Cardiology Viability paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2810727 -  STICH Viability Paper - https://www.nejm.org/doi/full/10.1056/NEJMoa1100358 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Listener feedback, oral anticoagulation in patients with ICH, an example of statistical significance but not clinical significance, and statins and diabetes 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. Listener Feedback October 13, 2023 This Week in Cardiology Podcast   https://www.medscape.com/viewarticle/997281 -  European Heart Journal: IVI for PCI   https://doi.org/10.1093/eurheartj/ehad430 -  Elgendy Meta-analysis of Imaging in PCI:   https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.116.003700 -  ULTIMATE:   https://www.jacc.org/doi/10.1016/j.jacc.2018.09.013 -  ILUMEIN IV: https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 -  OCTOBER:  https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 -  Main STEP-HFpEF paper -  Letter to the Editor on Lack of Obesity Paradox  https://doi.org/10.1016/j.amjcard.2019.04.037 II. Anticoagulation in ICH Oral Anticoagulation in ICH Patients With AF: New Data   https://www.medscape.com/viewarticle/997547 -   Lancet Neuro   Meta-analysis https://doi.org/10.1016/S1474-4422(23)00315-0 -   ENRICH AF letter   https://doi.org/10.1016/S0140-6736(23)02025-1 III. Million Hearts CMS 'Million Hearts' CVD Risk Reduction Model Works   https://www.medscape.com/viewarticle/997551 -   RCT JAMA IV. Statin Choice and Diabetes April 7, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/990542 -   LODESTAR Main Study -   LODESTAR Substudy You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Three stories regarding GLP-1 agonists, imaging during PCI, and the power of sham controls in procedure trials 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: https://www.medscape.com/twic I. FLOW Trial Positive Novo Nordisk Stops Ozempic Kidney Trial After Early Signs of Success https://www.medscape.com/s/viewarticle/997237 -  FLOW Trial – press release https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=166327 II. STEP HFpEF Semaglutide Win in HFpEF With Obesity Regardless of Ejection Fraction: STEP-HFpEF https://www.medscape.com/viewarticle/997185 The GLP-1 Agonist Semaglutide in HFpEF Cleared a Low Bar https://www.medscape.com/viewarticle/995872 -  STEP HFpEF substudy -   STEP HFpEF main paper III. GLP-1 Agonist Adverse Effects GLP-1 Agonists Linked to Higher Risk for Rare but Serious GI Complications https://www.medscape.com/viewarticle/997128 -  GI Adverse Effects of GLP-1 Agonists  https://jamanetwork.com/journals/jama/fullarticle/2810542 IV. Imaging in PCI Intravascular Imaging in PCI: Time for a Guideline Update? https://www.medscape.com/viewarticle/995677 -  Intravascular imaging during percutaneous coronary intervention: temporal trends and clinical outcomes in the USA https://academic.oup.com/eurheartj/article/44/38/3845/7226277 -  HEART Review of Studies of Intracoronary Imaging During PCI  https://heart.bmj.com/content/107/9/755 V. The Power of Placebo (Sham) control Hopeful Insights, No Overall HFpEF Gains From Splanchnic Nerve Ablation: REBALANCE-HF https://www.medscape.com/viewarticle/997318 -  Transvenous Right GSN Ablationin HFpEF https://doi.org/10.1016/j.jchf.2022.05.009 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Coated vs uncoated ASA, a new trial in CAD, conflicts of interest, first AF in the hospital, and changing HTN scoring and CHADSVASC 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: https://www.medscape.com/twic I. ASA No Benefit of Enteric-Coated Aspirin vs Uncoated in CVD https://www.medscape.com/viewarticle/997119 -  JAMA Cardiology: Coated vs Uncoated ASA https://jamanetwork.com/journals/jamacardiology/fullarticle/2809795 -  ADAPTABLE https://www.nejm.org/doi/10.1056/NEJMoa2102137 II. RECHARGE -  Revascularization Choices Among Under-Represented Groups Evaluation (The RECHARGE Program) https://www.pcori.org/research-results/2023/revascularization-choices-among-under-represented-groups-evaluation-recharge-program -  Gaudino/Stone: Reconsidering Coronary Revascularization Trials III. Conflicts of Interest -  Financial Conflicts of Interest in Public Comments on Medicare National Coverage Determinations of Medical Devices  https://jamanetwork.com/journals/jama/fullarticle/2808721 IV. First AF in the Hospital Decoding AFib Recurrence: PCPs' Role in Personalized Care https://www.medscape.com/viewarticle/997011 -  Annals of Internal Medicine: AF Recurrence https://doi.org/10.7326/M23-1411 V. Changing CHADSVASC Score -  JAMA Network Open: HTN Guidelines and CHADSVASC Up-Scoring  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809933 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Reader feedback, leadless pacing, ABIM, SGLT2 inhibitors, peri-operative MI after cardiac surgery, and. AHA late-breakers 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: https://www.medscape.com/twic I. Reader Feedback Sep 22, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/996694 -   ODYSSEY OUTCOMES trial https://www.nejm.org/doi/full/10.1056/nejmoa1801174 -   FOURIER https://www.nejm.org/doi/full/10.1056/nejmoa1615664 II. Leadless Pacing -   Leadless vs Transvenous Pacemaker Study https://doi.org/10.1093/europace/euad269 III. ABIM News Heart Societies Ready to Split From ABIM Over Long-Standing MOC Disputes https://www.medscape.com/viewarticle/996747 IV. SGLT2 inhibitors Empagliflozin Gets FDA Nod for CKD Without T2D or HF https://www.medscape.com/viewarticle/996873 -   EMPA-Kidney https://www.nejm.org/doi/full/10.1056/NEJMoa2204233 V. Peri-Op MI after Cardiac Surgery Cardiac Troponin Predicts Mortality Post Surgery https://www.medscape.com/viewarticle/996877 -   Austrian Perioperative MI study https://doi.org/10.1016/j.jacc.2023.07.011 -   Vision  https://www.nejm.org/doi/10.1056/NEJMoa2000803 VI. AHA Late Breakers -   Link to Late-Breakers https://professional.heart.org/en/meetings/scientific-sessions/programming/late-breaking-science#late-breaking You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Coronary calcium, cardiac arrest survival, Factor XI drug findings, APCs and a potential new board certification in cardiology are the topics discussed by John Mandrola, MD 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 Coronary Artery Calcium -   CONFIRM Registry - https://doi.org/10.1016/j.jcmg.2023.03.008 -   CURE -- https://www.nejm.org/doi/full/10.1056/nejmoa010746 II Cardiac Arrest Cardiac Arrest Centers No Benefit in OHCA Without STEMI https://www.medscape.com/viewarticle/995885 -   Cycling coverage https://velo.outsideonline.com/road/road-racing/nathan-van-hooydonck-forced-to-end-to-racing-career-due-to-heart-condition/ -   ARREST https://doi.org/10.1016/S0140-6736(23)01351-X -   SCD in Athletes Bob Harrington and Manesh Patel https://www.medscape.com/viewarticle/995575 III Factor XI Trial Halted for Bleeding Reduction With Abelacimab vs Rivaroxaban in AF https://www.medscape.com/viewarticle/996587 -   Press Release - https://anthostherapeutics.com/wp-content/uploads/2023/09/2023-09-18-Anthos-Press-Release-final.pdf -   Abelacimab, a Factor XI Inhibitor, Prevents VTE With Low Bleeding Risk in Knee Replacement -   NEJM proof-of-concept https://www.nejm.org/doi/full/10.1056/NEJMoa2105872 -   OCEANIC-AF https://classic.clinicaltrials.gov/ct2/show/NCT05643573 -   Will Factor XI Be the Goldilocks Anticoagulant Target? https://www.medscape.com/viewarticle/979634 IV APC Care NPs and PAs Handling Increasingly More Primary Care Visits: New Studies https://www.medscape.com/viewarticle/996709 BMJ paper -- https://www.bmj.com/content/382/bmj-2022-073933 V Possible Cardiology Board Certification Changes -   Heart Societies Ready to Split From ABIM Over MOC Disputes https://www.medscape.com/viewarticle/996747 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Reader feedback, imaging in the cath lab, AF ablation to relieve anxiety, and some possible help in hypertension 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. Reader Feedback Sep 08, 2023 This Week in Cardiology Podcast   https://www.medscape.com/viewarticle/996233 First Clinical Trial of CTO Procedures Fails to Deliver   https://www.medscape.com/viewarticle/877405 -   DanGerShock trial https://pubmed.ncbi.nlm.nih.gov/31176289/ II. Imaging in the Cath Lab Should Intravascular Imaging Be Almost Routine in PCI?    https://www.medscape.com/viewarticle/996375 -   ILUMIEN IV    https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 -   OCTOBER    https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 III. AF Ablation to Relieve Anxiety -   REMEDIAL Trial   https://jamanetwork.com/journals/jama/fullarticle/2809419 -   Sohaib and Francis; Meta analysis of Symptomatic Response Effect of CRT Pacing    https://pubmed.ncbi.nlm.nih.gov/24259043/ IV. HTN 'New Dawn' for Aldosterone as Drug Target in Hypertension?    https://www.medscape.com/viewarticle/996316 -   TARGET HTN -    https://jamanetwork.com/journals/jama/fullarticle/2809625 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ESC Recap Part 2: ECLS-SHOCK, FIRE, MULTISTARS-AMI, HEART FID, and DANPACE II are the trials 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. Cardiogenic Shock ECMO for Shock in Acute MI Won't Help, May Harm: ECLS-SHOCK  https://www.medscape.com/viewarticle/995882 -   ECLS-SHOCK trial  https://www.nejm.org/doi/full/10.1056/NEJMoa2307227 -   ECMO-CS trial  https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062949 II. FIRE TRIAL FIRE a Win for Physiology-Guided MI Complete Revascularization in Older Patients  https://www.medscape.com/viewarticle/995875 -   FIRE Trial  https://www.nejm.org/doi/full/10.1056/NEJMoa2300468 -   COMPLETE Trial  https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 III. Immediate vs Staged Revascularization Parity for Prompt vs Staged STEMI Complete Revascularization: MULTISTARS-AMI  https://www.medscape.com/viewarticle/995961 -   MULTISTARS AMI trial  https://www.nejm.org/doi/full/10.1056/NEJMoa2307823 -   Complete Revascularization Now Compulsory? MULTISTARS-AMI and FIRE in Context  https://www.medscape.com/viewarticle/995676 IV. Iron-Supplementation in Heart Failure IV Iron Shows Only Modest Benefit in HF: HEART-FID  https://www.medscape.com/viewarticle/995874 -   HEART-FID   https://www.nejm.org/doi/full/10.1056/NEJMoa2304968 -   EHJ meta-analysis of Iron Supplementation   https://doi.org/10.1093/eurheartj/ehad586 V. AF Prevention with Pacing Minimizing Atrial Pacing No Benefit in Sinus Node Disease: DANPACE II  https://www.medscape.com/viewarticle/996076 -   DANPACE II  https://doi.org/10.1093/eurheartj/ehad564 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine.  https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD.  https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ESC Wrap-up 1: Obesity, heart failure with preserved EF and reduced EF, AF, frailty, evidence translation, and catheter ablation 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. FRAIL AF    -FRAIL-AF Study    https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066485    -The Most Important Study From ESC: FRAIL-AF    https://www.medscape.com/viewarticle/996063 II. STEP-HFpEF Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 GLP-1 Agonist Semaglutide in HFpEF Cleared Low Bar https://www.medscape.com/viewarticle/995872 Semaglutide’s Big Step in HFpEF With Obesity: Investigator Inteview https://www.medscape.com/viewarticle/995673    -Semaglutide in Obese Patients With  HFpEF    https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 III. NOAH AFNET 6 Anticoagulation No Benefit in Presumed AF Detected by Cardiac Devices https://www.medscape.com/viewarticle/995861 How Much AF Warrants Anticoagulation? NOAH-AFNET 6 Provides Clues https://www.medscape.com/viewarticle/995871    -NOAH AFNET-6 – NEJM    https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 IV. ADVENT Pulsed Field Ablation Challenges Conventional Devices in AF https://www.medscape.com/viewarticle/995884 Pulsed Field Ablation Noninferior but Underwhelming in ADVENT https://www.medscape.com/viewarticle/995898    -PPFA vs Thermal Ablation for PAF    https://www.nejm.org/doi/10.1056/NEJMoa2307291 V. BUDAPEST CRT Impact of RV Pacing in Heart Failure, CRT Benefit Shown in BUDAPEST-CRT https://www.medscape.com/viewarticle/996035 Supporting Evidence for a Common Practice: BUDAPEST CRT https://www.medscape.com/viewarticle/995880    -BUDAPEST CRT Study: European Heart Journal    https://doi.org/10.1093/eurheartj/ehad591 VI. CASTLE HTx Advanced HF No Obstacle to AF Ablation Success: CASTLE-HTx https://www.medscape.com/viewarticle/995897 AF Ablation in End-Stage HF: Is CASTLE-HTx Too Good to Be True? https://www.medscape.com/viewarticle/995974    -CASTLE AF (2018)    https://www.nejm.org/doi/full/10.1056/nejmoa1707855    -CASTLE HTx    https://www.nejm.org/doi/full/10.1056/NEJMoa2306037 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

GLP-1 agonists in HFpEF, DOACs for subclinical AF, renal denervation, and the matter of remaining in the profession 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. Obesity and HFpEF GLP-1 Agonists in HFpEF With Obesity: Are We There Yet? https://www.medscape.com/viewarticle/993980 Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 - Semaglutide in Obese Patients With HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 - Rationale/Protocol Paper https://doi.org/10.1016/j.jchf.2023.05.010 II. DOAC for Subclinical AF - NOAH-AFNET 6 Rationale/Protocol https://doi.org/10.1016/j.ahj.2017.04.015 - NOAH-AFNET 6 Trial Results https://www.nejm.org/search?q=NOAH+AFNET III. Renal Denervation ReCor Renal Denervation System Safe, Effective: FDA Panel https://www.medscape.com/viewarticle/995741 FDA Panel Split on Efficacy of Spyral Renal Denervation https://www.medscape.com/viewarticle/995800 SPYRAL HTN-ON MED https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00455-X/fulltext IV. Maintenance of Certification As MOC Debate Heats Up, Cardiology Societies Weigh In https://www.medscape.com/viewarticle/moc-debate-heated-cardiology-societies-weigh-2023a1000jju Features Mandrola's 5 Things to Look for at the Upcoming ESC 2023 https://www.medscape.com/viewarticle/995614 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

ICD generator change, less is more in VT management, co-morbidity in HF, and SGLT2i after AF ablation are the topics discussed by John Mandrola, MD, 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. ICD Gen Change - Patients’ Perspectives Regarding Generator Exchanges of Implantable Cardioverter Defibrillators https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.122.009827 - DEFINITE https://www.nejm.org/doi/10.1056/nejmoa033088 - SCD-HeFT https://www.nejm.org/doi/full/10.1056/nejmoa043399 - DANISH https://www.nejm.org/doi/10.1056/NEJMoa1608029 - Poole and colleagues; 11-year follow-up of  SCD-HeFT https://doi.org/10.1016/j.jacc.2020.05.061 - Editorial – Howell/Stecker https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010266 II. VT Therapy Crossed Wires: Ischemia Testing and Monomorphic VT Storm https://www.medscape.com/viewarticle/995401 - Cleveland Clinic Study   https://doi.org/10.1016/j.jacep.2023.04.030 III. Co-Morbidity in HF - Hospital admissions in the last year of life of patients with heart failure   https://doi.org/10.1093/ehjqcco/qcad047 - Four Horsemen of Apocalypse Lecture   http://www.louisvillelectures.org/imblog/2017/10/5/whw8sf0m1k0wi6lm6kvjsx4nxzzjg5 IV. SGLT2i After Ablation for AF SGLT2 Inhibitors Curb AF Post-Ablation Recurrences in Diabetes   https://www.medscape.com/viewarticle/995415 - Observational Study – Abu-Qaoud et al   https://www.jacc.org/doi/full/10.1016/j.jacep.2023.06.008 - Meta-analysis SGLT2i and AF   https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022222 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Observational studies, another defense of digoxin, CTO-PCI, BP measurement, and a possible revolution in cardiovascular protection 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. Observational Research Yeh; Credibility in Observational  Research https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064645 Hernan; Causal Language in Observational Research  https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304337 Wang; RCT Duplicate Initiative https://jamanetwork.com/journals/jama/fullarticle/2804067 II. Defense of Digoxin Brophy; Beta Blockers, Digoxin, or Both https://doi.org/10.1016/j.cjca.2023.06.009 Dorian editorial https://doi.org/10.1016/j.cjca.2023.07.013 Ziff Digoxin Meta-analysis https://www.bmj.com/content/351/bmj.h4451.long DIG trial  https://www.nejm.org/doi/full/10.1056/nejm199702203360801 Davila Analysis of DIG Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801940/ Kotecha Meta-analysis of Beta Blockers https://pubmed.ncbi.nlm.nih.gov/25193873/ RATE-AF https://jamanetwork.com/journals/jama/fullarticle/2774407 III. CTO-PCI PCI of Chronic Total Occlusions Improves Angina, Quality of Life in Trials https://www.medscape.com/viewarticle/994739 JAMA Network Open Meta-analysis IV. BP Measurement One Size Doesn’t Fit All in Blood Pressure Measurement https://www.medscape.com/viewarticle/995216 Ishigami Blood Pressure Measurement Comparison https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2807853 V. GLP-1 SELECT Trial Semaglutide Cuts Cardiovascular Events in Landmark Trial https://www.medscape.com/viewarticle/995270 SELECT Protocol Paper You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Listener feedback re observational studies, surgeons’ dissent from recent guidelines, aspirin for primary prevention, and fish oil are the topics discussed by John Mandrola.MD 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. Heart Surgeons Dissent Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 New Revascularization Guidelines: Key Points and Navigating Controversies https://www.medscape.com/viewarticle/972014 - AHA Guidelines - https://doi.org/10.1161/CIR.0000000000001168 - AATS statement 2023 https://doi.org/10.1016/j.jtcvs.2023.03.001 - Yusef and colleagues 1994 Meta-analysis - https://doi.org/10.1016/S0140-6736(94)91963-1 - 10-year SYNTAXES https://doi.org/10.1016/S0140-6736(19)31997-X - Surgeons’ argument 2021 https://doi.org/10.1016/j.athoracsur.2021.12.003 - FAME 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 - Gaudino Meta-analysis of Medical Therapy vs CABG https://doi.org/10.1016/j.jtcvs.2022.06.003 - NOBLE https://doi.org/10.1016/S0140-6736(19)32972-1 - EXCEL 5 years https://www.nejm.org/doi/full/10.1056/nejmoa1909406 II. ASA for Primary Prevention Daily Aspirin Challenged in Primary Stroke Prevention: ASPREE https://www.medscape.com/viewarticle/994963 - ASPREE – All-cause mortality - ASPREE (MACE and Bleeding) https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - ASPREE (disability) https://www.nejm.org/doi/full/10.1056/NEJMoa1800722 - JAMA Network Open Subanalysis  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807630 III. Fish Oil - OMEMI Substudy https://doi.org/10.1016/j.clnu.2023.07.002 - Gencer and colleagues Meta-analysis - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 - OMEMI Main Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.052209 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Antiarrhythmic drugs in patients with CAD, observational studies, GLP-1 agonists, and the subcutaneous ICD 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. AAD in Patients with CAD - The Feasibility and Safety of Flecainide Use Among Patients With Varying Degrees of Coronary Disease https://doi.org/10.1016/j.jacep.2022.12.021 - Three Questions for Evidence-Based Cardiac Electrophysiology https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 - The Cardiac Arrhythmia Suppression Trial (CAST) https://www.nejm.org/doi/full/10.1056/nejm198908103210608 II. GLP-1 Agonists Tirzepatide Powers Weight Loss in Two More Pivotal Trials https://www.medscape.com/viewarticle/994889 Semaglutide Use Surges in US Adults With Type 2 Diabetes https://www.medscape.com/viewarticle/994873 - Tirzepatide Once Weekly for the Treatment of Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 - Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(23)01200-X III. S-ICD S-ICD Shows Virtues, Limits in 'Real World' Postmarket Study https://www.medscape.com/viewarticle/994851 - Postapproval Study of a Subcutaneous Implantable Cardioverter-Defibrillator System https://doi.org/10.1016/j.jacc.2023.05.034 - Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 - Letter to the Editor  https://www.nejm.org/doi/full/10.1056/NEJMc2034917 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Listener feedback, conduction system pacing, eating fish vs fish pills, exercise, and an RCT for diet are the topics discussed by John Mandrola,.MD, 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. Listener Feedback Monitor HF and AHA Jun 02, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/992678 - Link to the ACC Email -- https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/07/18/17/21/monitor-hf - Tweet From Anthony Pearson https://twitter.com/skepcard/status/1681288604990189574 II. Conduction System Pacing - Clinical Outcomes in Conduction System Pacing Compared to Right Ventricular Pacing in Bradycardia https://doi.org/10.1016/j.jacep.2022.10.016 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://www.acpjournals.org/doi/abs/10.7326/0003-4819-117-12-1016 III. Fish Oil Omega-3s and AF: No Added Risk From Eating Fish but High-Dose Supplement Questions Persist https://www.medscape.com/viewarticle/994559 - Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation https://www.jacc.org/doi/full/10.1016/j.jacc.2023.05.024 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 IV. Exercise Even Exercise by 'Weekend Warriors' Can Cut CV Risk https://www.medscape.com/viewarticle/994617 - Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease https://jamanetwork.com/journals/jama/article-abstract/2807286 V. Diet Cognitive Benefit of Highly Touted MIND Diet Questioned https://www.medscape.com/viewarticle/994550 - Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons https://www.nejm.org/doi/full/10.1056/NEJMoa2302368 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Carotid stents, the paclitaxel story now closed, inclisiran, DOAC failures, and primary vs secondary prevention 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: https://www.medscape.com/twic I. Carotid Stenting CMS Proposal Expanded Coverage of Carotid Stenting in CMS Draft Proposal https://www.medscape.com/viewarticle/994315 No Added Benefit From Revascularization in Low-Risk CAS https://www.medscape.com/viewarticle/992524 - Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&NCAId=311 - Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy https://doi.org/10.1016/S0140-6736(21)01910-3 - SPACE-2 https://journals.sagepub.com/doi/10.1177/1747493019833017 - Rationale, Design, and Implementation of Intensive Risk Factor Treatment in the CREST2 Trial 10.1161/STROKEAHA.120.030730 II. Paclitaxel FDA: No Excess Mortality Risk From Paclitaxel Stents, Balloons for Peripheral Intervention https://www.medscape.com/viewarticle/994253 - FDA Statement https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality?utm_medium=email&utm_source=govdelivery#_FDA_Actions III. Inclisiran FDA Expands Inclisiran Statin-Adjunct Indication to Include Primary Prevention https://www.medscape.com/viewarticle/994185 - ORION 10-11 Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol https://www.nejm.org/doi/10.1056/NEJMoa1912387 - Effect of inclisiran on lipids in primary prevention: the ORION-11 trial https://doi.org/10.1093/eurheartj/ehac615 - Inclisiran and cardiovascular events: a patient-level analysis of phase III trials https://pubmed.ncbi.nlm.nih.gov/36331326/ IV. DOAC Failure Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant https://doi.org/10.1212/WNL.0000000000207422 V. Primary or Secondary Prevention You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

European HTN Guidelines, vitamin D, bempedoic acid, and leadless pacing, with some critical appraisal techniques thrown in, are the topics John Mandrola, MD, tackles 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. European Hypertension Guidelines New ESH Hypertension Guidelines Aim for Simplified Message https://www.medscape.com/viewarticle/993913 - 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH) https://pubmed.ncbi.nlm.nih.gov/37345492/ II. Vitamin D CV Benefit From Vitamin-D Caps Hinted in Huge D-Health Trial https://www.medscape.com/viewarticle/993996 - Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial https://www.bmj.com/content/381/bmj-2023-075230 - Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials https://jamanetwork.com/journals/jamacardiology/fullarticle/2735646 III. Bempedoic Acid 'Striking' Benefit of Lipid Lowering in Primary Prevention https://www.medscape.com/viewarticle/993666 - Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients https://jamanetwork.com/journals/jama/fullarticle/2806646 - Bempedoic Acid for High-Risk Primary Prevention of Cardiovascular Disease https://jamanetwork.com/journals/jama/fullarticle/2806647 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients https://www.nejm.org/doi/full/10.1056/NEJMoa2215024 IV. Leadless Pacing FDA Approves First Leadless Dual-Chamber Pacing System https://www.medscape.com/viewarticle/994033 - A Dual-Chamber Leadless Pacemaker https://www.nejm.org/doi/full/10.1056/NEJMoa2300080 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Starting HF meds during hospitalization for HF, Impella, testosterone, and colchicine 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. Starting HF Meds During Hospitalization for HF Starting Indicated Heart Failure Meds In-Hospital: Progress, Opportunities https://www.medscape.com/viewarticle/993539 - Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction https://www.jacc.org/doi/full/10.1016/j.jchf.2023.04.015 II. Impella - Comparative Effectiveness of Percutaneous Microaxial Left Ventricular Assist Device vs Intra-Aortic Balloon Pump or No Mechanical Circulatory Support in Patients With Cardiogenic Shock https://jamanetwork.com/journals/jamacardiology/fullarticle/2806562 - Evidence Generation for Novel Cardiovascular Devices—Putting the Horse Back in Front of the Cart https://jamanetwork.com/journals/jamacardiology/fullarticle/2806565 III. Testosterone Big Trial Reassures on Heart Safety of Testosterone in Men https://www.medscape.com/viewarticle/993322 - Cardiovascular Safety of Testosterone-Replacement Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa2215025 IV. Colchicine for CV Disease Low-Dose Colchicine Approved for CVD: Now What? https://www.medscape.com/viewarticle/993578 - Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmoa1912388 - Colchicine in Patients with Chronic Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa2021372 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF screening, BNP, a new SGLT2 inhibitor, a sky-is-blue study, and the UK Mini Mitral surgical trial are discussed 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 AF Screening - Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064361 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 - Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders https://www.jacc.org/doi/full/10.1016/j.jacc.2019.09.050 - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 - Stepwise mass screening for atrial fibrillation using N-terminal pro b-type natriuretic peptide: the STROKESTOP II study design https://doi.org/10.1093/europace/euw319 - Current misconception 3: that subgroup-specific trial mortality results often provide a good basis for individualising patient care https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068511/ II Frailty and GDMT of HFrEF Frailty Linked to Lower Use of Guideline Treatments in HFrEF https://www.medscape.com/viewarticle/993218 - Physical Frailty and Use of Guideline‐Recommended Drugs in Patients With Heart Failure and Reduced Ejection Fraction https://www.ahajournals.org/doi/10.1161/JAHA.122.026844 III Sotagliflozin FDA Approves New Drug, Sotagliflozin, for Heart Failure https://www.medscape.com/viewarticle/992518 - Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2030186 - Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2030183 IV Mini-Mitral Support for Minimally Invasive Mitral Valve Repair: Mini Mitral Published https://www.medscape.com/viewarticle/993191 - Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair https://jamanetwork.com/journals/jama/article-abstract/2805908 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

Impella, digital health, low-value processes, are tricuspid valve interventions with pacing leads are the topics Dr. 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. Impella Class I Recall FDA Class I Recall for Some Abiomed Impella Heart Pumps https://www.medscape.com/viewarticle/992845 - A Prospective, Randomized Clinical Trial of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary Intervention https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.112.098194 - Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction https://doi.org/10.1016/j.jacc.2016.10.022 https://www.sciencedirect.com/science/article/pii/S0735109716367675?via%3Dihub - The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.044007 - Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock https://jamanetwork.com/journals/jama/fullarticle/2761003 - Danish Cardiogenic Shock Trial (DanShock) https://clinicaltrials.gov/ct2/show/NCT01633502 II. Wearable Devices - Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805753 doi:10.1001/jamanetworkopen.2023.16634 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 III. The Cost of Quality Measures - The Volume and Cost of Quality Metric Reporting https://jamanetwork.com/journals/jama/fullarticle/2805705 - Goodhart's law https://en.wikipedia.org/wiki/Goodhart%27s_law IV. Tricuspid Valve Interventions and Pacing Leads Leadless Dual-Chamber Pacemaker Clears Early Safety, Performance Hurdles https://www.medscape.com/viewarticle/992464 - Transcatheter Tricuspid Valve Replacement With the EVOQUE System: 1-Year Outcomes of a Multicenter, First-in-Human Experience https://www.jacc.org/doi/10.1016/j.jcin.2022.01.280 - Effects of Implantable Cardioverter-Defibrillator Leads on the Tricuspid Valve and Right Ventricle: A Randomized Comparison of Transvenous versus Subcutaneous Leads https://eppro01.ativ.me/src/EventPilot/php/express/web/planner.php?id=HRS23&utm_source=heartrhythm&utm_medium=nav-button&utm_campaign=hr23-webtracking - Management and Outcomes of Transvenous Pacing Leads in Patients Undergoing Transcatheter Tricuspid Valve Replacement https://www.jacc.org/doi/10.1016/j.jcin.2020.04.054 - TRILUMINATE trial -- Transcatheter Repair for Patients with Tricuspid Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Listener feedback on the most important study in a decade, MONITOR-HF, a flawed paper and analysis, and the tension between pathos and logos 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. Listener Feedback Earlier Anticoagulation Safe in Stroke With AF: ELAN https://www.medscape.com/viewarticle/992411 - Early versus Later Anticoagulation for Stroke with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2303048 - Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmoa1301092 II. Monitor HF CardioMEMS Boosts QoL, Curbs HF Hospitalizations: MONITOR-HF https://www.medscape.com/viewarticle/992333 - Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial https://doi.org/10.1016/S0140-6736(23)00923-6 - Remote pulmonary artery pressure monitoring in heart failure care: part of the new normal? https://doi.org/10.1016/S0140-6736(23)01010-3 - Sowell’s A Conflict of Visions https://en.wikipedia.org/wiki/A_Conflict_of_Visions III. Intensive BP Treatment in Older Patients – Pathos vs Logos - Clinical Outcomes of Intensive Inpatient Blood Pressure Management in Hospitalized Older Adultshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2805021 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

An HRS meeting recap, Impella failure, sacubitril/valsartan, the purpose of trials, and a major breakthrough in evidence generation are the topics discussed by John Mandrola, MD 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. HRS Meeting Recap II. Impella in VT ablation - First-in-human Experience with Impella 5.0/5.5 for High-Risk Patients with Advanced Heart Failure Undergoing VT Ablationhttps://www.jacc.org/doi/10.1016/j.jacc.2023.05.012 III. Sacubitril/Valsartan ARNI Bests ARB to Reduce NT-proBNP in Stabilized Preserved-EF HF https://www.medscape.com/viewarticle/992461 - Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure https://www.jacc.org/doi/10.1016/j.jacc.2023.04.019 - Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/nejmoa1908655 - Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF https://doi.org/10.1093/eurheartj/ehad344 - Bogdan Tweet https://twitter.com/bogdienache/status/1660356776204595201?s=20 IV. Big Change in Reporting of Medical Evidence – Elan Trial - Early versus Later Anticoagulation for Stroke with Atrial Fibrillationhttps://www.nejm.org/doi/full/10.1056/NEJMoa2303048 - Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN): Protocol for an international, multicentre, randomised-controlled, two-arm, open, assessor-blinded trial https://doi.org/10.1177/23969873221106043 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

When to use an ICD, risk stratification for HCM, blending EP and structural cardiology to improve care in post-TAVI patients, and hsTroponins 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. ICD in Patients with NICM Simple Risk Score Predicts VT in Nonischemic Cardiomyopathy https://www.medscape.com/viewarticle/992018 - Declining Risk of Sudden Death in Heart Failure    https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 - Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure    https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 - Reduction in mortality from implantable cardioverter-defibrillators in non-ischaemic cardiomyopathy patients is dependent on the presence of left ventricular scar https://doi.org/10.1093/eurheartj/ehy437 - RCT of Implantable Defibrillators in Patients With Non Ischemic Cardiomyopathy, Scar and Severe Systolic Heart Failure (BRITISH)   https://clinicaltrials.gov/ct2/show/NCT05568069 II. Risk Stratification in HCM - Changing Risk Stratification in Hypertrophic Cardiomyopathy? https://www.medscape.com/viewarticle/992014 - NOAH–AFNET 6 trial terminates ahead of time (NOAH AFNET 6 trial)   https://dzhk.de/en/news/latest-news/article/noah-afnet-6-trial-terminates-ahead-of-time-noah-afnet-6-trial/ III. Blending EP and Structural to Improve TAVI Care - Impact of Right Ventricular Pacing in Patients With TAVR Undergoing Permanent Pacemaker Implantation   https://www.jacc.org/doi/full/10.1016/j.jcin.2023.02.003 IV. Troponins - Age-Specific Cut-Offs Needed for Cardiac Troponin Tests? https://www.medscape.com/viewarticle/992167 - Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in U.S. Adults https://www.jacc.org/doi/full/10.1016/j.jacc.2023.03.403 - What Is a Normal Troponin Anyway? https://www.jacc.org/doi/10.1016/j.jacc.2023.03.404 - Updating Our Thinking on Troponin Use and Interpretation    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Two new papers on left atrial appendage occlusion, the promise of DNA, statins in the elderly, and SGLT2 inhibitors 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. Listener Feedback - When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808 II. Left Atrial Appendage Closure LAA Closure Outcomes Improve With CCTA: Swiss-Apero Subanalysis https://www.medscape.com/viewarticle/991623 - Impact of Preprocedural Computed Tomography on Left Atrial Appendage Closure Success: A Swiss-Apero Trial Subanalysis https://doi.org/10.1016/j.jcin.2023.02.027 - Outcomes of percutaneous left atrial appendage occlusion device implantation in atrial fibrillation patients based on underlying stroke risk https://doi.org/10.1093/europace/euad049 III. Polygenic Risk Scores - Predictive Accuracy of a Polygenic Risk Score Compared With a Clinical Risk Score for Incident Coronary Heart Disease https://jamanetwork.com/journals/jama/fullarticle/2761086 - Cardiovascular Disease Risk Assessment Using Traditional Risk Factors and Polygenic Risk Scores in the Million Veteran Program https://jamanetwork.com/journals/jamacardiology/article-abstract/2804439 - Validity of polygenic risk scores: are we measuring what we think we are? https://doi.org/10.1093/hmg/ddz205 IV. Statins in Older Patients High Cholesterol in Seniors: Use Statins for Primary Prevention? https://www.medscape.com/viewarticle/991801 V. SGLT2 Inhibitors FDA Expands Use of Dapagliflozin to Broader Range of HF https://www.medscape.com/viewarticle/991736 - Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Beta-blockers post MI, public perception of statins, trust in the medical profession, BMI, and TAVI 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: https://www.medscape.com/twic I. Post-MI Beta Blockers Long-term Beta-Blockers Not Needed After MI with Preserved Systolic Function? https://www.medscape.com/viewarticle/991542 - Association of beta-blockers beyond 1 year after myocardial infarction and cardiovascular outcomes https://heart.bmj.com/content/early/2023/04/16/heartjnl-2022-322115 - Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/nejmoa1608029 II. Statin Perceptions Statin Misinformation on Social Media Flagged by AI https://www.medscape.com/viewarticle/991585 - Artificial Intelligence–Enabled Analysis of Statin-Related Topics and Sentiments on Social Media https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803988 III. BMI BMI Is a Flawed Measure of Obesity. What Are Alternatives? https://www.medscape.com/viewarticle/991210 IV. TAVI Access Better Access to Transcatheter Aortic Valve Replacement Associated With Improved Outcomes https://www.medscape.com/viewarticle/991573 - Regional Differences in Outcomes for Patients Undergoing Transcatheter Aortic Valve Replacement in New York State and Ontario https://doi.org/10.1016/j.cjca.2023.01.025 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

Two studies of cardiac device infections, observational studies, RCTs, and our ways of knowing in Medicine are the topics discussed by John Mandrola, MD 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. Cardiac Device Infection Mortality Climbs When CIED Infections Are 'Delayed' After Implant https://www.medscape.com/viewarticle/990692 - Association of the Timing and Extent of Cardiac Implantable Electronic Device Infections With Mortality https://jamanetwork.com/journals/jamacardiology/fullarticle/2803627 - Low Utilization of Lead Extraction Among Patients With Infective Endocarditis and Implanted Cardiac Electronic Devices https://www.jacc.org/doi/full/10.1016/j.jacc.2023.02.042 - Cardiac Implantable Electronic Devices and Infective Endocarditis: A Call to Arms...∗ https://www.jacc.org/doi/full/10.1016/j.jacc.2023.02.043 II. Can RCTs be Emulated with Real World Evidence? - Emulation of Randomized Clinical Trials With Nonrandomized Database Analyses https://jamanetwork.com/journals/jama/fullarticle/2804067 - Randomized Trials vs Real-world Evidence https://jamanetwork.com/journals/jama/fullarticle/2804092 - Reanalyses of Randomized Clinical Trial Data https://jamanetwork.com/journals/jama/fullarticle/1902230 III. Multi-Morbidity Effects in Trials Pivotal CV Trials May Not Apply to Complex Patients https://www.medscape.com/viewarticle/989129 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

John Mandrola, MD discusses early vs delayed AF ablation, a report on a devastating complication of AF ablation, and a potential crosswind for a major therapeutic fashion in electrophysiology. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Early Vs Delayed Ablation - Impact of Early Versus Delayed Atrial Fibrillation Catheter Ablation on Atrial Arrhythmia Recurrences https://doi.org/10.1093/eurheartj/ehad247 - Diagnosis-to-Ablation Time and Recurrence of Atrial Fibrillation Following Catheter Ablation https://www.ahajournals.org/doi/full/10.1161/CIRCEP.119.008128 - Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa2029980 - Progression of Atrial Fibrillation after Cryoablation or Drug Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa2212540 II Atrial-Esophageal Fistula CT and Surgery Best Diagnose and Manage Esophageal Fistula https://www.medscape.com/viewarticle/990933 - A worldwide survey on incidence, management and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: The POTTER-AF study https://doi.org/10.1093/eurheartj/ehad250 - Oesophageal Probe Evaluation in Radiofrequency Ablation of Atrial Fibrillation (OPERA): results from a prospective randomized trial https://doi.org/10.1093/europace/euaa209 - Temperature monitoring and temperature-driven irrigated radiofrequency energy titration do not prevent thermally induced esophageal lesions in pulmonary vein isolation: A randomized study controlled by esophagoscopy before and after catheter ablation https://doi.org/10.1016/j.hrthm.2021.02.003 III High-Power Short-Duration Ablation Short, High-Power Ablation on Par With Standard AF Ablation https://www.medscape.com/viewarticle/972087 - Power-Fast Trial https://clinicaltrials.gov/ct2/show/NCT04153747 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

SCAI consensus document on LAAC, semaglutide/tirzepatide disruption, NSAIDs, and interventional echocardiography are the topics discussed by John Mandrola, MD, on 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. SCAI Consensus Document New Update on Left Atrial Appendage Closure Recommendations https://www.medscape.com/viewarticle/990507 - SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure https://doi.org/10.1016/j.jscai.2022.100577 - Transcatheter Left Atrial Appendage Closure Comes of Age https://doi.org/10.1016/j.jscai.2023.100592 - EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update https://doi.org/10.1093/europace/euz258 II. Semaglutide and Tirzepatide Disruption Tirzepatide Powers 'Unprecedented' Weight Loss in Obesity Trial https://www.medscape.com/viewarticle/975061 - Obesity Management in Primary Care https://reference.medscape.com/recap/982874 - The $76 Billion Diet Industry Asks: What to Do About Ozempic? https://www.wsj.com/amp/articles/ozempic-wegovy-mounjaro-weight-loss-industry-89419ecb III. NSAIDs and HF NSAID Use in Diabetes May Worsen Risk for First HF Hospitalization https://www.medscape.com/viewarticle/990642 - Heart Failure Following Anti-Inflammatory Medications in Patients With Type 2 Diabetes Mellitus https://doi.org/10.1016/j.jacc.2023.02.027 IV. Interventional Echocardiography New ASE Guideline on Interventional Echocardiography Training https://www.medscape.com/viewarticle/990520 - Recommendations for Special Competency in Echocardiographic Guidance of Structural Heart Disease Interventions: From the American Society of Echocardiography https://doi.org/10.1016/j.echo.2023.01.014 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

Chat GPT, a relatively unknown therapy for HFpEF, and two fun studies on statins and secondary prevention 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. Artificial Intelligence and CHAT GPT Can ChatGPT Replace Diabetes Educators? Perhaps Not Yet https://www.medscape.com/viewarticle/990381 - Potential and Pitfalls of ChatGPT and Natural-Language Artificial Intelligence Models for Diabetes Education https://doi.org/10.2337/dc23-0197 II. Exercise and HFpEF AHA, ACC Advocate Supervised Exercise Training in HFpEF https://www.medscape.com/viewarticle/990351 - Supervised Exercise Training for Chronic Heart Failure With Preserved Ejection Fraction: A Scientific Statement From the American Heart Association and American College of Cardiology https://doi.org/10.1016/j.jacc.2023.02.012 III. Statins and Muscles Statins Don't Worsen Muscle Injury From Moderately Intense Exercise https://www.medscape.com/viewarticle/990473 - Prolonged Moderate-Intensity Exercise Does Not Increase Muscle Injury Markers in Symptomatic or Asymptomatic Statin Users https://doi.org/10.1016/j.jacc.2023.01.043 IV. Statins in Secondary Prevention Treat to LDL Target or High-Intensity Statin for All With Clinical CAD: LODESTAR https://www.medscape.com/viewarticle/989884 - Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease https://jamanetwork.com/journals/jama/article-abstract/2802214 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

Diets, coronary artery calcium, statins, basic CAD knowledge, and AF ablation 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. Diet Some Diets Better Than Others for Heart Protection https://www.medscape.com/viewarticle/990305 - Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis https://doi.org/10.1136/bmj-2022-072003 Plant-Based Diets Not Always Healthy; Quality Is Key https://www.medscape.com/viewarticle/990178 - Association of Healthful Plant-based Diet Adherence With Risk of Mortality and Major Chronic Diseases Among Adults in the UK https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802814 II. CAC and Statins - Using the Coronary Artery Calcium Score to Guide Statin Therapy https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.113.000799 III. Subclinical Atherosclerosis Subclinical CAD by CT Predicts MI Risk, With or Without Stenoses https://www.medscape.com/viewarticle/990254 - Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort A Prospective Observational Cohort Study 0799 https://www.acpjournals.org/doi/10.7326/M22-3027 - A Prospective Natural-History Study of Coronary Atherosclerosis https://www.nejm.org/doi/10.1056/NEJMoa1002358?url_ver=Z39.88-2003 IV. AF ablation - Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation RecurrenceThe AWARE Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2802860 - Effect of Catheter Ablation Using Pulmonary Vein Isolation With vs Without Posterior Left Atrial Wall Isolation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial FibrillationThe CAPLA Randomized Clinical Trial https://jamanetwork.com/journals/jama/article-abstract/2800186 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine. https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Exercise, sudden cardiac death in sports, new TAVI data, behavioral psychology, EHR doing good things, maybe, and coffee 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. Fitness and Longevity Even Small Changes in Fitness Tied to Lower Mortality Risk https://www.medscape.com/viewarticle/989906 - Changes in Cardiorespiratory Fitness and Survival in Patients With or Without Cardiovascular Disease https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.027 II. SCD in Sports Sports-Related Sudden Cardiac Arrest 'Extremely' Rare in Women https://www.medscape.com/viewarticle/990025 - Incidence of Cardiac Arrest During Sports Among Women in the European Union https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.015 - Sex-Related Differences in Sports-Related Sudden Cardiac Death Should Be Reflected in Guideline Screening Recommendations∗   https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.014 - Association between physical activity and risk of incident arrhythmias in 402 406 individuals: evidence from the UK Biobank cohort https://doi.org/10.1093/eurheartj/ehz897 III. EVOLUT Three Year Data Encouraging 3-Year Data for TAVR in Low-Risk Patients: EVOLUT https://www.medscape.com/viewarticle/989144 - Three-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis https://www.jacc.org/doi/10.1016/j.jacc.2023.02.017 - Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients https://www.nejm.org/doi/full/10.1056/nejmoa1816885 - Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk https://www.jacc.org/doi/10.1016/j.jacc.2020.12.052 IV. Behavioral Psychology NUDGE-FLU: Electronic 'Nudges' Boost Flu Shot Uptake in Seniors https://www.medscape.com/viewarticle/989108 - The Effect of Electronic Nudges on Influenza Vaccination Rate in Older Adults With Cardiovascular Disease: a Prespecified Analysis of the NUDGE-FLU Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064270 - Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.121.057042 EHR Alerts Boosted MRA Prescribing in HFrEF: BETTER CARE-HF https://www.medscape.com/viewarticle/989110 - Cluster-Randomized Trial Comparing Ambulatory Decision Support Tools to Improve Heart Failure Care https://doi.org/10.1016/j.jacc.2023.02.005 - The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure https://www.nejm.org/doi/full/10.1056/nejm199909023411001 V. Coffee - Acute Effects of Coffee Consumption on Health among Ambulatory Adults https://www.nejm.org/doi/full/10.1056/NEJMoa2204737 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ACC Recap No. 2: Pacing in HFpEF, Oral PCSK9 inhibitor, PAH, soft thinking on adherence, and so called metabolically healthy obese are discussed by John Mandrola, MD, 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. Pacing in HFpEF No Exercise Boost From Pacemaker in HFpEF With Impaired HR Response: RAPID-HF https://www.medscape.com/viewarticle/989681 - Rate-Adaptive Atrial Pacing for Heart Failure With Preserved Ejection FractionThe RAPID-HF Randomized Clinical Trial https://jamanetwork.com/journals/jama/article-abstract/2802147 - Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 - Could a Breakthrough in Heart Failure With Preserved Ejection Fraction Just Take a Change of Pace? - https://www.medscape.com/viewarticle/988088 - Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction: The myPACE Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2801001 - Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction https://doi.org/10.1016/j.jacc.2021.08.073 II Oral PCSK9i Oral PCSK9 Inhibitor Shows Encouraging LDL Lowering https://www.medscape.com/viewarticle/989655 - Efficacy and safety of the oral PCSK9 inhibitor MK-0616: a phase 2b randomized controlled trial https://www.jacc.org/doi/10.1016/j.jacc.2023.02.018 III PAH 'Unheard of' PAH Improvement With Novel Drug: STELLAR https://www.medscape.com/viewarticle/989612 - Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension https://www.nejm.org/doi/full/10.1056/NEJMoa2213558 IV Medical Adherence Waiving Co-Pays for CV Meds as Adherence Incentive Doesn't Cut Clinical Risk: ACCESS Trial https://www.medscape.com/viewarticle/989474 - Eliminating Medication Copayments for Low-income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064188 - Medicaid Expansion: Good First Step, but No Panacea for CV Care https://www.medscape.com/viewarticle/975141 - Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120 - Rand Link https://www.rand.org/pubs/reports/R3055.html - The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/ - Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576 - Full Coverage for Preventive Medications after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmsa1107913 - Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial InfarctionThe ARTEMIS Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2720024 - Coronary CT Angiography and 5-Year Risk of Myocardial Infarction https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 IV Metabolically Healthy Obese 'Metabolically Healthy Obesity' Rising, but Still Uncommon https://www.medscape.com/viewarticle/989398 - Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802164 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ACC Recap Part 1: Sports, bempedoic acid NASCARs, tricuspid regurgitation, and more on revascularization of stable CAD. are the topics discussed by John Mandrola, MD, 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. Sports Cardiology Even Vigorous Exercise Appears Safe for Patients With Hypertrophic Cardiomyopathy: LIVE-HCM https://www.medscape.com/viewarticle/989351 - Lifelong endurance exercise and its relation with coronary atherosclerosis https://doi.org/10.1093/eurheartj/ehad152 - Increased average longevity among the "Tour de France" cyclists https://pubmed.ncbi.nlm.nih.gov/21618162/ II. Clear Outcomes Bempedoic Acid Cuts CV Events in Statin-Intolerant Patients: CLEAR Outcomes https://www.medscape.com/viewarticle/989100 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients https://www.nejm.org/doi/full/10.1056/NEJMoa2215024 - Bodgan Enache Tweet https://twitter.com/bogdienache/status/1632143539965509632?s=20 III. TRILUMINATE Trial Transcatheter Tricuspid Valve Repair Effective, Safe for Regurgitation: TRILUMINATE https://www.medscape.com/viewarticle/989103 - Transcatheter Repair for Patients with Tricuspid Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 - New Treatment Could Help Fix the Heart’s ‘Forgotten Valve.’ https://www.nytimes.com/2023/03/04/health/tricuspid-valve-clip-leakage.html - Rasha Al-Lamee Tweet https://twitter.com/rallamee/status/1632295242685612033?s=20 IV. REVIVED-BCIS Viability-Guided PCI Doubted in Stable Severe CAD: REVIVED-BCIS2 https://www.medscape.com/viewarticle/989101 - Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 Features: CLEAR Positives and Cautions With Bempedoic Acid for Statin Intolerance https://www.medscape.com/viewarticle/989098 The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? https://www.medscape.com/viewarticle/989105 Three Surprising Studies on Exercise Restriction and an Exercise Sweet Spot https://www.medscape.com/viewarticle/989417 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Renal denervation, AF ablation, omecamtiv mecarbil, and an ACC Preview are the topics discussed by John Mandrola, MD, 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. AF Ablation - Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures https://www.jacc.org/doi/10.1016/j.jacc.2022.11.060 II. Renal Denervation Consistent BP Cut With Renal Denervation: More on RADIANCE https://www.medscape.com/viewarticle/989006 - Endovascular Ultrasound Renal Denervation to Treat HypertensionThe RADIANCE II Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2801849 - Patient-Level Pooled Analysis of Ultrasound Renal Denervation in the Sham-Controlled RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO Trials https://jamanetwork.com/journals/jamacardiology/fullarticle/2802098 - Is There a Role for Renal Denervation in the Treatment of Hypertension? https://jamanetwork.com/journals/jamacardiology/fullarticle/2802099 III. Omecamtiv Mecarbil FDA Declines Approval for Omecamtiv Mecarbil in HFrEF https://www.medscape.com/viewarticle/988948 IV. ACC Preview ACC Scientific Session Returns Live, Virtually to New Orleans https://www.medscape.com/viewarticle/988803 - ‘Faith Healing’ and ‘Subtraction Anxiety’ in Unblinded Trials of Procedures https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004665 Features Mandrola's 5 Things to Look for at ACC 23 https://www.medscape.com/viewarticle/988808 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Reporting on potential fraud in medicine, AF, stroke, a possible new cholesterol-lowering drug, and the tone of debate in medical science 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. Potential Fraud in Medicine Inside the Big Business of Clogged Arteries https://www.medscape.com/viewarticle/988448 II. AF Screening and Stroke STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke https://jamanetwork.com/journals/jamaneurology/fullarticle/2795865 III. Bempedoic Acid New Studies Give Bempedoic Acid a Bump as Lipid-Lowering Agent https://www.medscape.com/viewarticle/911100 - Rationale and design of the CLEAR-outcomes trial: Evaluating the effect of bempedoic acid on cardiovascular events in patients with statin intolerance https://doi.org/10.1016/j.ahj.2020.10.060 - Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol https://www.nejm.org/doi/full/10.1056/NEJMoa1803917 - Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease https://jamanetwork.com/journals/jama/fullarticle/2754792 - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 - Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022 IV. The Technique of Critical Appraisal Why Evidence-Based Medicine Enthusiasts Could Use a Lesson in Persuasion https://www.medscape.com/viewarticle/988227 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Bradyarrhythmia during AF screening, thrombolysis in stroke, NP vs MD care, and the most biased paper this year — on LAAO — 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. Screening with ILR - Ade Adamson Tweet https://twitter.com/AdeAdamson/status/1625878856820482048?s=20 - The Rapid Rise in Cutaneous Melanoma Diagnoses https://www.nejm.org/doi/full/10.1056/NEJMsb2019760 - Loop Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 II. Thrombolysis in Mild Stroke Thrombolysis Not Necessary in Mild Nondisabling Stroke: ARAMIS https://www.medscape.com/viewarticle/988381 - PRISMS Trial https://jamanetwork.com/journals/jama/fullarticle/2687354 - Risk of selection bias assessment in the NINDS rt-PA stroke study https://pubmed.ncbi.nlm.nih.gov/35705913/ - Tissue Plasminogen Activator for Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/NEJM199512143332401 - Effects of alteplase for acute stroke; Hacke et al meta-analysis https://journals.sagepub.com/doi/10.1177/1747493017744464 - Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis https://onlinelibrary.wiley.com/doi/full/10.1111/ane.13656 - ECASS; Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/nejmoa0804656 - Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances https://pubmed.ncbi.nlm.nih.gov/32430395/ III. NP vs MD Care This Doc Still Supports NP/PA Led Care ... With Caveats https://www.medscape.com/viewarticle/967073 - The Productivity of Professions: Evidence from the Emergency Department https://www.nber.org/papers/w30608 - Independent Nurse Practitioners and Physician Assistants: A Doc's View https://www.medscape.com/viewarticle/924047 IV. LAAO vs OAC - Comparative Effectiveness of Left Atrial Appendage Occlusio Versus Oral Anticoagulation by Sex https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062765 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Drug and non-drug therapies for HFpEF, the search for AF, and exercise as medicine 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. SGLT2 Inhibitors in HFpEF Dapagliflozin Gets Expanded Heart Failure Indication in Europe https://www.medscape.com/viewarticle/988034 Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 II. HFpEF and Heart Rate Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 III. Stroke and AF STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease https://jamanetwork.com/journals/jama/fullarticle/2780490 Cryptogenic Stroke and Underlying Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1313600 Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT https://pubmed.ncbi.nlm.nih.gov/28329139/ Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 IV. Exercise as Medicine Trending Clinical Topic: Exercise Prescription https://reference.medscape.com/viewarticle/985373 Effect of Moderate and Vigorous Aerobic Exercise on Incident Diabetes in Adults With Obesityhttps://pubmed.ncbi.nlm.nih.gov/36716009/ Features Could a Breakthrough in Heart Failure With Preserved Ejection Fraction Just Take a Change of Pace? https://www.medscape.com/viewarticle/988088 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

A possible major breakthrough in thinking about diastolic dysfunction and HFpEF, MRI scanning and cardiac devices, and AF and dementia 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: https://www.medscape.com/twic I. New Thinking in HFpEF Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 - Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction: The myPACE Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2801001 - Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction https://doi.org/10.1016/j.jacc.2021.08.073 - A Targeted Treatment Opportunity for HFpEF: Taking Advantage of Diastolic Tone https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056412 - Lenient versus Strict Rate Control in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1001337 II. MRI and ICD Function Legacy ICDs Exposed to MRI Still Shock, Pace as Needed https://www.medscape.com/viewarticle/987729 - Implantable Defibrillator System Shock Function, Mortality, and Cause of Death After Magnetic Resonance Imaging https://doi.org/10.7326/M22-2653 - 2017 HRS expert consensus statement on magnetic resonance imaging and radiation exposure in patients with cardiovascular implantable electronic devices https://pubmed.ncbi.nlm.nih.gov/28502708/ III. AF and Dementia Atrial Fibrillation and Dementia: What Do We Know? https://www.medscape.com/viewarticle/985900 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Exercise for AF, drugs have more than one effect, AI bots and the future of medicine, and the good and bad news about prognosis 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: https://www.medscape.com/twic I. AF and Exercise Aerobic Exercise Can Reduce AF Frequency, Severity: ACTIVE-AF https://www.medscape.com/viewarticle/957322 An Exercise and Physical Activity Program in Patients With Atrial Fibrillation: The ACTIVE-AF Randomized Controlled Trial https://www.jacc.org/doi/full/10.1016/j.jacep.2022.12.002 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 II. GLP-1 Inhibitors and Retinopathy Eye Check Important Before Starting Semaglutide for Diabetes https://www.medscape.com/viewarticle/987418 Glucagon-like peptide 1-receptor agonists and A1c: Good for the heart but less so for the eyes? https://doi.org/10.1016/j.dsx.2022.102696 III. AI Bot Passes USMLEs AI Bot ChatGPT Passes US Medical Licensing Exams Without Cramming – Unlike Students https://www.medscape.com/viewarticle/987549 Performance of ChatGPT on USMLE: Potential for AI-Assisted Medical 2 Education Using Large Language Models https://www.medrxiv.org/content/10.1101/2022.12.19.22283643v2.full.pdf Tyler Cowen Comments -- GPT and my own career trajectory https://marginalrevolution.com/marginalrevolution/2023/01/gpt-and-my-own-career-trajectory.html IV. HF Prognosis Temporal trends in the incidence of malignancy in heart failure: a nationwide Danish study https://doi.org/10.1093/eurheartj/ehac797 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The loop diuretic duels, adverse events during hospital admissions, BP accuracy, and, again, left main revascularization strategies (again) are the topics John Mandrola 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. TRANSFORM HF Clarity on Torsemide vs Furosemide in HF: TRANSFORM-HF Published https://www.medscape.com/viewarticle/987128 • Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure https://jamanetwork.com/journals/jama/fullarticle/2800428 • RANSFORM-HF—Can We Close the Loop on Diuretics in Heart Failure? https://jamanetwork.com/journals/jama/fullarticle/2800445 II. Adverse Events in the Hospital Adverse Events Reported in One Quarter of Inpatient Admissions https://www.medscape.com/viewarticle/987091 • The Safety of Inpatient Health Care https://www.nejm.org/doi/full/10.1056/NEJMsa2206117 III. BP Accuracy Experts Demand Validation of Automatic Blood Pressure Devices https://www.medscape.com/viewarticle/987032 IV. Left Main Coronary Artery Disease Real-World Examination of Revascularization Strategies for Left Main Coronary Disease in Ontario, Canada https://doi.org/10.1016/j.jcin.2022.10.016 Management of Left Main Coronary Artery Disease in Nonemergent Settings: The Heart of Multidisciplinary Teamwork https://doi.org/10.1016/j.jcin.2022.11.024 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

FOURIER authors’ response, a possible practice-changing paper in electrophysiology, and the ATLAS and CAPLA trials 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. FOURIER Authors Respond Recount of FOURIER Data Finds Higher Mortality With Evolocumab; Trialists Push Back https://www.medscape.com/viewarticle/986634 Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data https://bmjopen.bmj.com/content/12/12/e060172 Letter to the Editor RE: "Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data". BMJ Open https://bmjopen.bmj.com/content/12/12/e060172.responses#letter-to-the-editor-re-restoring-mortality-data-in-the-fourier-cardiovascular-outcomes-trial-of-evolocumab-in-patients-with-cardiovascular-disease-a-reanalysis-based-on-regulatory-data-bmj-open-2022123060172 Risk of selection bias assessment in the NINDS rt-PA stroke study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202115/ Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis https://doi.org/10.1111/ane.13656 II. A Potential Practice-Changing Paper in Cardiac Pacing Novel 'Cure' May Avert Lead Extraction in CIED Pocket Infections https://www.medscape.com/viewarticle/986762 Regional Antibiotic Delivery for Implanted Cardiovascular Electronic Device Infections https://doi.org/10.1016/j.jacc.2022.10.022 Treatment of Localized Implantable Cardiac Device Pocket Infections https://doi.org/10.1016/j.jacc.2022.11.018 III. ATLAS Trial Perioperative Safety and Early Patient and Device Outcomes Among Subcutaneous Versus Transvenous Implantable Cardioverter Defibrillator Implantations https://doi.org/10.7326/M22-1566 Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/10.1056/NEJMc2034917 IV. CAPLA Published CAPLA Shows Limits of Further Ablation Post PVI in Persistent AF https://www.medscape.com/viewarticle/986901 Effect of Catheter Ablation Using Pulmonary Vein Isolation With vs Without Posterior Left Atrial Wall Isolation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2800186 Catheter Ablation for Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2800200 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Damar Hamlin, obesity and semaglutide, Open Data and PCSK9 inhibitors, and TAVI vs SAVR trials 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. Damar Hamlin Five Thoughts on the Damar Hamlin Collapse https://www.medscape.com/viewarticle/986550 II. Semaglutide and Obesity in Adolescents FDA Approves Wegovy (Semaglutide) for Obesity in Teens 12 and Up https://www.medscape.com/viewarticle/986403 • Once-Weekly Semaglutide in Adolescents with Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2208601 III. Open Data and PCSK9 inhibitors Evolocumab Added to Statins Cuts CV Events in FOURIER Trial https://www.medscape.com/viewarticle/877348 • Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data https://bmjopen.bmj.com/content/12/12/e060172 • Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/nejmoa1615664 • PCSK9 deficiency rewires heart metabolism and drives heart failure with preserved ejection fraction https://pubmed.ncbi.nlm.nih.gov/34252181/ • Bendary Tweet https://twitter.com/DrBendary/status/1609849852979986432?s=20&t=FDDhGIofS_HQ4jxf8aHwBA IV. Open Data and TAVI vs SAVR Trials Risk of Bias in Randomized Clinical Trials Comparing Transcatheter and Surgical Aortic Valve Replacement https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799937 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The top ten stories of the year plus a few honorary mentions. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Annual Wrap Ups on Medscape - Mandrola’s Top 10 Cardiology Stories of 2022 https://www.medscape.com/viewarticle/985607 - 2022 in Review Through a Cardiology Lens https://www.medscape.com/viewarticle/984505 - Top Cardiology Trials of 2022 https://www.medscape.com/viewarticle/985647 II REVIVED BCIS2 - Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/nejmoa2206606 - PCI Fails in Stable Disease Again: REVIVED-BCIS https://www.medscape.com/viewarticle/979862 - PCI Fails to Beat OMT in Ischemic Cardiomyopathy: REVIVED-BCIS2 https://www.medscape.com/viewarticle/979853 III GUIDE HF - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - CardioMEMS Remote HF Monitoring: Resist the Spin and FOMO https://www.medscape.com/viewarticle/970278 - GUIDE-HF: CardioMEMS-Guided Meds Fall Short in Mild to Moderate Heart Failure https://www.medscape.com/viewarticle/957390 IV DECAAF II - Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation The DECAAF II Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2793452 - DECAAF II: AF, Fibrosis Ablation Technique Falls Short, but Signs of Hope https://www.medscape.com/viewarticle/957469 V DANCAVAS - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 - DANCAVAS Misses Primary Endpoint but Hints at Benefit from Comprehensive CV Screening https://www.medscape.com/viewarticle/979854 - Judicious CVD Screening May Work in Men: DANCAVAS https://www.medscape.com/viewarticle/980153 - DANCAVAS: Might Cardiovascular Screening Extend Men's Lives? https://www.medscape.com/viewarticle/979632 VI SODIUM HF - Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5 - Low-Sodium Diet Did Not Cut Clinical Events in Heart Failure Trial https://www.medscape.com/viewarticle/971482 - Sodium Restriction in Heart Failure: Another Dogma Felled by Randomization https://www.medscape.com/viewarticle/971697 - SODIUM-HF Simplifies Message to Patients on Diet https://www.medscape.com/viewarticle/971547 VII STRONG-HF - Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial https://doi.org/10.1016/S0140-6736(22)02076-1 - Rapidly, Fully Optimize HF Meds After Hospital Discharge: STRONG-HF https://www.medscape.com/viewarticle/983870 - STRONG HF: More Beats Less After Discharge for Heart Failure https://www.medscape.com/viewarticle/983698 VIII Health Insurance Access - Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://doi.org/10.1001/jamacardio.2022.1282 - Medicaid Expansion: Good First Step, but No Panacea for CV Care https://www.medscape.com/viewarticle/975141 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

BP control over the long term, omecamtiv mecarbil, incentives and Goodhart’s law, and open science 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: https://www.medscape.com/twic I. Long-Term BP Control - Final SPRINT Data Confirm Lower BP Is Better https://www.medscape.com/viewarticle/951572 - Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control https://jamanetwork.com/journals/jamacardiology/fullarticle/2797064 - Let's Not SPRINT to Judgment About New Blood Pressure Goals https://www.acpjournals.org/doi/full/10.7326/M15-3123 - Should We SPRINT Toward New Blood Pressure Goals or Let the Dust Settle? https://doi.org/10.1016/j.amjmed.2016.04.022 II. Omecamtiv Mecarbil - FDA Panel Votes No on Omecamtiv Mecarbil for Heart Failure https://www.medscape.com/viewarticle/985593 - Omecamtiv Mecarbil Fails to Improve Exercise Capacity in HFrEF https://www.medscape.com/viewarticle/978355 - Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2025797 - Effect of Omecamtiv Mecarbil on Exercise Capacity in Chronic Heart Failure With Reduced Ejection Fraction https://jamanetwork.com/journals/jama/fullarticle/2794362 - Effects of omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial https://doi.org/10.1093/eurheartj/ehac293 III. Measuring Quality of Care - MIPS Quality Scores Don't Reflect Quality of Care: Study https://www.medscape.com/viewarticle/985396 - Association Between Individual Primary Care Physician Merit-based Incentive Payment System Score and Measures of Process and Patient Outcomes https://jamanetwork.com/journals/jama/article-abstract/2799153 - Pay for Performance When Slogans Overtake Science in Health Policy https://jamanetwork.com/journals/jama/fullarticle/2799177 - Goodhart's law https://en.wikipedia.org/wiki/Goodhart%27s_law IV. Open Science - Radial Artery Outlasts SVG as Second CABG Conduit, Cuts 5-Year Clinical Risk https://www.medscape.com/viewarticle/896122 - Many Analysts, One Data Set: Making Transparent How Variations in Analytic Choices Affect Results https://doi.org/10.1177/2515245917747646 - Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting https://academic.oup.com/ejcts/article/62/1/ezac345/6604735?login=false - Do all roads lead to Rome? Critical reassessment of the individual patient meta-analysis on bypass grafts by Gaudino et al. https://doi.org/10.1093/ejcts/ezac564 - Editorial: Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting: Different conduits or different trials? https://doi.org/10.1093/ejcts/ezac562 Features - Mandrola’s Top 10 Cardiology Stories of 2022 https://www.medscape.com/viewarticle/985607 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Nudges, statins, AI, less-is-more in the ICU, myocarditis, exercise as medicine, and December in the hospital 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: https://www.medscape.com/twic I. Nudges and Statin Prescribing EHR Alerts to Both Doc and Patient May Boost Statin Prescribing https://www.medscape.com/viewarticle/984944 Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing https://jamanetwork.com/journals/jamacardiology/article-abstract/2798971 Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia https://jamanetwork.com/journals/jama/fullarticle/2719307 Lack of Efficacy of a Salience Nudge for Substituting Selection of Lower-Calorie for Higher-Calorie Milk in the Work Place https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488787/ II. AI and Chest X-Ray Single Chest X-Ray Could Predict 10-Year CVD Risk https://www.medscape.com/viewarticle/984910 III. BOX Trial Shorter Fever Prevention Duration Effective After Cardiac Arrest https://www.medscape.com/viewarticle/984852 Duration of Device-Based Fever Prevention after Cardiac Arrest https://www.nejm.org/doi/10.1056/NEJMoa2212528 Oxygen Targets in Comatose Survivors of Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJMoa2208686 Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJMoa2208687 Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2032510 IV. Myocarditis Mortality Higher in Myocarditis After Virus Than After COVID Vax https://www.medscape.com/viewarticle/985045 Autopsy-based histopathological characterization of myocarditis after anti-SARS-CoV-2-vaccination https://link.springer.com/article/10.1007/s00392-022-02129-5#Tab2 Myopericarditis After COVID-19 mRNA Vaccination Among Adolescents and Young Adults https://jamanetwork.com/journals/jamapediatrics/fullarticle/2798866 Prognosis of Myocarditis Developing After mRNA COVID-19 Vaccination Compared With Viral Myocarditis https://www.jacc.org/doi/full/10.1016/j.jacc.2022.09.049 V. Exercise as Medicine Just 8 Minutes of Exercise a Day Is All You Need https://www.medscape.com/viewarticle/984684 Vigorous physical activity, incident heart disease, and cancer: how little is enough? https://doi.org/10.1093/eurheartj/ehac572 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine   The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected] John M Mandrola, MD

SGLT2 inhibitors, publishing choices, second and third order effects of interventions, decision support, and patient selection for preventive procedures 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. EMPA Kidney - EMPA-Kidney Seals SGLT2 Inhibitors as 'Foundational' for CKD https://www.medscape.com/viewarticle/984439 - EMPA-Kidney Moves the Needle for SGLT2 Inhibitors in Kidney Disease https://www.medscape.com/viewarticle/983521 - Empagliflozin in Patients with Chronic Kidney Disease https://www.nejm.org/doi/pdf/10.1056/NEJMoa2204233 - Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy https://www.nejm.org/doi/10.1056/NEJMoa1811744 - Dapagliflozin in Patients with Chronic Kidney Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2024816 - Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials https://doi.org/10.1016/S0140-6736(22)02074-8 II. Publishing Choices - Motorcycle Rallies Linked to Spike in Organ Transplants https://www.medscape.com/viewarticle/984623 - Organ Donation and Transplants During Major US Motorcycle Rallies https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2798550 III. Second and Third Order Effects - Heart Disease Deaths Spiked During COVID After 10-Year Decline https://www.medscape.com/viewarticle/984605 IV. Decision Support - Patient App Aids Decisions on Anticoagulants: ENHANCE-AF https://www.medscape.com/viewarticle/984253 - A Randomized Clinical Trial to Evaluate an Atrial Fibrillation Stroke Prevention Shared Decision‐Making Pathway https://www.ahajournals.org/doi/10.1161/JAHA.122.028562 V. Percutaneous Left Atrial Appendage Closure - Consider Life Expectancy When Referring for LAA Closure? https://www.medscape.com/viewarticle/981117 - Transcatheter Left Atrial Appendage Occlusion: A Multi-Center Real Life Experience https://www.mdpi.com/2077-0383/11/23/6944 - Incidence and Predictors of Early Death in Patients Undergoing Percutaneous Left Atrial Appendage Closure https://www.jacc.org/doi/full/10.1016/j.jacep.2022.06.012 - Indications for Left Atrial Appendage Occlusion in the United States and Associated In-Hospital Outcomes: Results From the NCDR LAAO Registry https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.121.008418 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AHA 2022, Part 2: IRONMAN, ECMO-CS, CTS-AMI, and PROGRESSIVE AF are the trials John Mandrola, MD, reviews 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. Pushback on PROMINENT Zimerman Thread: https://twitter.com/AndreZimerman/status/1593019800036708353 II. IRONMAN IRONMAN Galvanizes Case for IV Iron Repletion in Heart Failure https://www.medscape.com/viewarticle/984030 Is Iron Replacement in Heart Failure Worth the Trouble? https://www.medscape.com/viewarticle/983622 - Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial https://doi.org/10.1016/S0140-6736(22)02083-9 III. ECMO-CS Avoid Routine Early ECMO in Severe Cardiogenic Shock: ECMO-CS https://www.medscape.com/viewarticle/983618 - Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062949 - Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118.004905 IV. CTS-AMI Chinese Herbal Medicine May Offer Benefits in STEMI: CTS-AMI https://www.medscape.com/viewarticle/983619 V. PROGRESSIVE AF First-Line AF Ablation Cuts Risk of Progression vs Drug Therapy https://www.medscape.com/viewarticle/983882 Role of Ablation Type and Risk Factors in Paroxysmal AF: PROGRESSIVE-AF Interview https://www.medscape.com/viewarticle/983474 - Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa2029980 - Progression of Atrial Fibrillation after Cryoablation or Drug Therapy https://www.nejm.org/doi/10.1056/NEJMoa2212540 - Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders https://pubmed.ncbi.nlm.nih.gov/31779791/ You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AHA 2022 Part 1: ISCHEMIA-EXTEND, STRONG-HF, chlorthalidone vs HCTZ, experts vs practitioners; torsemide vs furosemide; and TG lowering are discussed by John Mandrola, MD, 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. AHA Meta-comments II. ISCHEMIA-Extended - ISCHEMIA-EXTEND: Conservative Stable CAD Management Holds Up https://www.medscape.com/viewarticle/983657 - Survival After Invasive or Conservative Management of Stable Coronary Disease https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062714 III. STRONG-HF - Rapidly, Fully Optimize HF Meds After Hospital Discharge: STRONG-HF https://www.medscape.com/viewarticle/983870 - STRONG HF: More Beats Less After Discharge for Heart Failure https://www.medscape.com/viewarticle/983698 - Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial https://doi.org/10.1016/S0140-6736(22)02076-1 IV. DCP - Diuretic Agents Equal to Prevent CV Events in Hypertension: DCP https://www.medscape.com/viewarticle/983608 - HCTZ vs Chlorthalidone -- A Win for Practicing Doctors and Science https://www.medscape.com/viewarticle/983614 V. TRANSFORM HF - No Survival Advantage for Either Torsemide or Furosemide in HF: TRANSFORM-HF https://www.medscape.com/viewarticle/983611 VI. PROMINENT - Triglyceride Lowering Fails to Show CV Benefit in Large Fibrate Trial https://www.medscape.com/viewarticle/983610 - Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2210645 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF conversion in the ED, HRT, a shining example of evidence-based medicine and less-is-more, multimorbidity, and what’s coming at AHA 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: https://www.medscape.com/twic I. AF Conversion - IV Potassium and Magnesium an Acute Treatment for AF? https://www.medscape.com/viewarticle/983137 - Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797474 II. HRT - USPSTF Doesn't Change Postmenopausal Hormone Recommendations https://www.medscape.com/viewarticle/983349 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://doi.org/10.7326/0003-4819-117-12-1016 - Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Results From the Women's Health Initiative Randomized Controlled Trial https://jamanetwork.com/journals/jama/fullarticle/195120 - Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal PersonsUS Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2797867 - Menopausal Hormone Therapy for Prevention of Chronic Conditions https://jamanetwork.com/journals/jama/fullarticle/2797897 III. BP Targets After Stroke Intervention - Intensive BP Lowering Harmful in Acute Ischemic Stroke: ENCHANTED2/MT https://www.medscape.com/viewarticle/983176 - Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial https://doi.org/10.1016/S0140-6736(22)01882-7 IV. Multimorbidity - ACC Issues Guidance on Integrating ASCVD and Multimorbidity Care https://www.medscape.com/viewarticle/983123 - 2022 ACC Expert Consensus Decision Pathway for Integrating Atherosclerotic Cardiovascular Disease and Multimorbidity Treatment: A Framework for Pragmatic, Patient-Centered Care: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2022.08.754 V. AHA Preview - AHA 2022 to Recapture In-Person Vibe but Preserve Global Reach https://www.medscape.com/viewarticle/983315 - Mandrola's Top 5 Picks From AHA 2022 Previewed https://www.medscape.com/viewarticle/983237 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ERASE AF follow-up, recreational drugs and AF, etripamil, misuse of science, and diabetes as a cardiovascular risk factor 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. Follow-up on ERASE AF II. Recreational Drugs Four Commonly Abused Drugs Linked With Atrial Fibrillation https://www.medscape.com/viewarticle/983052 III. Etripamil RAPID: Positive Data for Etripamil Nasal Spray in Paroxysmal SVT https://www.medscape.com/viewarticle/982787 - Milestone Pharmaceuticals Announces Positive Results from Phase 3 RAPID Clinical Trial of Etripamil Nasal Spray in Patients with Paroxysmal Supraventricular Tachycardia https://investors.milestonepharma.com/news-releases/news-release-details/milestone-pharmaceuticals-announces-positive-results-phase-3 IV. Misuse of Science When Bad Actors Hijack Good Research https://www.medscape.com/viewarticle/982936 - Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/31050775/ V. Diabetes as a Risk Factor Diabetes Becoming Less Potent Risk Factor for CVD Events https://www.medscape.com/viewarticle/982801 - Trends in the Association Between Diabetes and Cardiovascular Events, 1994-2019 https://jamanetwork.com/journals/jama/fullarticle/2797494 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The ERASE AF ablation trial, left bundle pacing, finerenone, and perceptions of cardiology 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. AF Ablation - Low-Voltage Myocardium-Guided Ablation Trial of Persistent Atrial Fibrillation https://evidence.nejm.org/doi/10.1056/EVIDoa2200141 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 - Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2793452 - Circumferential Pulmonary Vein Isolation Plus Low-Voltage Area Modification in Persistent Atrial Fibrillation: The STABLE-SR-II Trial https://www.jacc.org/doi/full/10.1016/j.jacep.2022.03.012 - Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2772281 - Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation https://www.ahajournals.org/doi/full/10.1161/CIRCEP.120.009288 II. Left Bundle Branch Area Pacing - FDA OKs Medtronic Lead for Left Bundle Branch Pacing https://www.medscape.com/viewarticle/982577 - Left bundle branch area pacing outcomes: the multicentre European MELOS study https://academic.oup.com/eurheartj/article/43/40/4161/6671019 - Randomized Trial of Left Bundle Branch vs Biventricular Pacing for Cardiac Resynchronization Therapy https://www.jacc.org/doi/full/10.1016/j.jacc.2022.07.019 - Early sudden distal conductor fracture of a stylet-driven lead implanted for left bundle branch area pacing https://doi.org/10.1016/j.hrcr.2022.10.004 - Repositioning and extraction of stylet-driven pacing leads with extendable helix used for left bundle branch area pacing https://pubmed.ncbi.nlm.nih.gov/33825263/ - Safety and Procedural Success of Left Atrial Appendage Exclusion With the Lariat Device https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2289126 III. Finerenone - Finerenone Benefits T2D Across Spectrum of Renal Function https://www.medscape.com/viewarticle/982626 - Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes https://www.nejm.org/doi/10.1056/NEJMoa2110956 - Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis https://academic.oup.com/eurheartj/article/43/6/474/6433104 - Finerenone and Heart Failure Outcomes by Kidney Function/Albuminuria in Chronic Kidney Disease and Diabetes https://www.jacc.org/doi/10.1016/j.jchf.2022.07.013 IV. Perceptions of Cardiology - IM Residents Rate Cardiology Low on Work-Life Balance https://www.medscape.com/viewarticle/982578 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Chest pain evaluation in the ED, peer review, the NordICC trial, and a surgeon lost too early 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. Chest Pain Consensus Pathway - ACC Issues Guidance on ED Evaluation of Acute Chest Pain https://www.medscape.com/viewarticle/982302 - 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2022.08.750 - 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001030#d20522356e1 II. Peer Review - Big Name Researchers May Get Special Treatment, Limiting New Science https://www.medscape.com/viewarticle/982193 - Nobel and Novice: Author Prominence Affects Peer Review https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4190976 - Editorial peer review for improving the quality of reports of biomedical studies https://www.cochrane.org/MR000016/METHOD_editorial-peer-review-for-improving-the-quality-of-reports-of-biomedical-studies III. NordICC - Colonoscopy Lowers CRC Risk and Death, but Not by Much: NordICC https://www.medscape.com/viewarticle/982143 - Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death https://www.nejm.org/doi/full/10.1056/NEJMoa2208375 - The arrogance of preventive medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117852/ - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 IV. Domenico Pagano - Surgeon Domenico Pagano Has Died, EACTS Announces https://www.medscape.com/viewarticle/982351 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Post-PCI antiplatelet therapy, palliative care in patients with HF, Watchman information on hospital websites, and HCM in athletes 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: https://www.medscape.com/twic I. Post-Stent Antiplatelet Therapy SMART-CHOICE 3-Year Results Support Dropping Aspirin After PCI https://www.medscape.com/viewarticle/981741 Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention https://jamanetwork.com/journals/jamacardiology/fullarticle/2796902 The Smart(est) Choice for Dual Antiplatelet Therapy is a Patient-Directed One https://jamanetwork.com/journals/jamacardiology/fullarticle/2796904 Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention https://jamanetwork.com/journals/jama/fullarticle/2736564 II. Palliative Care in HF Home-Based Palliative Care Improves Heart Failure Outcomes https://www.medscape.com/viewarticle/981715 Regional collaborative home-based palliative care and health care outcomes among adults with heart failure https://doi.org/10.1503/cmaj.220784 III. Watchman Info on Hospital Websites Concern Over US Hospital Patient Information on LAA Closure https://www.medscape.com/viewarticle/981961 Analysis of Patient-Focused Information About Left Atrial Appendage Occlusion on US Hospital Web Pages https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2797102 IV. HCM and Exercise in Athletes Athletes With Mild HCM Can Likely Continue Competitive Sports https://www.medscape.com/viewarticle/981782 Impact of Exercise on Outcomes and Phenotypic Expression in Athletes With Nonobstructive Hypertrophic Cardiomyopathy https://www.jacc.org/doi/full/10.1016/j.jacc.2022.08.715 A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD) https://pubmed.ncbi.nlm.nih.gov/24126876/ You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Pulmonary embolism, coffee, when DOACs don’t work, lipoprotein (a), and the marginal benefits of current CV therapy 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. Pulmonary Embolism - Positive Data on Thrombectomy Catheter That Avoids Thrombolytics in Acute PE https://www.medscape.com/viewarticle/981322 - Acute Outcomes for the Full US Cohort of the FLASH Mechanical Thrombectomy Registry in Pulmonary Embolism https://eurointervention.pcronline.com/article/acute-outcomes-for-the-full-us-cohort-of-the-flash-mechanical-thrombectomy-registry-in-pulmonary-embolism - PEERLESS Study https://clinicaltrials.gov/ct2/show/NCT05111613 - Ultrasound-facilitated, Catheter-directed, Thrombolysis in Intermediate-high Risk Pulmonary Embolism (HI-PEITHO) https://clinicaltrials.gov/ct2/show/NCT04790370 - A Prospective, Single-Arm, Multicenter Trial of Catheter-Directed Mechanical Thrombectomy for Intermediate-Risk Acute Pulmonary Embolism: The FLARE Study https://doi.org/10.1016/j.jcin.2018.12.022 II. Coffee Again - Coffee Linked to Reduced Cardiovascular Disease and Mortality https://www.medscape.com/viewarticle/981518 Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 - The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank https://doi.org/10.1093/eurjpc/zwac189 III. DOAC and Mechanical Valves - PROACT Xa Trial of Apixaban With On-X Heart Valve Stopped https://www.medscape.com/viewarticle/981644 - Artivion Follows Recommendation to Stop PROACT Xa Clinical Trial https://investors.artivion.com/news-releases/news-release-details/artivion-follows-recommendation-stop-proact-xa-clinical-trial - PROACT Xa - A Trial to Determine if Participants With an On-X Aortic Valve Can be Maintained Safely on Apixaban https://clinicaltrials.gov/ct2/show/NCT04142658 - Dabigatran versus Warfarin in Patients with Mechanical Heart Valves https://www.nejm.org/doi/full/10.1056/nejmoa1300615 IV. Lipoprotein(a) - Aspirin Primary Prevention Benefit in Those With Raised Lp(a)? https://www.medscape.com/viewarticle/981602 - Aspirin for Primary Prevention of Cardiovascular Events in Relation to Lipoprotein(a) Genotypes https://www.jacc.org/doi/full/10.1016/j.jacc.2022.07.027 - A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women https://www.nejm.org/doi/full/10.1056/nejmoa050613 - Effect of Aspirin on Disability-free Survival in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1800722 - Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1803955 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

In this week’s podcast, John Mandrola, MD, discusses the PROTECTED TAVR trial, renal denervation, left atrial appendage closure and deprescribing aspirin. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Cerebral Embolic Protection After TAVI - Clear Stroke Benefit Eludes Embolic Protection: PROTECTED TAVR https://www.medscape.com/viewarticle/980978 - Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement https://www.nejm.org/doi/10.1056/NEJMoa2204961 - Protection Against Cerebral Embolism During Transcatheter Aortic Valve Replacement https://doi.org/10.1016/j.jacc.2016.10.023 - Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 - Randomised Trial Of Intravenous Streptokinase, Oral Aspirin, Both, Or Neither Among 17 187 Cases Of Suspected Acute Myocardial Infarction: Isis-2 https://doi.org/10.1016/S0140-6736(88)92833-4 II Renal Denervation - Legacy of Neutral Renal Denervation Trial Recast by Long-term Outcomes: SYMPLICITY HTN-3 https://www.medscape.com/viewarticle/981062 - Long-term outcomes after catheter-based renal artery denervation for resistant hypertension: final follow-up of the randomised SYMPLICITY HTN-3 Trial https://doi.org/10.1016/S0140-6736(22)01787-1 - A systematic review, meta-analysis, and meta regression of the sham controlled renal denervation randomized controlled trials https://doi.org/10.1016/j.tcm.2022.05.009 - Legacy of Neutral Renal Denervation Trial Recast by Long-term Outcomes: SYMPLICITY HTN-3 https://www.medscape.com/viewarticle/981062 - A Controlled Trial of Renal Denervation for Resistant Hypertension https://www.nejm.org/doi/10.1056/NEJMoa1402670 III Percutaneous Left Atrial Appendage Occlusion (LAAO) - Amulet, Watchman 2.5 LAAO Outcomes Neck and Neck at 3 Years https://www.medscape.com/viewarticle/981199 - Consider Life Expectancy When Referring for LAA Closure? https://www.medscape.com/viewarticle/981117 - Incidence and Predictors of Early Death in Patients Undergoing Percutaneous Left Atrial Appendage Closure https://www.jacc.org/doi/full/10.1016/j.jacep.2022.06.012 IV Deprescribing Aspirin - Deprescribing Aspirin for Warfarin Patients May Reduce Bleeding https://www.medscape.com/viewarticle/981243 - Assessment of an Intervention to Reduce Aspirin Prescribing for Patients Receiving Warfarin for Anticoagulation https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796492 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The safety of very low LDL-C, the win-ratio analytic method, sacubitril/valsartan, SGLT2 inhibitors, and percutaneous left atrial appendage closure are discussed 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 PCSK9I Evolocumab Benefits Accrue With Longer Follow-up: FOURIER OLE https://www.medscape.com/viewarticle/979950 - Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/nejmoa1615664 - Long-Term Evolocumab in Patients with Established Atherosclerotic Cardiovascular Disease https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061620 II Analytic Methods and Re-Analysis of Old Trials - PARADISE-MI Results Obscured As Post Hoc Analysis Finds Flaws https://www.medscape.com/viewarticle/980776 - Angiotensin Receptor–Neprilysin Inhibition in Acute Myocardial Infarction https://www.nejm.org/doi/10.1056/NEJMoa2104508 - Impact of Sacubitril/Valsartan Versus Ramipril on Total Heart Failure Events in the PARADISE-MI Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057429 - The Year’s Most Important Study Adds to Uncertainty in Science https://www.medscape.com/viewarticle/904286 III SGLT2i Post MI - Early Signal of Benefit for Empagliflozin in Acute MI: EMMY https://www.medscape.com/viewarticle/980180 - Empagliflozin in acute myocardial infarction: the EMMY trial https://doi.org/10.1093/eurheartj/ehac494 IV Percutaneous Left Atrial Appendage Closure - Incidence and Predictors of Early Death in Patients Undergoing Percutaneous Left Atrial Appendage Closure https://www.jacc.org/doi/10.1016/j.jacep.2022.06.012 - Cost‐Effectiveness of Left Atrial Appendage Closure for Stroke Reduction in Atrial Fibrillation: Analysis of Pooled, 5‐Year, Long‐Term Data https://www.ahajournals.org/doi/10.1161/JAHA.118.011577 - Baseline Comorbidities And Bleeding Events Of Patients Undergoing Percutaneous Left Atrial Appendage Occlusion Among Medicare Beneficiaries https://www.jacc.org/doi/10.1016/S0735-1097%2822%2901158-5 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

A potential new anticoagulant, surveillance stress testing, a trial misinterpretation, an old diuretic, and AI in cardiology 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. Factor XI inhibitors - Factor XIa Inhibitor After MI, Stroke Encouraging in Early Phase 2 Studies https://www.medscape.com/viewarticle/979942 - AXIOMATIC-SSP: Cautious Optimism on Factor XI Inhibitor in Stroke https://www.medscape.com/viewarticle/979860 II. Surveillance Stress Testing - No Benefit of Routine Stress Test POST-PCI in High-Risk Patients https://www.medscape.com/viewarticle/979866 - Routine Functional Testing or Standard Care in High-Risk Patients after PCI https://www.nejm.org/doi/full/10.1056/NEJMoa2208335 III. New Diuretic for Acute Heart Failure - Vintage Drug Atop IV Loop Diuretics Boosts Decongestion in ADHF: ADVOR https://www.medscape.com/viewarticle/979851 - Acetazolamide in Acute Decompensated Heart Failure with Volume Overload https://www.nejm.org/doi/full/10.1056/NEJMoa2203094 IV. AI in Cardiology - In Blinded Trial, Artificial Intelligence Beats Sonographers for Echo Accuracy https://www.medscape.com/viewarticle/979857 - Video-based AI for beat-to-beat assessment of cardiac function https://www.nature.com/articles/s41586-020-2145-8 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

A second ESC review covering REVIVED, the DANCAVAS CV screening trial, DELIVER on dapagliflozin in HF with mildly reduced EF, and the INVICTUS trial of rivaroxaban in rheumatic heart disease. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I REVIVED BCIS - PCI Fails to Beat OMT in Ischemic Cardiomyopathy: REVIVED-BCIS2 https://www.medscape.com/viewarticle/979853 - Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 - Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction https://www.nejm.org/doi/full/10.1056/nejmoa1100356 II DANCAVAS - DANCAVAS Misses Primary Endpoint but Hints at Benefit from Comprehensive CV Screening https://www.medscape.com/viewarticle/979854 - Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 - Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 III DELIVER Trial - Dapagliflozin's HFpEF Benefit Recasts Heart Failure Treatment: DELIVER https://www.medscape.com/viewarticle/979855 - Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 - SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials https://doi.org/10.1016/S0140-6736(22)01429-5 IV Rheumatic Heart Disease - Rivaroxaban Outmatched by VKAs for AF in Rheumatic Heart Disease https://www.medscape.com/viewarticle/979861 - Rivaroxaban in Rheumatic Heart Disease–Associated Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2209051 - Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve https://www.nejm.org/doi/full/10.1056/NEJMoa2029603 - Outcomes of Direct Oral Anticoagulants in Patients With Mitral Stenosis https://www.jacc.org/doi/full/10.1016/j.jacc.2018.12.047 Features: - Do SGLT2 Inhibitors DELIVER in All Patients With Heart Failure? https://www.medscape.com/viewarticle/979852 - PCI Fails in Stable Disease Again: REVIVED-BCIS https://www.medscape.com/viewarticle/979862 - DANCAVAS: Might Cardiovascular Screening Extend Men's Lives? https://www.medscape.com/viewarticle/979632 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Early rhythm control in AF, treating coronary artery disease before transcatheter aortic valve implantation, and an ESC 2022 preview 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: https://www.medscape.com/twic I. Early Rhythm Control - Early AF Rhythm-Control Advantage Climbs With Comorbidity Burden: EAST-AFNET4 https://www.medscape.com/viewarticle/979627 - Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.122.060274 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 II. CAD and Aortic Stenosis - No Survival Gains Seen From Pre-TAVR PCI of Complex CAD https://www.medscape.com/viewarticle/979408 - The Effect of Coronary Lesion Complexity and Preprocedural Revascularization on 5-Year Outcomes After TAVR https://doi.org/10.1016/j.jcin.2022.06.019 - Transcatheter Aortic Valve Implantation With or Without Percutaneous Coronary Artery Revascularization Strategy: A Systematic Review and Meta‐Analysis https://www.ahajournals.org/doi/10.1161/JAHA.117.005960 - ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic Valve implantaTION): A Randomized Clinical Trial https://www.jacc.org/doi/full/10.1016/j.jcin.2021.06.041 III. ESC Trials - Mandrola Previews His Top 5 Trials From ESC 2022 https://www.medscape.com/viewarticle/979560 TIME - Bedtime dosing of antihypertensive medications: systematic review and consensus statement: International Society of Hypertension position paper endorsed by World Hypertension League and European Society of Hypertension https://pubmed.ncbi.nlm.nih.gov/35983870/ - Empirical Evaluation of Very Large Treatment Effects of Medical Interventions https://jamanetwork.com/journals/jama/fullarticle/1386610 SECURE - Polypill Strategy in Secondary Cardiovascular Prevention http://www.nejm.org/doi/full/10.1056/NEJMoa2208275 CAPLA - Catheter ablation for persistent atrial fibrillation: A multicenter randomized trial of pulmonary vein isolation (PVI) versus PVI with posterior left atrial wall isolation (PWI) - The CAPLA study http://www.sciencedirect.com/science/article/pii/S0002870321002453?via%3Dihub IV. ESC Preview - Barcelona Beckons for First Hybrid ESC Congress https://www.medscape.com/viewarticle/979477 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The obesity paradox in AF and paradoxes in general, digital health gets whacked again, and direct-to-consumer ads are the topics discussed by John Mandrola, MD 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. Collider Bias and the Obesity Paradox - 'Obesity Paradox' in Atrial Fibrillation Challenged as Mortality Climbs With BMI https://www.medscape.com/viewarticle/979150 - Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF https://openheart.bmj.com/content/9/2/e002038 - Collider bias https://catalogofbias.org/biases/collider-bias/ - Pediatric obesity appears to lower the risk of diabetes if selection bias is ignored https://pubmed.ncbi.nlm.nih.gov/29374028/ - Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2480484 II. Digital Health - Blood Pressure Smartphone App Fails to Beat Standard Self-Monitoring https://www.medscape.com/viewarticle/979341 - Effectiveness of Standard vs Enhanced Self-measurement of Blood Pressure Paired With a Connected Smartphone Application https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794971 III. Direct-to-Consumer Ads - Does DTC Heart Drug Advertising Discourage Lifestyle Changes? https://www.medscape.com/viewarticle/979404 - Association of Direct-to-Consumer Advertising of Prescription Drugs With Consumer Health-Related Intentions and Beliefs Among Individuals at Risk of Cardiovascular Disease https://jamanetwork.com/journals/jama-health-forum/fullarticle/2794995 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF screening; sodium, potassium, BP, and CV outcomes; drug prices; and cardio-respiratory fitness 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: https://www.medscape.com/twic I. AF Screening - Using Wearable Devices to Detect AF Is 'Cost Effective' https://www.medscape.com/viewarticle/978861 - Cost-effectiveness of Screening for Atrial Fibrillation Using Wearable Devices https://jamanetwork.com/journals/jama-health-forum/fullarticle/2794835 - Screening for Atrial Fibrillation in Asymptomatic Older Adults https://www.nejm.org/doi/full/10.1056/NEJMclde2203726 II. Salt Substitutes - More Evidence Salt Substitutes Lower Risk of CVD and Death https://www.medscape.com/viewarticle/978999 - Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis https://heart.bmj.com/content/early/2022/07/21/heartjnl-2022-321332 - Effect of Salt Substitution on Cardiovascular Events and Death https://www.nejm.org/doi/10.1056/NEJMoa2105675 - Settling the controversy of salt substitutes and stroke: sodium reduction or potassium increase? https://doi.org/10.1093/eurheartj/ehac160 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention https://www.nejm.org/doi/full/10.1056/nejmoa0807611 III. Drug Prices - House Could Soon Give Biden Win on Medicare Drug Negotiations, Insulin Costs https://www.medscape.com/viewarticle/978988 IV. Fitness is Under-rated - Cardiorespiratory Fitness Key to Longevity for All? https://www.medscape.com/viewarticle/978854 - Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex https://www.jacc.org/doi/full/10.1016/j.jacc.2022.05.031 - Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation https://doi.org/10.1016/j.ijcha.2022.101083 You also may like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Hyperkalemia in heart failure, CV health in America, primary prevention ICDs, and a debate about posters at medical meetings are the topics discussed by John Mandrola, MD 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. Hyperkalemia in Heart Failure - DIAMOND: Adding Patiromer Helps Optimize HF Meds, Foils Hyperkalemia https://www.medscape.com/viewarticle/971616 - Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial https://doi.org/10.1093/eurheartj/ehac401 - Potassium Binders for Patients With Heart Failure? The Real Enlightenment of the DIAMOND Trial https://doi.org/10.1093/eurheartj/ehac399 - The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure https://www.nejm.org/doi/full/10.1056/nejm199909023411001 - Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms https://www.nejm.org/doi/full/10.1056/nejmoa1009492 - Evaluation of the efficacy and safety of RLY5016, a polymeric potassium binder, in a double-blind, placebo-controlled study in patients with chronic heart failure (the PEARL-HF) trial https://pubmed.ncbi.nlm.nih.gov/21208974/ II. CV Health in America - ‘Staggering’ CVD Rise Projected in US, Especially in Minorities https://www.medscape.com/viewarticle/978366 - Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates https://www.jacc.org/doi/10.1016/j.jacc.2022.05.033 III. Primary Prevention ICDs in Modern Era - Do ICDs Still ‘Work’ in Primary Prevention Given Today’s Recommended HF Meds? https://www.medscape.com/viewarticle/978254 - Guideline-Directed Medical Therapy and the Risk of Death in Primary Prevention Defibrillator Recipients https://doi.org/10.1016/j.jacep.2022.05.001 - Declining Risk of Sudden Death in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 - Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 IV. Medical Meetings and Posters - As Digital Posters Take Over, Traditionalists Push Back https://www.medscape.com/viewarticle/978384 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

A big new HF and EP trial, doctors and probability, LV assist devices in cardiogenic shock, vitamin D, and exercise in PAD 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. Left vs Left RCT Taking Cardiac Pacing From Boring to Super-Cool https://www.medscape.com/viewarticle/973615 Conduction-System Pacing Shines vs BiV Pacing for CRT in Early Studies https://www.medscape.com/viewarticle/974173 • Baylor led research awarded $31 Million for Resynchronization Therapy in Patients with Heart Failure https://www.bcm.edu/news/baylor-led-research-awarded-31-million-for-resynchronization-therapy-in-patients-with-heart-failure II. Probability and Conjunction Fallacy Is What You Call Probable...Impossible? https://www.medscape.com/viewarticle/976451 • Analysis of Physicians’ Probability Estimates of a Medical Outcome Based on a Sequence of Events https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793624 III. LV Assist Devices Impella Pump for MI With Cardiogenic Shock Again Fares Poorly vs IABP in Study https://www.medscape.com/viewarticle/977994 • Clinical Outcomes and Cost Associated With an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump in Patients Presenting With Acute Myocardial Infarction Complicated by Cardiogenic Shock https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2794390 • Intravascular Microaxial Left Ventricular Assist Device for Acute Myocardial Infarction With Cardiogenic Shock—A Call for Evidence of Benefit https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794394 • Intra-aortic Balloon Pump Therapy for Acute Myocardial InfarctionA Meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2210888 IV. Vitamin D Vitamin D Supplements Do Not Lower Risk of Fractures https://www.medscape.com/viewarticle/978108 Why Is Vitamin D Hype So Impervious to Evidence? https://www.medscape.com/viewarticle/968682 • Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults https://www.nejm.org/doi/full/10.1056/NEJMoa2202106 V. Peripheral Artery Disease For Patients With Peripheral Artery Disease, Pain Can Be Gain https://www.medscape.com/viewarticle/978053 • Effects of Walking Exercise at a Pace With Versus Without Ischemic Leg Symptoms on Functional Performance Measures in People With Lower Extremity Peripheral Artery Disease: The LITE Randomized Clinical Trial https://www.ahajournals.org/doi/10.1161/JAHA.121.025063 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact mailto:[email protected]

Therapeutic fashion and conduction system pacing, early rhythm control in AF, statins in CKD, and salt intake in HF are the topics discussed by John Mandrola, MD, 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 – Therapeutic Fashion and Conduction System Pacing - Medical Necessity vs Therapeutic Fashion: How Evidence-Based Is Your Field of Medicine? https://www.medscape.com/viewarticle/977358 - Conduction System Pacing Noninferior to Biventricular Pacing for HF With Wide QRS https://www.medscape.com/viewarticle/971740 - His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure https://www.jacc.org/doi/full/10.1016/j.jacc.2019.04.026 II – Early Rhythm Control - Benefit of Early Rhythm Control Questioned in Newly Diagnosed Atrial Fibrillation https://www.medscape.com/viewarticle/977584 - Presenting Pattern of Atrial Fibrillation and Outcomes of Early Rhythm Control Therapy https://doi.org/10.1016/j.jacc.2022.04.058 - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 III – Statins and CKD - Rosuvastatin Again Linked With Risks to Kidneys https://www.medscape.com/viewarticle/977646 - Association of Rosuvastatin Use with Risk of Hematuria and Proteinuria https://doi.org/10.1681/ASN.2022020135 - Atorvastatin in Patients with Type 2 Diabetes Mellitus Undergoing Hemodialysis https://www.nejm.org/doi/10.1056/NEJMoa043545 - Rosuvastatin and Cardiovascular Events in Patients Undergoing Hemodialysis https://www.nejm.org/doi/full/10.1056/nejmoa0810177 IV – Sodium and HF - Overly Tight Sodium Restriction May Worsen HFpEF Outcomes https://www.medscape.com/viewarticle/977441 - Salt restriction and risk of adverse outcomes in heart failure with preserved ejection fraction https://heart.bmj.com/content/early/2022/06/07/heartjnl-2022-321167 - Spironolactone for Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/nejmoa1313731 - Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The LIFE study, multimorbidity and evidence translation, cardiac arrest and therapeutic fashion, diabetes and cardiology, and EP cuts are the topics John Mandrola, MD, tackles 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 – LIFE Study and Substudy - LIFE: ARNI Does Not Best Valsartan in Advanced Heart Failure https://www.medscape.com/viewarticle/952681 - Tolerability of Sacubitril/Valsartan in Patients With Advanced Heart Failure: Analysis of the LIFE Trial Run-In https://www.jacc.org/doi/10.1016/j.jchf.2022.04.013 - Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection FractionA Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2785700 II – Early Angiography and Therapeutic Fashion - Emergency Angiography for Cardiac Arrest Without ST Elevation? https://www.medscape.com/viewarticle/975434 - Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac ArrestResults of the Randomized, Multicentric EMERGE Trial https://jamanetwork.com/journals/jamacardiology/article-abstract/2793310 - Immediate Coronary Angiography in Survivors of Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJM199706053362302 - Coronary Angiography after Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa1816897 - Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049569 - Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa2101909 - Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis https://www.jclinepi.com/article/S0895-4356(22)00100-7/fulltext III – Diabetes and Cardiology - Medicare Advantage Tied to Less Use of Pricey Diabetes Drugs https://www.medscape.com/viewarticle/977181 - Diabetes Care Among Older Adults Enrolled in Medicare Advantage Versus Traditional Medicare Fee-For-Service Plans: The Diabetes Collaborative Registry https://doi.org/10.2337/dc21-1178 IV – EP Cuts - EP Ablation Rate Changes in 2022 Physician Fee Schedule https://www.acc.org/Latest-in-Cardiology/Articles/2021/11/18/01/44/EP-Ablation-Rate-Changes-in-2022-Physician-Fee-Schedule You also may like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

On this week’s podcast, John Mandrola, MD discusses fish oil, America’s heart health, pharmacists and prescribing and statins This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - Fish Oil - New Biomarker Data Add to Concerns Over REDUCE-IT Trial https://www.medscape.com/viewarticle/976490 - Effects of Randomized Treatment With Icosapent Ethyl and a Mineral Oil Comparator on Interleukin-1β, Interleukin-6, C-Reactive Protein, Oxidized Low-Density Lipoprotein Cholesterol, Homocysteine, Lipoprotein(a), and Lipoprotein-Associated Phospholipase A2: A REDUCE-IT Biomarker Substudy https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059410 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular RiskThe STRENGTH Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2773120 - Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: final results of the EVAPORATE trial https://academic.oup.com/eurheartj/article/41/40/3925/5898836 II - US Heart Health - New AHA Checklist: Only 1 in 5 Adults Have Optimal Heart Health https://www.medscape.com/viewarticle/976519 - Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association https://www.ahajournals.org/doi/10.1161/CIR.0000000000001078 - Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates from the National Health and Nutrition Examination Survey (NHANES), 2013-2018 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.060911 III - Pharmacist Prescribing - Paxlovid Is Here: A Pharmacist's Prescribing Pearls https://www.medscape.com/viewarticle/973260 - Coronavirus (COVID-19) Update: FDA Authorizes Pharmacists to Prescribe Paxlovid with Certain Limitations https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-pharmacists-prescribe-paxlovid-certain-limitations IV - Statin Eligibility - New European Guidelines ‘Drastically’ Reduce Statin Eligibility https://www.medscape.com/viewarticle/976715 - Statin Eligibility for Primary Prevention of Cardiovascular Disease According to 2021 European Prevention Guidelines Compared With Other International Guidelines https://jamanetwork.com/journals/jamacardiology/article-abstract/2793729 - Time to Revisit Using 10-Year Risk to Guide Statin Therapy https://jamanetwork.com/journals/jamacardiology/article-abstract/2793732 - Mendelian randomization studies: using naturally randomized genetic data to fill evidence gaps https://doi.org/10.1097/mol.0000000000000247 You May Also Like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

A non-significant but wonderful trial in AF, smoking and HF, vitamins, and pre-op risk screening are the topics discussed by John Mandrola, MD, 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 – DECAAF II Trial DECAAF II: AF, Fibrosis Ablation Technique Falls Short, but Signs of Hope https://www.medscape.com/viewarticle/957469 • Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation https://jamanetwork.com/journals/jama/article-abstract/2793452 • Association of Atrial Tissue Fibrosis Identified by Delayed Enhancement MRI and Atrial Fibrillation Catheter Ablation https://jamanetwork.com/journals/jama/fullarticle/1820433 II – Smoking and HF Cigarettes Linked to HF With Preserved or Reduced EF https://www.medscape.com/viewarticle/976066?src= • Cigarette Smoking, Cessation, and Risk of Heart Failure With Preserved and Reduced Ejection Fraction https://www.jacc.org/doi/full/10.1016/j.jacc.2022.03.377 III – Vitamins Evidence Still Lacking That Vitamins Prevent CVD, Cancer: USPSTF https://www.medscape.com/viewarticle/975965 • Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2793446 IV – Pre-Op Risk Add Atrial Fibrillation to Pre-Noncardiac Surgery Risk Evaluation: New Support https://www.medscape.com/viewarticle/975926 • Preoperative Atrial Fibrillation and Cardiovascular Outcomes After Noncardiac Surgery https://doi.org/10.1016/j.jacc.2022.04.021 • Patterns and Determinants of Low-Value Preoperative Testing in Michigan https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2779744 • Coronary-Artery Revascularization before Elective Major Vascular Surgery https://www.nejm.org/doi/full/10.1056/nejmoa041905 • Stress testing before abdominal aortic aneurysm repair does not lead to a reduction in perioperative cardiac events https://doi.org/10.1016/j.jvs.2021.02.032 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Statin Intolerance, external validity of trials, contrast shortage, and expansion of cardiology into diabetes and nephrology 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 - Statin Intolerance - New National Lipid Association Statement on Statin Intolerance https://www.medscape.com/viewarticle/975674 - What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. https://academic.oup.com/eurjpc/article/21/4/464/5926070 - Unblinded and Blinded N-of-1 Trials Versus Usual Care: A Randomized Controlled Trial to Increase Statin Uptake in Primary Care. https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.120.007793 - Role of Blinding in N-of-1 Trials https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.122.008914 - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 II - External Validity - Is Paxlovid, the Covid Pill, Reaching Those Who Most Need It? The Government Won't Say https://www.medscape.com/viewarticle/973906 - Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2118542 - PFE Press Release on EPIC SR https://www.pfizer.com/news/press-release/press-release-detail/pfizer-reports-additional-data-paxlovidtm-supporting III - Contrast Shortage - Global Contrast Media Shortage Blamed on COVID Lockdown in China https://www.medscape.com/viewarticle/973810 IV - Cardiology Expands - Experts Elevate New Drugs for Diabetic Kidney Disease https://www.medscape.com/viewarticle/975724 - SGLT2 Inhibitors Cut AFib Risk in Real-Word Analysis https://www.medscape.com/viewarticle/975542 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 - Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/nejmoa2110956 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

More ISCHEMIA controversy, health Insurance and CV outcomes, testosterone, and flawed observational studies are the topics discussed by John Mandrola, MD 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 – More Ischemia Controversy - Data Concerns Mount Despite ISCHEMIA Substudy Correction https://www.medscape.com/viewarticle/974974 - ISCHEMIA Substudy Data Just Don't Add Up, Cardiac Surgeons Say https://www.medscape.com/viewarticle/974107 - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 - Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049755 - Link to Bakaeen and Sabik Second letter (agree to terms to download the letter): https://protect-us.mimecast.com/s/nfDdCwp5G6HLjLO9GHV9Cnm?domain=wetransfer.com II – Health Insurance and CV outcomes - Medicaid Expansion: Good First Step, but No Panacea for CV Care https://www.medscape.com/viewarticle/975141 - Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120 - Rand Link https://www.rand.org/pubs/reports/R3055.html - The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/ - Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576 III – Testosterone - Jury Still Out on Cardiovascular Safety of Testosterone https://www.medscape.com/viewarticle/975273 - Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis https://doi.org/10.1016/S2666-7568(22)00096-4 - Adverse events associated with testosterone administration. https://www.nejm.org/doi/full/10.1056/NEJMoa1000485 IV – Voting and Mortality - Blue Counties Enjoy Dramatic Mortality Edge https://www.medscape.com/viewarticle/975217 - Political environment and mortality rates in the United States, 2001-19: population based cross sectional analysis https://www.bmj.com/content/377/bmj-2021-069308 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Devices for HF, Twitter for disseminating science, HDL levels, and dubious post-hoc studies 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 – Interatrial Shunts for HF - Interatrial Shunt in HF Hints at Heart Structural, Functional Benefits https://www.medscape.com/viewarticle/974776 - Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00016-2 - Reducing Lung CongestIon Symptoms in Advanced Heart Failure (RELIEVE-HF) https://clinicaltrials.gov/ct2/show/NCT03499236 II – Twitter for Science Communication - Twitter Promotion Boosts Visibility, Citation for CV Research https://www.medscape.com/viewarticle/974653 - Twitter promotion is associated with higher citation rates of cardiovascular articles: the ESC Journals Randomized Study https://doi.org/10.1093/eurheartj/ehac150 - A Randomized Trial of Social Media From Circulation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.013509 III – HDL Level - Very High HDL-C: Too Much of a Good Thing? https://www.medscape.com/viewarticle/974651 - Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations https://jamanetwork.com/journals/jamacardiology/article-abstract/2792282 - Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889017/ IV – Dubious Sub-Studies: Omecamtiv Mecarbil - Myosin Inhibitor May Benefit Data-Deprived Patients With Heart Failure and Low Blood Pressure https://www.medscape.com/viewarticle/974960 - Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2025797 - METEORIC-HF: Omecamtiv Mecarbil Does Not Improve Exercise Capacity in HFrEF Patients https://www.acc.org/Latest-in-Cardiology/Articles/2022/04/02/13/22/Sun-945am-METEORIC-HF-acc-2022 - Effects of Omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac293/6590348 You might also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Ischemia vs anatomic testing for CAD, UK-TAVI trial, TAVI for AR? and post-PCI anti-thrombotics 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 – Ischemic vs Anatomic Evaluation for CAD - ISCHEMIA Substudy Data Just Don't Add Up, Cardiac Surgeons Say https://www.medscape.com/viewarticle/974107 - Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.049755 - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 - Forget Ischemia: It’s All About the Plaque https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054102 - Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.743963 - Baseline stress myocardial perfusion imaging results and outcomes in patients with stable ischemic heart disease randomized to optimal medical therapy with or without percutaneous coronary intervention https://doi.org/10.1016/j.ahj.2012.05.018 - Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease https://www.nejm.org/doi/full/10.1056/nejmoa1415516 - Coronary CT Angiography and 5-Year Risk of Myocardial Infarction https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 - Five Reasons I Don't Believe an Imaging Test Improves Outcomes https://www.medscape.com/viewarticle/901204 II – UK-TAVI Trial - UK TAVI: Similar Outcomes to Surgery in Real World https://www.medscape.com/viewarticle/927729 - Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis https://jamanetwork.com/journals/jama/fullarticle/2792251 III – TAVI for AI? - JenaValve Trilogy Takes Another Step Forward in Severe AR https://www.medscape.com/viewarticle/974304 IV – Post PCI DAPT - One-Month DAPT Enough for Complex PCI if Bleeding Risk High https://www.medscape.com/viewarticle/974224 - Duration of Antiplatelet Therapy After Complex Percutaneous Coronary Intervention In Patients at High Bleeding Risk: a MASTER DAPT trial sub-analysis https://doi.org/10.1093/eurheartj/ehac284 - Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2108749 Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Obstructive hypertrophic cardiomyopathy and mavacamten, SGLT2 inhibitors, the triple whammy, espresso, and clinician burnout are the topics John Mandrola, MD, covers 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 – Mavacamten - FDA Clears Mavacamten (Camzyos) for Obstructive Hypertrophic Cardiomyopathy https://www.medscape.com/viewarticle/972945 - Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(20)31792-X - FDA approves new drug to improve heart function in adults with rare heart condition https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-new-drug-improve-heart-function-adults-rare-heart-condition II – Dapagliflozin in HFpEF - Positive Topline Results for Dapagliflozin in HFpEF: DELIVER https://www.medscape.com/viewarticle/973490 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 III – Triple Whammy for AKI - Mixing BP Meds With NSAID May Be 'Triple Whammy' for Kidneys https://www.medscape.com/viewarticle/973885 IV – Espresso - Espresso Coffee Associated With Increased Total Cholesterol https://www.medscape.com/viewarticle/973819 - Association between espresso coffee and serum total cholesterol: the Tromsø Study 2015–2016 https://openheart.bmj.com/content/9/1/e001946 - Is everything we eat associated with cancer? A systematic cookbook review https://pubmed.ncbi.nlm.nih.gov/23193004/ - Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 V – Clinician Burnout - Administrative Hassle Hacks: Strategies to Curb Physician Stress https://www.medscape.com/viewarticle/973597 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

HRS meeting presentations: conduction system pacing, AF in the ED, a possible new treatment for vagal bradycardia, and women in EP 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 – HRS Comments II – Conduction System Pacing Conduction System Disease Recast as Preventive Therapy Target https://www.medscape.com/viewarticle/973488 • Rescue Left Bundle Branch Area Pacing in Coronary Venous Lead Failure or Non-response to Biventricular Pacing: Results From International LBBAP Collaborative Study Group https://doi.org/10.1016/j.hrthm.2022.04.024 • Clinical Outcomes Of Conduction System Pacing Compared To Biventricular Pacing In Patients Requiring Cardiac Resynchronization Therapy https://doi.org/10.1016/j.hrthm.2022.04.023 III – Emergency Triage of AF Early Arrhythmia-Specialist Consult, Ordered in the ER, a Boon to AF Outcomes: ER2EP Study https://www.medscape.com/viewarticle/973250 • ClinicalTrials.gov Reference https://clinicaltrials.gov/ct2/show/NCT04476524 • George Bernard Shaw Reference: https://jamanetwork.com/journals/jama/fullarticle/2623628 IV – Cardioneural Ablation Can Ablation Abolish Vasovagal Syncope? Early Series Promising https://www.medscape.com/viewarticle/973346 V – Women in EP Why Are Numbers of Women, Minorities So Low in Cardiac EP? https://www.medscape.com/viewarticle/972968 • Temporal and geographical trends in women operators of electrophysiology procedures in the United States https://doi.org/10.1016/j.hrthm.2022.02.015 • Quantification of Female and Underrepresented Minority Applicants to Clinical Cardiac Electrophysiology Fellowship https://www.jacc.org/doi/full/10.1016/j.jacep.2022.04.001 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Aspirin for primary prevention, time-restricted feeding, renal denervation, and a potential new obesity drug 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: https://www.medscape.com/twic I – ASA for Primary Prevention: - USPSTF Final Recommendation on Aspirin for Primary CV Prevention https://www.medscape.com/viewarticle/972761 - Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2791399 - Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/10.1056/NEJMoa1805819 - Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1803955 II – Time Restricted Feeding - Is There a Benefit to Fasting Plus Calorie Counting? https://www.medscape.com/viewarticle/972579 - Calorie Restriction with or without Time-Restricted Eating in Weight Loss https://www.nejm.org/doi/full/10.1056/NEJMoa2114833 - Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity. The TREAT Randomized Clinical Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 III – Renal Denervation - Renal Denervation BP Benefits Remain at 3 Years: SPYRAL HTN-ON https://www.medscape.com/viewarticle/971883 - Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00455-X IV – Tirzepatide for Obesity - Tirzepatide Excites in Obesity Now Too, Says Lilly https://www.medscape.com/viewarticle/972936 - Lilly's tirzepatide delivered up to 22.5% weight loss in adults with obesity or overweight in SURMOUNT-1 https://www.prnewswire.com/news-releases/lillys-tirzepatide-delivered-up-to-22-5-weight-loss-in-adults-with-obesity-or-overweight-in-surmount-1--301534871.html You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Critiques of last week’s comments on VT ablation and a review of EHRA presentations, including new ways to ablate atrial myocardium and pace the ventricle, are discussed by John Mandrola, MD, 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 – VT ablation - VT Ablation After First ICD Shock Boosts Survival: PARTITA https://www.medscape.com/viewarticle/971969 - Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598 - Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050 - Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 II – Pulsed-Field Ablation - Pulsed Field Ablation Treats AF With Few Complications https://www.medscape.com/viewarticle/972147 - Pulsed Field Ablation for Persistent Atrial Fibrillation (PersAFOne): Hope or Hype? https://www.jacc.org/doi/10.1016/j.jacc.2020.07.032 III – High-Power Short Duration Ablation - Short, High-Power Ablation on Par With Standard AF Ablation https://www.medscape.com/viewarticle/972087 IV – LBB-Area Pacing - MELOS: LBB Area Pacing Promising for Bradyarrhythmias, HF https://www.medscape.com/viewarticle/972270 Also of interest... - Conduction System Pacing Noninferior to Biventricular Pacing for HF With Wide QRS https://www.medscape.com/viewarticle/971740 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ACC Recap, Part 2: VT ablation, HF care, three-vessel disease, and patiromer 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: https://www.medscape.com/twic I – VT ablation VT Ablation After First ICD Shock Boosts Survival: PARTITA https://www.medscape.com/viewarticle/971969 • Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598 • Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050 • Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 II – HF Care Alerts Improve Prescribing of HF Quadruple Therapy: PROMPT-HF https://www.medscape.com/viewarticle/972079 • Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice: A Cluster Randomized Trial https://www.jacc.org/doi/10.1016/j.jacc.2022.03.338 • Reassessing Quality Assessment — The Flawed System for Fixing a Flawed System https://www.nejm.org/doi/full/10.1056/NEJMms2200976 III – Three-Vessel Disease FAME 3 Subanalysis Adds Twist to Negative Primary Results https://www.medscape.com/viewarticle/971495 • Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery https://www.nejm.org/doi/10.1056/NEJMoa2112299 • Quality of Life After Fractional Flow Reserve-Guided PCI Compared with Coronary Bypass Surgery https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.060049 IV – Treating Drug Side Effects with More Drugs DIAMOND: Adding Patiromer Helps Optimize HF Meds, Foils Hyperkalemia https://www.medscape.com/viewarticle/971616 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ACC Recap: John Mandrola, MD, provides part 1 of an ACC recap 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 – HTN in Pregnancy - Hypertension Control During Pregnancy Validated in Large Trial https://www.medscape.com/viewarticle/971486 - Treatment for Mild Chronic Hypertension during Pregnancy https://www.nejm.org/doi/full/10.1056/NEJMoa2201295 II – Prevention of Bleeding in Non-Cardiac Surgery - POISE-3 Backs Wider Use of Tranexamic Acid in Noncardiac Surgery https://www.medscape.com/viewarticle/971483 - Tranexamic Acid in Patients Undergoing Noncardiac Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa2201171 III – HCM - VALOR-HCM: Novel Drug May Delay, Avert Invasive Therapy in OHCM https://www.medscape.com/viewarticle/971484 IV – Left Atrial Appendage Occlusion - Small Leaks After LAAO Linked to Thromboembolism, Bleeding https://www.medscape.com/viewarticle/971709 V – Low Sodium Diet for HF - Low-Sodium Diet Did Not Cut Clinical Events in Heart Failure Trial https://www.medscape.com/viewarticle/971482 - Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5 VI – Flu Vaccine and Heart Failure - Flu Vaccines Cut Seasonal Death in Patients With Heart Failure https://www.medscape.com/viewarticle/971619 VII – New Anticoagulant? - Less Bleeding With Factor XI Inhibitor Anticoagulant? PACIFIC-AF https://www.medscape.com/viewarticle/971702 Features: - Sodium Restriction in Heart Failure: Another Dogma Felled by Randomization https://www.medscape.com/viewarticle/971697 - Percutaneous Left Atrial Appendage Occlusion: ACC Data Challenge Promise vs Reality https://www.medscape.com/viewarticle/971512 - Mavacamten in Hypertrophic Cardiomyopathy: Reasons for Both Optimism and Caution https://www.medscape.com/viewarticle/971485 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

Coronary CTA, semaglutide, coronary artery calcium, exercise, and an ACC and EHRA preview are the topics discussed by John Mandrola, MD, 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 – Coronary CTA Feedback - Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients With Suspected Coronary Artery Disease https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 II – Semaglutide - FDA Okays Semaglutide Higher Dose, 2 mg/Week, for Type 2 Diabetes https://www.medscape.com/viewarticle/971156 - Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial https://doi.org/10.1016/S2213-8587(21)00174-1 - Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa1607141 - Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 III – CAC and SCD - Calcium Scores Predict Sudden-Death Risk in Preclinical CAD in Large Cohort Study https://www.medscape.com/viewarticle/971056 - Coronary Artery Calcium for Risk Stratification of Sudden Cardiac Death: The Coronary Artery Calcium Consortium https://www.jacc.org/doi/10.1016/j.jcmg.2022.02.011 IV – Exercise and COVID-19 - More Exercise Linked to Lower Chance of Severe COVID-19: Study https://www.medscape.com/viewarticle/949468 - Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes http://dx.doi.org/10.1136/bjsports-2021-105159 V – ACC Preview - Hybrid ACC.22 Resurrects the Live Scientific Session https://www.medscape.com/viewarticle/971083 - Mandrola Previews the 2022 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/971084 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF ablation vs rate control in HF, TAVI vs SAVR, atherosclerosis, and surrogate endpoints in observational studies 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 – AF ablation vs Rate Control RAFT-AF, Despite Itself, Hints at Advantage for Ablation Rhythm Control in Heart Failure With AF https://www.medscape.com/viewarticle/951326 • Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in Patients with Heart Failure and Atrial Fibrillation: Results from the RAFT-AF trial https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.057095 • Catheter Ablation for Atrial Fibrillation with Heart Failure https://www.nejm.org/doi/full/10.1056/nejmoa1707855 • Lenient versus Strict Rate Control in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1001337 II – TAVI vs SAVR Surgery Groups Push Back on VARC-3 Valve Trial Definitions https://www.medscape.com/viewarticle/970753 • Joint Surgical Associations (EACTS, LACES, ASCVTS, AATS, and STS) Position Statement Regarding the VARC-3 Definitions for Aortic Valve Clinical Research https://doi.org/10.1093/ejcts/ezac110 III – Atherosclerosis Medical Management Best for Atherosclerotic Stroke: New AAN Guidance https://www.medscape.com/viewarticle/970886 • Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory https://n.neurology.org/content/98/12/486 IV – ECHO parameters with Rhythm Control Global Gains in Heart Function From Early AF Rhythm Control https://www.medscape.com/viewarticle/970329 • Restoring Sinus Rhythm Reverses Cardiac Remodeling and Reduces Valvular Regurgitation in Patients With Atrial Fibrillation https://doi.org/10.1016/j.jacc.2021.12.029 • Effects of Atrial Fibrillation and Sinus Rhythm on Cardiac Remodeling and Valvular Regurgitation https://doi.org/10.1016/j.jacc.2021.12.028 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF screening, CTA, stroke prevention and broken observational studies, and medical writing 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 - AF Screening - Handheld ECGs Ease A-Fib Screening in the Very Elderly https://www.medscape.com/viewarticle/969846 - Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: the VITAL-AF Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057014 II - CTA - DISCHARGE: CTA Shows Safety Edge vs Cath in Intermediate-Risk Stable Chest Pain https://www.medscape.com/viewarticle/969732 - CT or Invasive Coronary Angiography in Stable Chest Pain https://www.nejm.org/doi/full/10.1056/NEJMoa2200963 III - Stroke Prevention post TAVI - Silver Lining Emerges for Embolic Protection in Post-TAVR Stroke https://www.medscape.com/viewarticle/969992 - Cerebral Embolic Protection and Stroke-Related Mortality Following Transcatheter Aortic Valve Replacement https://www.jacc.org/doi/full/10.1016/j.jcin.2022.01.007 - Safety and efficacy of cerebral protection devices in transcatheter aortic valve replacement: A clinical end-points meta-analysis https://pubmed.ncbi.nlm.nih.gov/29550047/ - Cerebral Embolic Protection and Outcomes of Transcatheter Aortic Valve Replacement: Results From the Transcatheter Valve Therapy Registry https://pubmed.ncbi.nlm.nih.gov/33619968/ IV - Medical Writing - Writing Program Asks Physicians to Explore Their Experiences https://www.medscape.com/viewarticle/969973 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

An update to CardioMEMs post, ARBs and cancer, troponins, empagliflozin, and low-value care are the topics discussed by John Mandrola, MD, 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 – Invasive Monitoring for HF - FDA Expands Eligibility for CardioMEMS Heart Failure System https://www.medscape.com/viewarticle/969004 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 II – ARBs and Cancer - ARBs and Cancer Risk: New Meta-Analysis Raises Questions Again https://www.medscape.com/viewarticle/969510 - Risk of cancer with angiotensin-receptor blockers increases with increasing cumulative exposure: Meta-regression analysis of randomized trials https://doi.org/10.1371/journal.pone.0263461 - Marciniak Meta-analysis in FDA Medical Review 206316Orig1Orig2s000 https://rb.gy/myhlvy III – Troponins and Cardiac Surgery - What Troponin Level Indicates Injury After Cardiac Surgery? https://www.medscape.com/viewarticle/969617?src= - High-Sensitivity Troponin I after Cardiac Surgery and 30-Day Mortality https://www.nejm.org/doi/full/10.1056/NEJMoa2000803 - Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1909406 IV – Empagliflozin in HFpEF - FDA Okays Empagliflozin for HF Regardless of Ejection Fraction https://www.medscape.com/viewarticle/969118 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 - Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 V – Low-Value Care - AHA Targets 'Low-Value' Heart Care in New Scientific Statement https://www.medscape.com/viewarticle/969107 - Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association https://www.ahajournals.org/doi/abs/10.1161/HCQ.0000000000000105 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

FDA approval of CardioMEMS, statins, VT storm, and fish oil and AF are the topics covered by John Mandrola, MD, 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 - Invasive Monitoring for HF - FDA Expands Eligibility for CardioMEMS Heart Failure System https://www.medscape.com/viewarticle/969004 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial https://doi.org/10.1016/S0140-6736(11)60101-3 II - Statin Use in Primary Prevention - USPSTF Tweaks Primary Prevention Statin Recommendations in New Draft Guidance https://www.medscape.com/viewarticle/968963 - Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/statin-use-primary-prevention-cardiovascular-disease-adults - The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment https://www.aafp.org/afp/2019/1215/p734.html III - VT-Storm - Transcutaneous Magnetic Stimulation Promising Against VT Storm https://www.medscape.com/viewarticle/968955 - Effect of Transcutaneous Magnetic Stimulation in Patients With Ventricular Tachycardia Storm https://jamanetwork.com/journals/jamacardiology/fullarticle/2788915 IV - Fish Oil and AF risk - Fish Oil Supplements May Increase the Risk for Atrial Fibrillation: What Does This Mean? https://www.medscape.com/viewarticle/967159 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Spinal cord stimulation to prevent post-cardiac surgery AF, statin intolerance, heart failure with preserved ejection fraction, and Vitamin D are discussed by John Mandrola, MD, 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 Post-Cardiac Surgery AF Spinal Cord Stimulation May Cut AF After Cardiac Surgery https://www.medscape.com/viewarticle/968478 • Autonomic Neuromodulation for Atrial Fibrillation Following Cardiac Surgery: JACC Review Topic of the Week https://www.jacc.org/doi/10.1016/j.jacc.2021.12.010 • Temporary Spinal Cord Stimulation to Prevent Postcardiac Surgery Atrial Fibrillation: 30-Day Safety and Efficacy Outcomes https://www.jacc.org/doi/10.1016/j.jacc.2021.08.078 II – Statin Intolerance Statin Intolerance 'Overestimated and Overdiagnosed' https://www.medscape.com/viewarticle/968627 • Prevalence of statin intolerance: a meta-analysis https://doi.org/10.1093/eurheartj/ehac015 III – HFpEF Risk in Preserved-EF HF Varies With Normal vs High Natriuretic Peptides https://www.medscape.com/viewarticle/968748 • Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality https://doi.org/10.1093/eurheartj/ehab911 • 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: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association https://pubmed.ncbi.nlm.nih.gov/33605000/ Features: Why Is Vitamin D Hype So Impervious to Evidence? https://www.medscape.com/viewarticle/968682 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: [email protected]

LDL equations, stroke interventions, post-PCI antiplatelets, the transitive function and network meta-analysis, and lipoprotein(a) 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 - LDL-C Equations: - Standard LDL Equations Yield Discordant Results https://www.medscape.com/viewarticle/968112 - Discordance Between Standard Equations for Determination of LDL Cholesterol in Patients With Atherosclerosis https://www.jacc.org/doi/10.1016/j.jacc.2021.11.042 - LDL-C Estimation: The Perils of Living With Imperfection https://www.jacc.org/doi/10.1016/j.jacc.2021.12.005 II - Acute Stroke Care - Endovascular Therapy Benefits Stroke With Larger Ischemic Core? https://www.medscape.com/viewarticle/968203 - Endovascular Therapy for Acute Stroke with a Large Ischemic Region https://www.nejm.org/doi/full/10.1056/NEJMoa2118191 III - Post PCI Antiplatelet Regimens - Study Parses Out Merits of Short DAPT, De-escalation in ACS https://www.medscape.com/viewarticle/968050 - Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes https://www.jacc.org/doi/10.1016/j.jcin.2021.11.028 IV - Lipoprotein (a) - Positive Topline Results for siRNA in Raised Lipoprotein(a) https://www.medscape.com/viewarticle/968278 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Interatrial shunt therapy, the power of the RCT, chronic stress, anxiety and cardiometabolic risk, and TAVR, are the topics covered by John Mandrola, MD, 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 - Interatrial Shunt - Interatrial Shunt Falters in Preserved, Mid-Range LVEF Heart Failure: REDUCE LAP-HF 2 https://www.medscape.com/viewarticle/967792 - Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00016-2 II - Chronic Stress - Chronic Stress Accelerates Aging: Epigenetic Evidence https://www.medscape.com/viewarticle/967828 - Psychological and biological resilience modulates the effects of stress on epigenetic aging https://www.nature.com/articles/s41398-021-01735-7 - DNA methylation GrimAge strongly predicts lifespan and healthspan https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366976/ III – Anxiety, Neuroticism, and CardioMetabolic Risk Factors - Anxiety in Men Tied to Risk Factors for CVD, Diabetes https://www.medscape.com/viewarticle/967811 - Neuroticism, Worry, and Cardiometabolic Risk Trajectories: Findings From a 40‐Year Study of Men https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022006 IV - TAVR Implant Success - VARC-3 TAVR Technical Failure Definition 'Highly Clinically Relevant https://www.medscape.com/viewarticle/967717 - Validation of the Valve Academic Research Consortium 3 Technical Success Definition in Patients Undergoing TAVR https://www.jacc.org/doi/full/10.1016/j.jcin.2021.11.013 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF Screening, alcohol, sports-related sudden death, non-MD-led healthcare, and CPR 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 - AF Screening - USPSTF Says Evidence Still Lacking for AF Screening in Asymptomatic Patients https://www.medscape.com/viewarticle/967275 - Screening for Atrial Fibrillation US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2788340 - Screening for Atrial Fibrillation—New Devices, Same Challenges https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788475 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 II - Vaccine Induced Myocarditis - Hong Kong, US, Israeli Data Illuminate COVID Vaccine Myocarditis https://www.medscape.com/viewarticle/967355 III - Alcohol and Heart - No Amount of Alcohol Safe for the Heart: WHF https://www.medscape.com/viewarticle/967124 IV - Sports Related Sudden Cardiac Arrest - Survival Improving in Sports-Related Sudden Cardiac Arrest https://www.medscape.com/viewarticle/967061 - Evolution of Incidence, Management, and Outcomes Over Time in Sports-Related Sudden Cardiac Arrest https://www.jacc.org/doi/full/10.1016/j.jacc.2021.11.011 V - Non MD vs MD-led Care - This Doc Still Supports NP/PA Led Care ... With Caveats https://www.medscape.com/viewarticle/967073 VI - CPR - Should We Always Offer CPR? https://www.medscape.com/viewarticle/966886 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Olive oil, breastfeeding and CV health, informed consent during stroke, and controversy regarding revascularization guidelines 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: https://www.medscape.com/twic I – Olive Oil - Olive Oil Intake Tied to Reduced Mortality https://www.medscape.com/viewarticle/966366 - Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults https://www.jacc.org/doi/full/10.1016/j.jacc.2021.10.041 - Can Small Amounts of Olive Oil Keep the Death Away? https://www.jacc.org/doi/10.1016/j.jacc.2021.11.006 II – Breastfeeding and CV Maternal Health - Breastfeeding Linked to Lower CVD Risk in Later Life https://www.medscape.com/viewarticle/966767 - Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women https://www.ahajournals.org/doi/10.1161/JAHA.121.022746 - Meta-analysis: pitfalls and hints https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868184/ III – Informed Consent - New Guidance on Consent in Acute Ischemic Stroke https://www.medscape.com/viewarticle/966889 - Consent Issues in the Management of Acute Ischemic Stroke https://n.neurology.org/content/98/2/73 - The Case Against Thrombolytic Therapy in Stroke https://www.medscape.com/viewarticle/895159 - tPA in Stroke: 'The Facts Are Clear' https://www.medscape.com/viewarticle/895370 IV – Controversy in Revascularization Guidelines - 'Incomprehensible' CABG Recommendation Raises Concerns https://www.medscape.com/viewarticle/966819 - Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 - Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration https://doi.org/10.1016/S0140-6736(94)91963-1 - Ten-Year Follow-Up Survival of the Medicine, Angioplasty, or Surgery Study (MASS II) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.911669 - What constitutes an appropriate empirical trial of antianginal therapy in patients with stable angina before referral for revascularisation? https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02045-6/fulltext - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Xeno-transplantation, weight loss drugs, DOAC coverage, vitamin D, LAAC and frailty, and recalled LVADs are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – Xenotransplantation - Pig Heart Successfully Transplanted to Man https://www.medscape.com/viewarticle/966367 - What Does a Pig-to-Human Heart Transplant Mean for Medicine? https://www.medscape.com/viewarticle/966488 II – Weight Loss Drugs - Wegovy Tops Sibling Saxenda for Weight Loss https://www.medscape.com/viewarticle/966376 - Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes https://jamanetwork.com/journals/jama/article-abstract/2787907 III – DOAC Coverage - CVS Caremark Formulary Change Freezes Out Apixaban https://www.medscape.com/viewarticle/966588 IV – Vitamin D - More Vitamin D Not Better for Reducing Cancer or CVD Incidence https://www.medscape.com/viewarticle/966333 - The D-Health Trial: a randomised controlled trial of the effect of vitamin D on mortality https://doi.org/10.1016/S2213-8587(21)00345-4 - Vitamin D supplementation and prevention of cardiovascular disease and cancer in the Finnish Vitamin D Trial—a randomized controlled trial https://doi.org/10.1093/ajcn/nqab419 - Association between vitamin D supplementation and mortality: systematic review and meta-analysis https://www.bmj.com/content/366/bmj.l4673 V – LAAC and Frailty - Frailty in patients undergoing percutaneous left atrial appendage closure https://doi.org/10.1016/j.hrthm.2022.01.007 - Net Clinical Benefit of Left Atrial Appendage Closure Versus Warfarin in Patients With Atrial Fibrillation: A Pooled Analysis of the Randomized PROTECT-AF and PREVAIL Studies https://pubmed.ncbi.nlm.nih.gov/31752643/ VI – LVAD recall - A High-Risk Medical Device Didn't Meet Federal Standards. The Government Paid Millions for More. https://www.medscape.com/viewarticle/966255 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected] This podcast is intended for US health professionals only.

Causes of sudden death, inclisiran, DOAC choices, and alcohol and VT/VF are the topics discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – Causes of Sudden Death - Cardiac Device Interrogation After Death 'Richly Informative' https://www.medscape.com/viewarticle/965730 - Postmortem Interrogation of Cardiac Implantable Electronic Devices: A 15-Year Experience https://www.jacc.org/doi/full/10.1016/j.jacep.2021.10.011 - Sudden Death in Patients With Cardiac Implantable Electronic Devices https://pubmed.ncbi.nlm.nih.gov/26098676/ - Cardiac Implantable Electronic Device Interrogation at Forensic Autopsy https://www.ahajournals.org/doi/full/10.1161/circulationaha.117.032367 II – Inclisiran - FDA Approves First-in-Class Inclisiran to Lower LDL-C https://www.medscape.com/viewarticle/965464 - ORION: Inclisiran Phase 3 Trials Published https://www.medscape.com/viewarticle/927107 - Meta-Analysis of Inclisiran for the Treatment of Hypercholesterolemia https://pubmed.ncbi.nlm.nih.gov/32892993/ - Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/nejmoa1615664 - Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome https://www.nejm.org/doi/10.1056/NEJMoa1801174 III – DOAC Choice - Apixaban: The 'Anticoagulant of Choice' for AF https://www.medscape.com/viewarticle/965390 - Association of Rivaroxaban vs Apixaban With Major Ischemic or Hemorrhagic Events in Patients With Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2787319 IV – Alcohol and VT/VF and SCD - Some Good News on Alcohol and 'Holiday Heart Syndrome' https://www.medscape.com/viewarticle/965498 - Alcohol consumption and risk of ventricular arrhythmias and sudden cardiac death: An observational study of 408,712 individuals https://www.heartrhythmjournal.com/article/S1547-5271(21)02215-3/fulltext You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

PFO closure, trans-mitral procedures, yoga as therapy, and a year-end-review are the topics John Mandrola, MD, covers in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – PFO Closure - Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke https://jamanetwork.com/journals/jama/fullarticle/2787115 - Patent Foramen Ovale Closure—Harnessing Clinical Trial Evidence to Inform Individualized Treatment Decisions https://jamanetwork.com/journals/jama/fullarticle/2787132 - Personalized evidence based medicine: predictive approaches to heterogeneous treatment effects https://pubmed.ncbi.nlm.nih.gov/30530757/ - Lord’s Paradox by Stephen Senn https://www.linkedin.com/pulse/cause-concern-stephen-senn/ II – Trans-Mitral Procedures - Transcatheter Mitral Valve Procedures Up Tenfold Since 2014 https://www.medscape.com/viewarticle/964657 - Transcatheter Mitral Valve Therapy in the United States: A Report From the STS-ACC TVT Registry https://www.jacc.org/doi/full/10.1016/j.jacc.2021.07.058 - Percutaneous Repair or Surgery for Mitral Regurgitation https://www.nejm.org/doi/full/10.1056/nejmoa1009355 - Transcatheter Mitral-Valve Repair in Patients with Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa1806640 - Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa1805374 III – Yoga for Vasovagal Syncope - Yoga Effective Adjunct Therapy in Recurrent Vasovagal Syncope https://www.medscape.com/viewarticle/964644 - Effect of Yoga on Clinical Outcomes and Quality of Life in Patients With Vasovagal Syncope (LIVE-Yoga) https://www.jacc.org/doi/full/10.1016/j.jacep.2021.09.007 - Effect of Yoga on Arrhythmia Burden, Anxiety, Depression, and Quality of Life in Paroxysmal Atrial Fibrillation: The YOGA My Heart Study https://www.jacc.org/doi/full/10.1016/j.jacc.2012.11.060 - Effects of yoga in patients with paroxysmal atrial fibrillation - a randomized controlled study https://pubmed.ncbi.nlm.nih.gov/26976659/ IV – Top Ten of 2021 - Mandrola's Top 10 Cardiology Stories of 2021 https://www.medscape.com/viewarticle/964818 - Top Cardiology Trials of 2021 https://www.medscape.com/viewarticle/963475 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF triggers, rising BP during the pandemic, long COVID, cardiac arrest care, and social media are the topics John Mandrola, MD discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – AF Triggers - Alcoholic Drinks Stand Out in Novel Trial Exploring AF Triggers https://www.medscape.com/viewarticle/962911 - Individualized Studies of Triggers of Paroxysmal Atrial Fibrillation https://jamanetwork.com/journals/jamacardiology/article-abstract/2786196 II – BP Increase During the Pandemic - Blood Pressure Control Worsened During COVID Pandemic https://www.medscape.com/viewarticle/964329 - Rise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057075 III – DOAC after VTE - Apixaban Outmatches Rivaroxaban for VTE in Study https://www.medscape.com/viewarticle/964301 - Risk for Recurrent Venous Thromboembolism and Bleeding With Apixaban Compared With Rivaroxaban: An Analysis of Real-World Data https://www.acpjournals.org/doi/full/10.7326/M21-0717 - Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 IV – Long Covid - In Long COVID, CPET Finds Abnormalities Other Tests Don't https://www.medscape.com/viewarticle/964250 - Use of Cardiopulmonary Stress Testing for Patients With Unexplained Dyspnea Post–Coronavirus Disease https://doi.org/10.1016/j.jchf.2021.10.002 V – Cardiac Arrest Care - Calcium Does Not Benefit Patients in Cardiac Arrest https://www.medscape.com/viewarticle/964059 - Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest https://jamanetwork.com/journals/jama/fullarticle/2786819 VI – Social Media - Online Reviews Most Important Factor in Choosing a Doctor: Survey https://www.medscape.com/viewarticle/964264 Features: - Booze Out, Coffee Okay to Outsmart Atrial Fibrillation? https://www.medscape.com/viewarticle/961993 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The AMAZE trial of left atrial appendage isolation, non-statin oral lipid lowering drugs, EHR alerts, non-MD care, and obesity are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – aMAZE Trial - No Advantage Shown for LAA Ligation as Adjunct to Pulmonary Vein Isolation https://www.medscape.com/viewarticle/962954 - Safety and Procedural Success of Left Atrial Appendage Exclusion With the Lariat Device https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2289126 - Left Atrial Appendage Isolation in Patients With Longstanding Persistent AF Undergoing Catheter Ablation: BELIEF Trial https://pubmed.ncbi.nl m.nih.gov/27788847/ II – Non-Statin Lipid Lowering - Obicetrapib: CETP Inhibitor Impresses in LDL Lowering https://www.medscape.com/viewarticle/963611 - Daily Oral PCSK9 Inhibitor Encouraging in Phase 1 Trials https://www.medscape.com/viewarticle/963550 III – EHR Alerts and Prognosis - EHR Alerts Have No Impact on Inpatient HF Treatment or Outcomes https://www.medscape.com/viewarticle/963002 - REVeAL-HF: Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice https://www.jacc.org/doi/full/10.1016/j.jchf.2021.03.006 IV – Non-MD Care Models - Remote Non-Physician Care Helps BP, LDL Control https://www.medscape.com/viewarticle/963783 - A Remotely Delivered Hypertension and Lipid Program in 10,000 Patients Across a Diverse Health Care Network https://www.abstractsonline.com/pp8/?_ga=2.141042993.2042594723.1635046736-1021258137.1633710264#!/9349/presentation/18153 V – Obesity in the Young - Obesity Rates Soar in Early Adulthood in the US https://www.medscape.com/viewarticle/963511 - Trends in Obesity Prevalence Among Adults Aged 18 Through 25 Years, 1976-2018 https://jamanetwork.com/journals/jama/article-abstract/2786516 Features - Doubting the BELIEF Trial on LAA Isolation https://www.medscape.com/viewarticle/850822 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

In AHA 2021 Part 1, John Mandrola, MD, reports on selected sessions from the virtual American Heart Association meeting. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - AVATAR - Early SAVR Tops Watchful Waiting in Severe, Asymptomatic Aortic Stenosis: AVATAR https://www.medscape.com/viewarticle/962904 - Aortic Valve ReplAcemenT versus Conservative Treatment in Asymptomatic SeveRe Aortic Stenosis: The AVATAR Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 - Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis https://www.nejm.org/doi/full/10.1056/NEJMoa1912846 II - TCV Repair - Concomitant Tricuspid-Mitral Surgery Beneficial but With a Tradeoff https://www.medscape.com/viewarticle/962899 - Concomitant Tricuspid Repair in Patients with Degenerative Mitral Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa2115961 III - PALACS - Procedure Reduces Postop AF After Cardiac Surgery: PALACS https://www.medscape.com/viewarticle/962907 - Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial https://doi.org/10.1016/S0140-6736(21)02490-9 IV - Left Main CAD - Left-Main PCI, CABG Mortality Similar; Choice Remains Complex https://www.medscape.com/viewarticle/963198 - Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis https://doi.org/10.1016/S0140-6736(21)02334-5 Features: - Questions Remain on Tricuspid Repair at Time of Mitral Surgery https://www.medscape.com/viewarticle/962902 - Despite Positive Trials, Early Surgery in Asymptomatic AS Should Wait https://www.medscape.com/viewarticle/962926 - Can New Meta-analysis of PCI vs CABG for Left Main CAD Settle the Debate? https://www.medscape.com/viewarticle/963295 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Left atrial appendage closure vs DOACs, TAVR vs SAVR, renal denervation, and an AHA 2021 preview are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - LAAC - PRAGUE-17: LAA Closure Holds Up Against DOACs Out to 4 Years https://www.medscape.com/viewarticle/962608 - LAAO vs DOAC: PRAGUE-17 Falls Short https://www.medscape.com/viewarticle/933641 - Left Atrial Appendage Closure versus Non-Warfarin Oral Anticoagulation in Atrial Fibrillation: 4-Year Outcomes of PRAGUE-17 https://www.jacc.org/doi/10.1016/j.jacc.2021.10.023 - Does Percutaneous Left Atrial Appendage Closure Stand the Test of Time? https://www.jacc.org/doi/10.1016/j.jacc.2021.10.022 II - SURTAVI (TAVR vs SAVR) - SURTAVI at 5 Years Reinforces TAVR but Was It Long-term Enough? https://www.medscape.com/viewarticle/962484 - Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients https://www.nejm.org/doi/full/10.1056/NEJMoa1700456 III - Renal Denervation - Renal Denervation Adds Clout to BP Meds in Resistant HTN: RADIANCE-HTN TRIO https://www.medscape.com/viewarticle/962508 - Renal Denervation Remains Only Promising in Meta-Analysis https://www.medscape.com/viewarticle/962369 - Renal Denervation for Hypertension: A Systematic Review and Meta-Analysis of Randomized, Blinded, Placebo-Controlled Trials https://doi.org/10.1016/j.jcin.2021.09.020 IV - AHA Preview - AHA 2021 Puts Scientific Dialogue, Health Equity Center Stage https://www.medscape.com/viewarticle/962524 - Mandrola Previews the Virtual AHA 2021 https://www.medscape.com/viewarticle/962468 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

FFR-guided PCI, ISCHEMIA trial challenged, QFR, and one of the most important studies of 2021 are discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - FFR-Guided PCI - FFR-Guided PCI Falls Short vs CABG in Multivessel CAD: FAME 3 https://www.medscape.com/viewarticle/962274 - Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 - The fallacies of fractional flow reserve https://pubmed.ncbi.nlm.nih.gov/31889563/ II - ISCHEMIA-Trial Challenged - How Applicable is ISCHEMIA Trial to US Clinical Practice? https://www.medscape.com/viewarticle/962233 - Comparison of Patients Undergoing Percutaneous Coronary Intervention in Contemporary U.S. Practice With ISCHEMIA Trial Population https://www.jacc.org/doi/full/10.1016/j.jcin.2021.08.047 - The Glass Is at Least Half Full https://www.jacc.org/doi/10.1016/j.jcin.2021.08.054 - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 III - QFR - FAVOR III China: QFR-Guided PCI Shows Advantage Over Angiography https://www.medscape.com/viewarticle/962328 - Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial https://doi.org/10.1016/S0140-6736(21)02248-0 Features: - The MI–Mortality Mismatch: When Lowering MI Doesn't Extend Life https://www.medscape.com/viewarticle/962276 - Assessment of Nonfatal Myocardial Infarction as a Surrogate for All-Cause and Cardiovascular Mortality in Treatment or Prevention of Coronary Artery Disease https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2785560 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ESUS, CAC 0, Takotsubo syndrome, and chest pain are the topics John Mandrola, MD, covers in today’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – ESUS Anticoagulation May Benefit Stroke Patients With LV Dysfunction https://www.medscape.com/viewarticle/961815 - Left Ventricular Dysfunction Among Patients With Embolic Stroke of Undetermined Source and the Effect of Rivaroxaban vs AspirinA Subgroup Analysis of the NAVIGATE ESUS Randomized Clinical Trial https://jamanetwork.com/journals/jamaneurology/article-abstract/2785030 - Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source https://www.nejm.org/doi/10.1056/NEJMoa1802686 - Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source https://www.nejm.org/doi/10.1056/NEJMoa1813959 II – CAC CAC Score 0 Unreliable to Rule Out Stenosis in Younger Patients https://www.medscape.com/viewarticle/961801 - Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients https://jamanetwork.com/journals/jamacardiology/fullarticle/2785586 - The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment https://www.aafp.org/afp/2019/1215/p734.html III – Takotsubo Cardiomyopathy Broken Heart Syndrome: On the Rise, Especially in Women 50-74 https://www.medscape.com/viewarticle/961307 - Sex‐ and Age‐Based Temporal Trends in Takotsubo Syndrome Incidence in the United States https://www.ahajournals.org/doi/10.1161/JAHA.120.019583 IV- Chest Pain Guidelines AHA/ACC Issues First Comprehensive Guidance on Chest Pain https://www.medscape.com/viewarticle/961806 - 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.jacc.org/doi/10.1016/j.jacc.2021.07.052 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Aspirin for primary prevention, induced hypothermia, half-dose DOAC, and social media, are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - ASA for Primary Prevention - USPSTF Rules Out Aspirin for Over 60s in Primary CVD Prevention https://www.medscape.com/viewarticle/960745 - Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication - Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31924-X/fulltext - Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus https://www.nejm.org/doi/full/10.1056/nejmoa1804988 - Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/nejmoa1803955 II - Induced Hypothermia - No Benefit From Lower Temps for Out-of-Hospital Cardiac Arrest https://www.medscape.com/viewarticle/961191 - The CAPITAL CHILL Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2785263 - Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest https://www.nejm.org/doi/10.1056/NEJMoa1310519 - Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 III - Half-dose DOAC - Half-Dose DOACs Cut Bleeding, Thrombus Risk Post-Watchman LAA Closure https://www.medscape.com/viewarticle/960974 - Half-Dose Direct Oral Anticoagulation Versus Standard Antithrombotic Therapy After Left Atrial Appendage Occlusion https://www.jacc.org/doi/full/10.1016/j.jcin.2021.07.031 IV - Social Media - Navigating Benefits, Pitfalls of Social Media as a Female Doctor https://www.medscape.com/viewarticle/961150 - Gender Differences in Physician Use of Social Media for Professional Advancement https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779868 Features: - USPSTF Statement on Aspirin: Poor Messaging at Best https://www.medscape.com/viewarticle/961118 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Two NEJM papers on mRNA-related myocarditis, AF and stroke, intensifying BP meds, and CCTA and high-sensitivity troponin are the topics John Mandrola, MD, covers in this week's podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I -- Vaccine-Induced Myocarditis New Reports Help Nail Down Myocarditis Risk With COVID-19 Vaccine https://www.staging.medscape.com/viewarticle/960537 • Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel https://www.nejm.org/doi/full/10.1056/NEJMoa2109730 • Myocarditis after Covid-19 Vaccination in a Large Health Care Organization https://www.nejm.org/doi/full/10.1056/NEJMoa2110737 II – AF and Stroke AF a Stroke Cause or Innocent Bystander? The Debate Continues https://www.medscape.com/viewarticle/960224 • Temporal Association Between Episodes of Atrial Fibrillation and Risk of Ischemic Stroke https://jamanetwork.com/journals/jamacardiology/fullarticle/2784332 • It's Time to Rethink (and Retrial) Our Framework for Stroke Prevention in Atrial Fibrillation https://jamanetwork.com/journals/jamacardiology/fullarticle/2784335 III- Intensification of BP Control Adding New Hypertensive May Be More Potent Than Upping Doses https://www.medscape.com/viewarticle/960454 • Adding a New Medication Versus Maximizing Dose to Intensify Hypertension Treatment in Older Adults https://doi.org/10.7326/M21-1456 IV- Hs-troponin and CAD Troponin Levels Tied to Increased CAD Risk, May Guide Imaging /viewarticle/960146 • Troponin-Guided Coronary Computed Tomographic Angiography After Exclusion of Myocardial Infarction https://doi.org/10.1016/j.jacc.2021.07.055 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Coronary artery calcification and exercise, translating clinical trials, the question of metabolically healthy obesity, and Watchman complications are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - CAC and Physical Activity - Physical Activity Paradoxically Tied to Higher Coronary Calcium https://www.medscape.com/viewarticle/959366 - Physical activity and the progression of coronary artery calcification http://dx.doi.org/10.1136/heartjnl-2021-319346 II - Translating Clinical Trials - SYNTAX Score II 2020 Wobbles in Real-World Validation https://www.medscape.com/viewarticle/958834 - Redevelopment and validation of the SYNTAX score II to individualise decision making between percutaneous and surgical revascularisation in patients with complex coronary artery disease: secondary analysis of the multicentre randomised controlled SYNTAXES trial with external cohort validation https://doi.org/10.1016/S0140-6736(20)32114-0 - External Validation of the SYNTAX Score II 2020 https://www.jacc.org/doi/full/10.1016/j.jacc.2021.07.027 III - Healthy and Obesity - ‘Metabolically Healthy Obesity’ Has Heart Risks. Is it a Misnomer? https://www.medscape.com/viewarticle/959994 - Metabolically healthy obesity and cardiovascular events: A nationwide cohort study https://doi.org/10.1111/dom.14492 - Relation of Obesity to New-Onset Atrial Fibrillation and Atrial Flutter in Adults https://pubmed.ncbi.nlm.nih.gov/29501206/ - Paediatric obesity appears to lower the risk of diabetes if selection bias is ignored https://pubmed.ncbi.nlm.nih.gov/29374028 IV - Watchman Complications - FDA Investigating Potential Sex Differences in LAAO Adverse Outcomes https://www.medscape.com/viewarticle/959806 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Dual antiplatelet therapy after PCI, statin side effects, nightshift work and AF, and a cautionary note regarding therapeutic enthusiasm in HF care are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - COVID - Alaska Sets Record for Daily COVID Cases https://www.medscape.com/viewarticle/958999 II - MASTER DAPT - MASTER DAPT: 1 Month DAPT Enough After High-Bleeding-Risk PCI https://www.medscape.com/viewarticle/957463 - Antiplatelets and Anticoagulation Post-PCI: More on MASTER DAPT https://www.medscape.com/viewarticle/958002 - Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2108749 - Abbreviated Antiplatelet Therapy in Patients at High Bleeding Risk With or Without Oral Anticoagulant Therapy After Coronary Stenting: An Open-Label, Randomized, Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056680 III - Statins and Side Effects - Most Muscle Pain on Statins Not a Drug Effect: SAMSON in Print https://www.medscape.com/viewarticle/958877 - Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment https://doi.org/10.1016/j.jacc.2021.07.022 IV - Nightshift Work and AF - Regular Nightshift Work Linked to Atrial Fibrillation, CHD https://www.medscape.com/viewarticle/959346?src= - Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease https://doi.org/10.1093/eurheartj/ehab505 V - Enthusiasm for HF Therapy - Empagliflozin's HFpEF Efficacy Catalyzes Redefinition of HF https://www.medscape.com/viewarticle/959249 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Cardiac arrest care, finerenone, carotids, meds post TAVI: less is more and the new may not be as grand as the tried and true. John Mandrola, MD, provides a third ESC review. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - Cardiac Arrest Care - Angiography Can Wait for Cardiac Arrest Without ST-Elevation https://www.medscape.com/viewarticle/957471 - Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/full/10.1056/NEJMoa2101909 - Coronary Angiography after Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/full/10.1056/NEJMoa1816897 II - Finerenone - FIDELITY: Finerenone Cuts CV Risk in T2D Across CKD Spectrum https://www.medscape.com/viewarticle/957470 - Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2110956 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 III - Carotid Intervention - ACST-2: Carotid Stenting, Surgery on Par in Asymptomatic Patients https://www.medscape.com/viewarticle/957474 - Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy https://doi.org/10.1016/S0140-6736(21)01910-3 IV - Post TAVI DOAC - 'Less Is More' for Edoxaban in Post-TAVI Anticoagulation: ENVISAGE-TAVI AF https://www.medscape.com/viewarticle/957466 - Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2111016 - ATLANTIS Hints at How to Choose Post-TAVR Antithrombotics https://www.medscape.com/viewarticle/951234 - A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve Replacement https://www.nejm.org/doi/full/10.1056/NEJMoa1911425 Features: - What Are the Implications of ACST-2 for Patients With Asymptomatic Carotid Stenosis? https://www.medscape.com/viewarticle/957502 - Top 5 Studies From ESC 2021 https://www.medscape.com/viewarticle/958598 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

ESC Wrap-up Part II: EMPEROR-Preserved, and the STEP, Guide-HF, and IAMI trials, are discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - HFpEF - EMPEROR-Preserved: Empagliflozin Scores HFpEF Breakthrough https://www.medscape.com/viewarticle/957405 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 II - BP Targets - STEP: Lowering Blood Pressure Below 130 mm Hg Shows CV Benefit https://www.medscape.com/viewarticle/957566 - Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension https://www.nejm.org/doi/full/10.1056/NEJMoa2111437 III- PA Catheter Monitoring - GUIDE-HF: CardioMEMS-Guided Meds Fall Short in Mild to Moderate Heart Failure https://www.medscape.com/viewarticle/957390 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial https://doi.org/10.1016/S0140-6736(11)60101-3 IV - Influenza Vaccine - Seasonal Flu Vax Cuts Post-MI Mortality in IAMI Trial https://www.medscape.com/viewarticle/957575 - Influenza Vaccination after Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial https://doi.org/10.1161/CIRCULATIONAHA.121.057042 - Stopping randomized trials early for benefit and estimation of treatment effects: systematic review and meta-regression analysis https://pubmed.ncbi.nlm.nih.gov/20332404/ You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine. https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

EMPEROR-Preserved, the LOOP study, ablate-and-pace for AF, and salt substitute and stroke: John Mandrola, MD provides a first of two ESC reviews. To read a partial transcript or to comment, visit: https://www.medscape.com/twic 1 - HFpEF - EMPEROR-Preserved: Empagliflozin Scores HFpEF Breakthrough https://www.medscape.com/viewarticle/957405 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 - Empagliflozin and Major Renal Outcomes in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMc2112411 - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2022190 2 - AF Screening - LOOP Trial Undercuts Value of Long-term Continuous ECG Screening for Atrial Fibrillation https://www.medscape.com/viewarticle/957473 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Subclinical Atrial Fibrillation and the Risk of Stroke https://www.nejm.org/doi/full/10.1056/nejmoa1105575 3 - Ablate and Pace for AF and HF - APAF-CRT: 'Ablate and Pace' Cuts Mortality in Narrow-QRS HF, Permanent AF https://www.medscape.com/viewarticle/957467 - A randomized controlled trial of atrioventricular junction ablation and cardiac resynchronization therapy in patients with permanent atrial fibrillation and narrow QRS https://academic.oup.com/eurheartj/article/39/45/3999/5078460 - AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS: the APAF-CRT mortality trial https://doi.org/10.1093/eurheartj/ehab569 4 - Salt Substitute and Stroke - Salt Substitute Shows Clear Reduction in Stroke, CV Events, and Death https://www.medscape.com/viewarticle/957472 - Effect of Salt Substitution on Cardiovascular Events and Death https://www.nejm.org/doi/full/10.1056/NEJMoa2105675 Features: - Incremental, Not Monumental, Win for Empagliflozin in Heart Failure With Preserved Ejection Fraction https://www.medscape.com/viewarticle/957465 - Empagliflozin in HFpEF: Putting EMPEROR-Preserved in Context https://www.medscape.com/viewarticle/957388 - Lessons on AF Screening From the LOOP Study https://www.medscape.com/viewarticle/957512 - Ablate-and-Pace Delivers a Huge Win for Those Sick With AF https://www.medscape.com/viewarticle/958033 - Will the Positive Findings From the SSaSS Trial on Salt Substitution Silence the Salt Skeptics? https://www.medscape.com/viewarticle/957510 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19, NEJM vaccine safety paper, full-dose anticoagulation in COVID-19, AF and Exercise, and early results on EMPEROR-Preserved are the studies John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic 1 - COVID-19 - Heart Inflammation More Common After COVID Than After Vaccination https://www.medscape.com/viewarticle/957343 - Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting https://www.nejm.org/doi/full/10.1056/NEJMoa2110475 2 - Full dose AC in COVID-19 - Heparin's COVID-19 Benefit Greatest in Moderately Ill Patients https://www.medscape.com/viewarticle/956630 - Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2105911 - Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2103417 3 - AF and Exercise - Aerobic Exercise Can Reduce AF Frequency, Severity: ACTIVE-AF https://www.medscape.com/viewarticle/957322 4 - EMPEROR AF - EMPEROR-Preserved: Empagliflozin Scores HFpEF Breakthrough https://www.medscape.com/viewarticle/957405 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19, Simpson’s Paradox, LAA appendage closure, multimorbidity, and an ESC preview are the topics John Mandrola, MD discusses in today’s podcast. https://www.medscape.com/twic 1 - COVID-19 - Lacking Beds, Hospitals Ship COVID-19 Patients to Other States https://www.medscape.com/viewarticle/956917 - Efficacy and Safety of Same-Day Discharge for Atrial Fibrillation Ablation https://pubmed.ncbi.nlm.nih.gov/32553209/ 2 - Simpson’s Paradox - Israeli data: How can efficacy vs. severe disease be strong when 60% of hospitalized are vaccinated? https://www.covid-datascience.com/post/israeli-data-how-can-efficacy-vs-severe-disease-be-strong-when-60-of-hospitalized-are-vaccinated - Simpson’s Paradox and Interpreting Data https://towardsdatascience.com/simpsons-paradox-and-interpreting-data-6a0443516765 - How SIMPSON'S PARADOX explains weird COVID19 statistics https://www.youtube.com/watch?v=t-Ci3FosqZs 3 - Left Atrial Appendage Closure - FDA Approves Abbott's Amplatzer Amulet for Atrial Fibrillation https://www.medscape.com/viewarticle/956726 - Chronic Kidney Disease Tied to Worse LAAO Outcomes https://www.medscape.com/viewarticle/956778 - The Association of Chronic Kidney Disease With Outcomes Following Percutaneous Left Atrial Appendage Closure https://www.jacc.org/doi/full/10.1016/j.jcin.2021.06.008 - Prophylactic Use of Implantable Cardioverter-Defibrillators in the Prevention of Sudden Cardiac Death in Dialysis https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.039818 4 - ESC Preview - SGLT2 inhibitors in HFpEF - EMPEROR-Preserved: Positive Top-Line Results for Empagliflozin in HFpEF https://www.medscape.com/viewarticle/954284 - AF Screening - Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/28454796/ 5 - Coming soon The anticoagulation in COVID-19 trial is one of the hardest I have seen in years. Stay tuned. You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19, vaccine-induced myocarditis, Watchman complications, SGLT2 inhibitors, and cardiogenic shock are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic 1 - COVID-19 - 18 Months Later, the COVID-19 Memories Won’t Go Away https://www.medscape.com/viewarticle/956335 2 - Vaccine-Myocarditis - Myocarditis in Adolescents After COVID-19 Vaccine Typically Mild https://www.medscape.com/viewarticle/956359 - Association of Myocarditis With BNT162b2 Messenger RNA COVID-19 Vaccine in a Case Series of Children https://jamanetwork.com/journals/jamacardiology/fullarticle/2783052 3 - Watchman - 'Striking' Difference in Adverse Events in Women With Watchman LAAO https://www.medscape.com/viewarticle/956593 - Sex Differences in Procedural Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion https://jamanetwork.com/journals/jamacardiology/fullarticle/2782726 4 - SGLT2 Inhibitors - EU Approves Dapagliflozin for Kidney Disease, Regardless of Diabetes https://www.medscape.com/viewarticle/956345 - Dapagliflozin in Patients with Chronic Kidney Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2024816 5 - Cardiogenic Shock - No Win for Milrinone Over Dobutamine in Cardiogenic Shock https://www.medscape.com/viewarticle/956222 - Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock https://www.nejm.org/doi/full/10.1056/NEJMoa2026845 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The COVID-19 surge, vaccine-induced myocarditis, Heart Rhythm news, the state of medical evidence, and doctors in unions are discussed by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic 1- COVID-19 Texas COVID-19 Wave Is Climbing More Steeply Than Past Waves https://www.medscape.com/viewarticle/956104 White House Says US Can Provide COVID-19 Boosters if Needed https://www.medscape.com/viewarticle/956016 2- Vaccine-Myocarditis Myocarditis Tied to COVID-19 Shots More Common Than Reported? https://www.medscape.com/viewarticle/956089 3- Heart Rhythm News The Three Big Stories from the Heart Rhythm Society's 2021 Meeting https://www.medscape.com/viewarticle/955989 4- Medical Evidence Despite Retraction, Study Using Fraudulent Surgisphere Data Still Cited https://www.medscape.com/viewarticle/956090 Ongoing Citations of a Retracted Study Involving Cardiovascular Disease, Drug Therapy, and Mortality in COVID-19 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2782460 5- Doctors in Unions? Physicians Need to Unionize Now https://www.medscape.com/viewarticle/955888 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Two studies on alcohol and AF incidence and an important paper on stable CAD are the topics John Mandrola discusses in this week’s podcast. https://www.medscape.com/twic 1 - COVID-19 New Vaccinations Increasing in COVID Hot Spots https://www.medscape.com/viewarticle/955680 2 - Alcohol - Moderate Drinking Protective After MI, Stroke in 'Flawed' Study https://www.medscape.com/viewarticle/955474 - Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation https://doi.org/10.1016/j.jacep.2021.05.013 - Can a Drink a Day Keep the Electrophysiologist Away? https://doi.org/10.1016/j.jacep.2021.06.010 - Association of alcohol consumption with morbidity and mortality in patients with cardiovascular disease: original data and meta-analysis of 48,423 men and women https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02040-2 3 - Coronary Artery Disease - CLARIFY Confirms Meds, Watchful Waiting in Angina, Stable CAD https://www.medscape.com/viewarticle/955313 - International Observational Analysis of Evolution and Outcomes of Chronic Stable Angina: The Multinational Observational CLARIFY Study https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.054567 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19 messaging, coffee, CTA and statins, and Watchman problems are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1- COVID-19: - COVID-19 Cases in US Triple Over 2 Weeks Amid Misinformation https://www.medscape.com/viewarticle/955269 - Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant https://www.nejm.org/doi/full/10.1056/NEJMoa2108891 - What Really Happened With that Weird Yankees COVID Outbreak https://nymag.com/intelligencer/2021/05/what-really-happened-with-that-weird-yankees-covid-outbreak.html 2- Coffee: - Coffee Not Linked to Increased Arrhythmia Risk in New Study https://www.medscape.com/viewarticle/954992 - Coffee Consumption and Incident Tachyarrhythmias https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782015 - Another Cup of Coffee Without an Arrhythmia, Please https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782021 3- CTA and Statins: - CTA May Guide Primary Prevention Statins in Nonobstructive CAD https://www.medscape.com/viewarticle/955030 - Reduction of Myocardial Infarction and All-Cause Mortality Associated to Statins in Patients Without Obstructive CAD https://www.jacc.org/doi/full/10.1016/j.jcmg.2021.05.022 4- Left Atrial Appendage Closure: - Five Risk Factors May Predict Thrombus on LAA Occlusion Implants https://www.medscape.com/viewarticle/955131 - Predictors of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion https://www.jacc.org/doi/full/10.1016/j.jacc.2021.04.098 - Device-Related Thrombus After Left Atrial Appendage Occlusion https://www.jacc.org/doi/10.1016/j.jacc.2021.05.028 Features: - Does Coffee Make Your Heart Flutter? https://www.medscape.com/viewarticle/954996 - Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19, Ivermectin, a dissolving pacer, clinician well-being, and finerenone are discussed this week. 1 COVID-19 US 'Losing Time' Against Delta Variant, NIH Chief Says https://www.medscape.com/viewarticle/954882 Ivermectin for COVID: How Do We Know What to Believe? https://www.medscape.com/viewarticle/954681 2 Dissolving Pacemaker Dissolving Pacemaker Impressive in Early Research https://www.medscape.com/viewarticle/954774 3 Clinician Well-being Global Heart Organizations Unite to Promote Clinician Well-Being https://www.medscape.com/viewarticle/954803 Clinician Well-Being: Addressing Global Needs for Improvements in the Health Care Field A Joint Opinion From the American College of Cardiology, American Heart Association, European Society of Cardiology, and the World Heart Federation https://www.jacc.org/toc/jacc/0/0 From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider https://www.annfammed.org/content/12/6/573.full Bullying in Academic Medicine Rife, Underreported https://www.medscape.com/viewarticle/954709 4 Finerenone FDA Approves Finerenone (Kerendia) for Slowing CKD in Type 2 Diabetes https://www.medscape.com/viewarticle/954606 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19, mRNA-vaccine-induced myocarditis, type 2 diabetes in kids, optimal medical therapy for CAD, and Alcohol are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1-COVID - Fast-spreading Delta Variant, Vaccination Rates, Reintroduction of Indoor Masks: COVID-19 Global Weekly Highlights https://www.medscape.com/viewarticle/940446 - Health care 'breaking point': Cox confirms some Springfield COVID-19 patients transferred to St. Louis, Kansas City https://www.news-leader.com/story/news/local/ozarks/2021/06/29/springfield-covid-delta-variant-missouri-hospitals-cox-some-patients-transferred-vaccines/7787970002/ 2- COVID Vaccine-Induced Myocarditis - New Details of Myocarditis Linked to COVID Vaccines https://www.medscape.com/viewarticle/954061 - Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military https://jamanetwork.com/journals/jamacardiology/fullarticle/2781601 - Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination https://jamanetwork.com/journals/jamacardiology/fullarticle/2781602 3- Diabetes in the Clinic - 'Staggering' Doubling of Type 2 Diabetes in Kids During Pandemic https://www.medscape.com/viewarticle/953816 4- Optimal Medical Therapy - OMT 'Best Insurance' for Extended Survival After Revascularization https://www.medscape.com/viewarticle/953959 - Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization https://doi.org/10.1016/j.jacc.2021.04.087 - Defining the Proper SYNTAX for Long-Term Benefit of Myocardial Revascularization With Optimal Medical Therapy https://doi.org/10.1016/j.jacc.2021.04.088 - Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease. https://www.nejm.org/doi/full/10.1056/nejmoa0804626 - Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial https://doi.org/10.1016/S0140-6736(19)31997-X 5- Alcohol - The Sick-Quitter Effect: How Alcohol Can Seem Cardioprotective When It Isn't https://www.medscape.com/viewarticle/953696 Features: - Vaccine-Induced Myocarditis Concerns Demand Respect, Not Absolutism https://www.medscape.com/viewarticle/954038 You may also like: - Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine - The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Myocarditis and the COVID vaccine, lipid lowering guidelines, financial toxicity, and deprescribing statins are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic 1 – COVID Varied COVID Vaccination Rates May Lead to 'Two Americas' https://www.medscape.com/viewarticle/953658 Nearly All COVID Deaths in US Are Now Among Unvaccinated https://www.medscape.com/viewarticle/953703 2 - COVID Vaccine Myocarditis FDA to Add Myocarditis Warning to mRNA COVID-19 Vaccines https://www.medscape.com/viewarticle/953647 3 – Lipid Guidelines Clinicians Slow to Implement Lipid-Lowering Guidelines: GOULD Registry https://www.medscape.com/viewarticle/953688 - Use of Lipid-Lowering Therapies Over 2 Years in GOULD, a Registry of Patients With Atherosclerotic Cardiovascular Disease in the US https://jamanetwork.com/journals/jamacardiology/fullarticle/2780713 4 - Financial Toxicity Financial Burden Higher With CVD Than Cancer https://www.medscape.com/viewarticle/953687 - Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States https://www.jacc.org/doi/10.1016/j.jaccao.2021.02.006 5 - Deprescribing Statins Stopping Statins Linked to Death, CV Events in Elderly https://www.medscape.com/viewarticle/953545 - Cardiovascular Outcomes and Mortality Associated With Discontinuing Statins in Older Patients Receiving Polypharmacy https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780952 - Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61240-4/fulltext - Rosuvastatin in Older Patients with Systolic Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa0706201 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID vaccine myocarditis, Christian Eriksen and sudden cardiac death, therapeutic hypothermia, and revascularization of stable CAD are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic 1- COVID-Vaccine-Myocarditis AHA: Don't Delay COVID Shot While CDC Reviews Myocarditis Cases https://www.medscape.com/viewarticle/953233 Myocarditis after BNT162b2 and mRNA-1273 Vaccination https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055913 2- Christian Eriksen Christian Eriksen: un survivant qui doit nous inspirer https://francais.medscape.com/voirarticle/3607279 Danish Soccer Player Suffered Cardiac Arrest During Euro Match https://www.webmd.com/news/20210614/danish-soccer-player-suffered-cardiac-arrest-during-euro-match Point/Counterpoint on Halting Implantation of the Subcutaneous ICD https://www.jacc.org/doi/10.1016/j.jacep.2021.03.006 3- Therapeutic Hypothermia Trial Supports Therapeutic Hypothermia in Nonshockable Cardiac Arrest https://www.medscape.com/viewarticle/919855 Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 PulmCrit – A history of hypothermia for cardiac arrest, 2002-2021 (RIP) https://emcrit.org/pulmcrit/ttm2/ 4 - Revascularization of Stable CAD Meta-analysis Muses Over ISCHEMIA Message Had Trial Lasted Longer https://www.medscape.com/viewarticle/951498 Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis https://doi.org/10.1093/eurheartj/ehab246 Impact of revascularisation on outcomes in chronic coronary syndromes: a new meta-analysis with the same old biases? https://doi.org/10.1093/eurheartj/ehab330 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID vaccine myocarditis, AF post-stroke, semaglutide, and iPhones and cardiac devices are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-Vaccine-Myocarditis More Evidence Links COVID Vaccines to Rare Cases of Myocarditis in Youth https://www.medscape.com/viewarticle/952905 - Symptomatic Acute Myocarditis in Seven Adolescents Following the Pfizer-BioNTech COVID-19 Vaccination https://pediatrics.aappublications.org/content/early/2021/06/04/peds.2021-052478 - At Least 18 Cases of Apparent Heart Problems in Young People in CT After COVID-19 Vaccine https://www.nbcconnecticut.com/news/coronavirus/connecticut-confirms-at-least-18-cases-of-apparent-heart-problems-in-young-people-after-covid-19-vaccination/2494534/ - C.D.C. Is Investigating a Heart Problem in a Few Young Vaccine Recipients https://www.nytimes.com/2021/05/22/health/cdc-heart-teens-vaccination.html - EMA Statement: https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-3-6-may-2021 - Is the Second Shot Giving Young Men a Dangerous Heart Condition? https://nymag.com/intelligencer/2021/06/israel-detects-link-between-myocarditis-and-covid-vaccine.html - Report to FDA https://www.fda.gov/media/150054/download AF and Stroke Evidence Mounts for Implantable AF Monitoring After Stroke https://www.medscape.com/viewarticle/952325 - The STROKE-AF Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2780490 - The PER DIEM Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2780491 Obesity FDA Approves 'Game Changer' Semaglutide for Weight Loss https://www.medscape.com/viewarticle/952441 iPhone 12 and Cardiac Device Evidence Builds for iPhone 12 Interference With Cardiac Devices https://www.medscape.com/viewarticle/952780 - Magnetic Interference on Cardiac Implantable Electronic Devices From Apple iPhone MagSafe Technology https://www.ahajournals.org/doi/10.1161/JAHA.121.020818 - Letter to the Editor—Lifesaving therapy inhibition by phones containing magnets https://www.heartrhythmjournal.com/article/S1547-5271(20)31227-3/fulltext - Smart wearable device accessories may interfere with implantable cardiac devices https://www.heartrhythmcasereports.com/article/S2214-0271(20)30274-8/fulltext Features: Feb 26, 2021 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/946476 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

John Mandrola, MD, presents an ACC 2021 recap. https://www.medscape.com/twic ACC 2021 Reveiw I -- Left Atrial Appendage Closure LAAOS III: Surgical LAA Closure Cuts AF Stroke Risk by One Third https://www.medscape.com/viewarticle/951232 - Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 Watchman Registry: 1-Year Stroke Estimates Reassuringly Low https://www.medscape.com/viewarticle/951235 II - Angiotensin-Neprilysin Inhibition PARADISE-MI: Sacubitril/Valsartan Can't Beat Ramipril in Patients With Acute MI https://www.medscape.com/viewarticle/951236 Life Trial Rationale Paper: https://doi.org/10.1016/j.jchf.2020.05.005 III - Renal Denervation Ultrasound Renal Denervation Drops BP in Patients on Triple Therapy https://www.medscape.com/viewarticle/951248 IV -- Clopidogrel vs ASA post Stent HOST-EXAM: Clopidogrel Beats Aspirin as Monotherapy After Stenting https://www.medscape.com/viewarticle/951294 - Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial https://doi.org/10.1016/S0140-6736(21)01063-1 V -- AF Ablation in HF RAFT-AF, Despite Itself, Hints at Advantage for Ablation Rhythm Control in Heart Failure With AF. https://www.medscape.com/viewarticle/951326 VI -- Rivaroxaban in COVID-19 – ACTION Trial Therapeutic Rivaroxaban Dose: Risk Outweighs Benefit in Stable COVID https://www.medscape.com/viewarticle/951475 VII -- REHAB-HF Trial Novel Rehab Program Fights Frailty, Boosts Capacity in Advanced HF https://www.medscape.com/viewarticle/951244 - Physical Rehabilitation for Older Patients Hospitalized for Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2026141 VIII – ASA 81 vs 325 – ADAPTABLE Trial ADAPTABLE: Low-Dose Aspirin as Good as High-Dose in CHD? https://www.medscape.com/viewarticle/951230 - Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2102137 Perspectives: Eight Things to Know About the Surgical Left Atrial Appendage Occlusion (LAAOS III) Trial https://www.medscape.com/viewarticle/951229 PARADISE-MI Makes Me Question the Benefits of Sacubitril/Valsartan https://www.medscape.com/viewarticle/951239 Sacubitril/Valsartan: Trending Toward PARADISE Post MI https://www.medscape.com/viewarticle/950300 Renal Denervation for Resistant Hypertension Is Not Back on Track https://www.medscape.com/viewarticle/951497 Acute Alcohol Consumption Raises Risk for Atrial Fibrillation https://www.medscape.com/viewarticle/950938 Does ADAPTABLE Inform Aspirin Dosing for Secondary Prevention? https://www.medscape.com/viewarticle/950969 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

The upcoming ACC meeting, polypharmacy, finerenone, and ethics and professionalism are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic ACC Preview: ACC.21 Looks to Repeat Success Despite Pandemic Headwinds https://www.medscape.com/viewarticle/950836 - Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/31050775/ Polypharmacy Hypertension Worsened by Commonly Used Prescription Meds https://www.medscape.com/viewarticle/950724 Finerenone Finerenone Scores Second Pivotal-Trial Success in Diabetic Kidney Disease https://www.medscape.com/viewarticle/951027 - Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 Ethics and Professionalism AHA/ACC Guidance on Ethics, Professionalism in Cardiovascular Care https://www.medscape.com/viewarticle/951018 - 2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report https://www.ahajournals.org/doi/10.1161/CIR.0000000000000963 Features: Mandrola Previews the 2021 (Virtual) American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/950797 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19 and BMI, TAVR vs SAVR, subcutaneous ICD, SGLT2 inhibitors, and physician-Moms are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 COVID-19 Severity Starts in Normal BMI Range, Especially in Young https://www.medscape.com/viewarticle/950568 - Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00089-9/fulltext TAVR vs SAVR VARC-3 Sets Goalpost for Future Aortic Valve Trials https://www.medscape.com/viewarticle/950012 - Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa799/6237954 TAVR Availability Patchy Growth of TAVR Programs Leaves Poorer Communities Behind https://www.medscape.com/viewarticle/950316 S-ICD Trade-offs Between Subcutaneous, Transvenous ICDs on Display in EFFORTLESS https://www.medscape.com/viewarticle/950328 - Implant and Midterm Outcomes of the Subcutaneous Implantable Cardioverter-Defibrillator Registry: The EFFORTLESS Study https://doi.org/10.1016/j.jacc.2017.06.040 - Reduction in Inappropriate Therapy and Mortality through ICD Programming https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 - Low inappropriate shock rates in patients with single- and dual/triple-chamber implantable cardioverter-defibrillators using a novel suite of detection algorithms: PainFree SST trial primary results https://doi.org/10.1016/j.hrthm.2015.01.017 Dapagliflozin and CKD FDA Approves Dapagliflozin (Farxiga) for Chronic Kidney Disease https://www.medscape.com/viewarticle/950329 Features New Physician Moms Need More Resources and Less Guilt in the Workplace https://www.medscape.com/viewarticle/949765 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID-19 and global vaccinations, AF screening, conduction-system pacing, FDA ban on menthol tobacco, and a heartfelt essay are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 Indians Rush for COVID-19 Vaccines as Death Toll Passes 200,000 https://www.medscape.com/viewarticle/950095 - Vaccine Breakthrough Infections with SARS-CoV-2 Variants https://www.nejm.org/doi/full/10.1056/NEJMoa2105000 AF Screening: Modest Clinical Gain for AF Screening of Asymptomatic Elderly: STROKESTOP https://www.medscape.com/viewarticle/949950 - Mass Screening for Untreated Atrial Fibrillation The STROKESTOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.014343 - Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials https://pubmed.ncbi.nlm.nih.gov/25596211/ - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350 Conduction System Pacing Keeping Pace: His-Bundle CRT for Heart Failure Impresses in Second Randomized Trial https://www.medscape.com/viewarticle/950037 - A Randomized Trial of His pacing versus Biventricular pacing in Symptomatic Heart Failure Patients with left bundle branch block (His-Alternative) https://www.jacc.org/doi/10.1016/j.jacep.2021.04.003 - His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure https://www.jacc.org/doi/full/10.1016/j.jacc.2019.04.026 FDA FDA Moves to Ban Menthol in Tobacco Products https://www.medscape.com/viewarticle/950223 Features: Losing Both Parents During COVID: A Physician's 'Unwitnessed Grief' https://www.medscape.com/viewarticle/949490 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Cardiac status post COVID-19 in athletes, AF ablation, and bias against procedural doctors are the topics covered by John Mandrola, MD, in this week’s podcast https://www.medscape.com/twic COVID-19 COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e2.htm Professor Zeynep Tufekci Newsletter: https://www.theinsight.org/p/facts-are-pieces-of-a-puzzle-not Post-COVID-19 Cardiac Involvement in NCAA athletes SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054824 AF and Durable PV isolation Paroxysmal AF Can Recur but Burden Plunges After 'Durable' Ablation https://www.medscape.com/viewarticle/949566 Radiofrequency vs. Cryoballoon Catheter Ablation for Paroxysmal Atrial Fibrillation: Durability of Pulmonary Vein Isolation and Effect on AF Burden: The RACE-AF Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009573 Bias Against Procedures: Apr 9, 2021 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/949000 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

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 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

Carotid screening, AF and alcohol, subcutaneous ICD, and medical education 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 Carotid Screening USPSTF Again Recommends Against Carotid Stenosis Screening https://www.medscape.com/viewarticle/945202 Subcutaneous ICD Recall FDA Recalls Subcutaneous-ICD Leads Due to Fracture Risk https://www.medscape.com/viewarticle/945168 Alcohol and AF Alcohol and the Electric Atrium, Part 2: When BAC Exceeds the Legal Limit https://www.medscape.com/viewarticle/945297 Medical Education USMLE Stuns Again: Clinical Skills Test Permanently Ended https://www.medscape.com/viewarticle/944756 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

AF and COVID-19, microthrombi in COVID-19 autopsies, vericiguat, and POTS are the topics covered by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment: http://www.medscape.com/twic AF and COVID AF at COVID-19 Admission Predicts Mortality, Demands Vigilance https://www.medscape.com/viewarticle/944802 Microthrombi and COVID Microthrombi, Necrosis Seen in COVID-19 Hearts on Autopsy https://www.medscape.com/viewarticle/944783 Vericiguat FDA Approval Adds Vericiguat (Verquvo) to HF Treatment Options https://www.medscape.com/viewarticle/944434 POTS: Lower-Body Compression Trims Orthostatic Tachycardia in POTS https://www.medscape.com/viewarticle/944791 Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment https://doi.org/10.1016/j.pcad.2020.03.010 Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance https://www.onlinecjc.ca/article/S0828-282X(19)31550-8/fulltext#secsectitle0130 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact [email protected]

COVID myocarditis, the Polypill, low-value care, and edge-to-edge tricuspid valve repair are discussed by John Mandrola, MD, in this week’s podcast.

COVID, ACE/ARBs, left atrial appendage closure, SGLT2 inhibitors, and a clue in AF mechanisms are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID vaccine schedules, trial translation, valve guidelines, and physician harassment on social media are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID, sacubitril/valsartan and spironolactone in patients with HFpEF, year-end comments are the topics discussed by John Mandrola, MD in this week’s podcast.

COVID, the clogged pipe frame of CAD, paclitaxel, and AF performance measures and Goodhart’s law are the topics John Mandrola, MD, covers in this week’s podcast.

COVID vaccines, tocilizumab, finerenone, type 2 MI care, coronary CTA, and sotagliflozin are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID-19 vaccines and virtual AHA presentations on statins and the nocebo effect, high dose omega-3s, and AF ablation are the topics John Mandrola, MD, discusses on this week’s podcast.

COVID19 vaccines, thrombolysis in stroke, industry payments to doctors, and the upcoming AHA are topics covered by John Mandrola, MD, in this week’s podcast.

COVID, AF ablation, pediatric “do not dos” from AAP, heart failure performance measures, and a brief AHA preview are the topics discussed by John Mandrola, MD on this week’s podcast.

Remdesivir, the athletic heart, troponin and echo abnormalities in patients with COVID-19, and a novel MRA drug are the topics John Mandrola, MD, discusses in this week's podcast

COVID, tocilizumab, hypertrophic cardiomyopathy, cerebral microbleeds, and surrogate endpoints are the topics discussed by John Mandrola, MD, in this week’s podcast

COVID drug trials and science news, BNP, polypharmacy in heart failure, and in-patient CPR are the topics john Mandrola, MD, discusses in this week’s podcast

COVID-19, scientific philosophy, left main coronary artery disease, empagliflozin and the SGLT2 inhibitors are the topics discussed by John Mandrola, MD in this week’s podcast

Scientific trust, publishing incentives, and the EXCEL trial, Vitamin D and COVID, and time-restricted eating are discussed by John Mandrola, MD, in this week’s podcast.

COVID sport participation guidelines, beta-blockers after MI, and low-dose DOAC therapy in AF are the topics covered by John Mandrola, MD, in this week’s podcast.

COVID, CMR after COVID, ISCHEMIA trial substudy, valvular heart disease and AF are the topics John Mandrola, MD, discusses in this week’s podcast.

COVID, icosapent ethyl, sudden death, and antiplatelet choices in the elderly are topics John Mandrola, MD, discusses in this week’s podcast.

COVID, trust in the FDA, and ESC Recap: Part 1 are the topics John Mandrola, MD, covers in this week’s podcast.

COVID and the heart, convalescent plasma, PCI in the VA system, and the upcoming ESC meeting are discussed by John Mandrola, MD, in this week’s podcast.

COVID, diversity, clinical research, the S-ICD, and ECGs are the topics discussed by John Mandrola, MD in this week’s podcast.

COVID, obesity, heart failure, Impella, and fitness are the topics John Mandrola, MD, discusses in this week’s podcast.

COVID, cardiac effects of COVID, AF ablation safety, and SGLT2i are the topics discussed by Dr John Mandrola in this week’s podcast.

COVID vaccines, T-cells, ICDs, Watchman, and two features are the topics John Mandrola, MD, discusses in this week’s podcast.

COVID, the EXCEL trial, AF ablation, and pacemaker techniques are the topics discussed by John Mandrola, MD in this week’s podcast.

COVID, sacubitril/valsartan, left atrial appendage occlusion, and statins are the topics Dr John Mandrola discusses in this week’s podcast.

COVID, science communication breakthrough, tricuspid valve disease, and AF ablation are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID19, corticosteroids, CAC, SGLT2i, and vericiguat are the topics discussed by Dr. John Mandrola in this week’s podcast.

ISCHEMIA, COVID-19 statistics, and racial justice are discussed by Dr John Mandrola in this week’s podcast.

COVID19, protests, Impella, Excel, Bayesian statistics, and journal retractions are discussed by John Mandrola, MD, in this week’s podcast.

COVID-19, nursing homes, evidence based medicine, hydroxychloroquine and VT, and remdesivir are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID-19, medical education, collider bias, Watchman, and VT are the topics John Mandrola, MD, discusses in this week’s podcast.

COVID-19 stats, anticoagulation in acute COVID-19 illness, ICD trials, and left bundle branch pacing are the topics discussed by John Mandrola, MD, in this week’s podcast.

COVID-19, the angiotensin receptor blocker, TAVR, and acute stroke care are covered by John Mandrola, MD, in this week’s podcast.

COVID-19, social distancing, ECG monitoring, thrombosis, and TAVR are discussed by John Mandrola, MD, in this week’s podcast.

New epidemiologic studies, pitfalls of testing, and treatments for COVID-19 are the topics discussed by John Mandrola, MD in this week’s podcast.

The COVID-19 crisis—epidemiology, viral therapeutics, pulmonary management, and coagulopathy—is the topic discussed by John Mandrola, MD in this week’s podcast.

The COVID-19 crisis—epidemiology, ventilation protocols, telemedicine, and humanity in these dark days—are the topics discussed by John Mandrola, MD in this week’s podcast.

The COVID19 crisis—heroes, viral spread, betrayals, and intolerance of ideas—are discussed by John Mandrola, MD in this week’s podcast.

The COVID-19 crisis—ethics, hydroxychloroquine, and angiotensin drugs—are among the topics discussed by John Mandrola, MD in this week’s podcast.

The newest developments in COVID-19 are discussed by John Mandrola, MD, in this week’s podcast.

COVID-19 is the topic of this week’s podcast.

COVID-19, left main coronary diseases, and cascades are the topics covered by Dr John Mandrola in this week’s podcast.

Social media tension, bempedoic acid, hopeful news from CMS, and carotid interventions are the topics discussed by Dr John Mandrola in this week’s podcast.

More fuel piled onto the EXCEL trial controversy, GI bleeds in AF, medical education, and revascularization procedures are covered by Dr John Mandrola in this week’s podcast.

Cardiac stents, cardio-oncology, VT ablation, acute AF are the topics discussed by Dr John Mandrola in this week's podcast.

The NEJM retraction, TAVR 5-year results, ICD selection, long QT reversals, and lung cancer screening are the topics discussed by John Mandrola, MD in this week's podcast.

Executive physicals, coconut fat, leadless pacemakers, coils, and independent nurse practitioners and physician assistants are the topics discussed by Dr. John Mandrola in this week’s podcast.

EXCEL, amyloid cardiomyopathy, drug prices, palliative care in cardiology, and gender bias are the topics covered by Dr John Mandrola in this week’s podcast.

The Excel trial, peripartum cardiomyopathy, marathoning, hot-spotting, and leadership in innovation are the topics discussed by Dr. John Mandrola in this week’s podcast.

The EXCEL debate, the NOBLE trial, alcohol and AF, cardiac devices, and hospital consolidation are the topics covered by John Mandrola, MD, in this week’s podcast.

A risk score for device infection, conflicts of interest, the Fragility Index, rhythm vs rate control for AF in HFpEF, and year-end highlights are discussed by John Mandrola, MD, in this week's podcast.

The EXCEL trial controversy, and Dr John Mandrola's experience with vernakalant at FDA are the topics covered in this week's podcast.

Vernakalent, CV death in cancer patients, dapagliflozin, and sacubitril/valsartan are the topics Dr. John Mandrola discusses in this week’s podcast.

Highlights from the 2019 AHA meeting are analyzed by Dr John Mandrola in this week’s podcast.

Interruption of oral anticoagulation, marijuana and stroke, ORBITA substudy, ISCHEMIA medical therapy targets, and more on AHA are the topics discussed by Dr. John Mandrola in this week’s podcast.

Words that harm, statins, thyroid replacement, and the ISCHEMIA trial are the topics discussed by Dr John Mandrola in this week’s podcast.

Mortality after AF ablation, cardiac rehab programs, hypertrophic cardiomyopathy, and clinician wellness are the topics Dr. John Mandrola discusses in this week’s podcast.

AF after TAVR, opioids after cardiac devices, hypertension in black adults, and post-cardiac surgery AF are the topics Dr John Mandrola discusses in this week’s podcast.

The Nobel Prize, more on the EXCEL trial, the costs of cardiac tests, familial hypercholesterolemia, and burnout are the topics discussed by Dr John Mandrola in this week’s podcast.

Left main PCI vs CABG trials and TAVR vs SAVR—in this week’s podcast, Dr John Mandrola takes a deeper dive.

Social effects of medicine, SGLT2 inhibitors, CIED infections, equity in cardiology, and post-PCI anti-thrombotic therapy are the topics discussed by Dr John Mandrola in this week’s podcast.

The polypill, dapagliflozin, TAVR, and video games are discussed by John Mandrola, MD, in this week’s podcast.

More from ESC: Antiplatelets and NOACs, blood glucose control, high sensitivity troponin tests, and ICD trials are all covered by John Mandrola, MD, in this week’s podcast.

Six major trials from the ESC meeting in Paris are reviewed by John Mandrola, MD, in this week’s podcast.

Digital health, a new LDL-c lowering drug, PCSK9i outcomes in higher risk patients, and an ESC preview are discussed by John Mandrola in this week’s podcast.

TAVR, baroreflex activation for heart failure, dapagliflozin for HF, and myocardial viability are the topics discussed by John Mandrola in this week’s podcast.

AI for AF detection, syncope and PE, thoracentesis, fish oil, and why doctors should organize are the topics covered by John Mandrola in this week’s podcast.

Digoxin, acupuncture and angina, heart failure with preserved ejection fraction, bariatric surgery, and cardiac device complications are the topics John Mandrola covers in this week's podcast.

CRT in patients with non-LBBB, ezetimibe, lifestyle diseases in the young, end of life care, and diabetes for the cardiologist are the topics John Mandrola, MD discusses in this week's podcast

Deprescribing beta bockers, interrupting oral anticoagulants, sudden death, quality measures, and acute stroke care are the topics John Mandrola, MD discusses in this week’s podcast.

High-sensitivity troponin assays, nursing education, negative risk markers, valve-in-valve TAVRs, and the use of AI in medical practice are covered in this week’s podcast.

Medical reversals, conflict of interest in the cardiac cath lab, cardiologist burnout, and changes in TAVR rules are discussed by John Mandrola, MD, in this week's podcast.

FDA hearings on paclitaxel devices in PAD, health news spin, myocarditis, difficult conversations, and TAVR in patients with end stage renal disease (ESRD) are discussed in this week’s podcast.

Vitamin D, ICD in patients on dialysis, aspirin, type 2 diabetes, and paclitaxel in PAD are the topics covered by John Mandrola in this week’s podcast.

Complications of PCI, health hubs, AV block after TAVR, VTE prevention, and rivaroxaban use in patients with heart failure are the topics discussed by Dr John Mandrola in this week's podcast.

Tricuspid valve repair, aortic stenosis, His-bundle pacing, deprescribing loop diuretics, and ‘leakage’ are covered in this week’s podcast.

Aspirin and ICH, late tPA for stroke, public reporting of outcomes, Impella, grapefruit juice and QT interval, and ICDs for primary prevention are discussed in this week’s podcast.

Renal and AF ablation in combination, infection risk of devices, neuromodulation of AF, pulsed field ablation and stroke of unknown source are covered in a HRS-heavy podcast.

Spin in the cardiovascular literature, palliative care for cardiac patients, tPA for acute stroke, and whether institutional volume affects AF ablation complications are the topics discussed this week.

Bike commuting and obesity, CMR for NSTEMI, Niacin in secondary prevention, cardiologists’ pay, and end-of-life conversations are in this week’s podcast.

Anticoagulation for embolic stroke of unknown origin, added-sugar labels, AF-patient knowledge, LDL-C and hemorrhagic stroke, and genetic signals in cancer-care cardiomyopathy are discussed this week.

Super-saturated oxygen in STEMI, Medicaid expansion and CV mortality, pacemakers in patients with HFpEF, HF readmissions, and exercise vs diet for weight loss are discussed in this week’s podcast.

ARB recalls, bystander compression-only CPR, renal denervation for hypertension, LDL cholesterol targets, and pre-op frailty are the topics discussed in this week’s podcast.

Catheter ablation for atrial fibrillation, eggs, booze, and anti-thrombotic agents for double vs triple therapy in patients with ACS and AF are discussed in this week’s podcast.

From ACC.19 and EHRA: The Apple Heart study, TAVR for low-surgical-risk AS, preventing cardiac device infections, COACT, VF arrest, and AF cardioversion are discussed in this week's podcast.

Obesity paradox studies and collider bias, the ISCHEMIA trial baseline findings, expanded indications for the MIitraClip, and an ACC preview are covered in this week’s podcast.

N of 1 hypertension trials, heart failure readmissions and HRRP, insulin, CTA vs functional stress testing, and the ongoing paclitaxel PAD controversy are discussed in this week’s podcast.

Lead extraction, AF triggers, cognitive decline and CV risk factors, low-value care, and secondary prevention in the real world are discussed in this week’s podcast.

Factor Xa reversal agent Andexa, PTSD, gender transition hormones and CVD, primary care physician shortage, and a commentary from a young interventional cardiologist are discussed this week.

The cost of cardiac care, statin adherence and mortality, syncope, ultra-processed food, and heart failure survival are discussed in this week's podcast.

Statins in the elderly, donor hearts and the opioid crisis, Impella, coronary calcium in exercisers, and the plateau in heart disease deaths are discussed in this week’s podcast.

New guidelines for atrial fibrillation, PFO closure for stroke prevention, fried chicken, skipping breakfast and e-cigarettes are discussed in this week’s podcast.

Aspirin for primary prevention, alcohol and Afib, high-sensitivity troponin, and women in interventional cardiology are discussed in this week’s podcast.

Burnout, aspiration thrombectomy, fish intake, insurance coverage, and the gout drug febuxostat are discussed in this week’s podcast.

Appropriate use criteria for imaging, HRRP efficacy, medical marijuana, radiation exposure in the cath lab, and hormone therapy are the topics discussed this week’s podcast.

The cost of treating high blood pressure, heart-failure readmission policies, abdominal fat, low flow/low gradient aortic stenosis and hypertensive disorders of pregnancy are discussed this week.

Dr John Mandrola discusses upcoding for PCI, hypertension, a pacing lead issue, a PAD trial discovery, and an FDA warning on fluoroquinolones in this week’s podcast.

Carotid stents, more stem-cell retractions, AHA statement on statin safety, flu vaccine rules, medication errors, veterans care, and wasteful NIH research on golfing are discussed in this week’s podcast.

Measures of hospital quality, statin under- or over-use, Botox for AF, smoking cessation and translating trial evidence to clinical practice are discussed in this week’s podcast.

TAVR vs surgery for high-risk aortic stenosis, conflicts of interest for physicians and societies, spin in the CV literature, and low-carb diets are discussed in this week’s podcast.

The top 5 studies from the recent American Heart Association meeting and the new cholesterol guidelines are discussed in this week’s podcast.

ODYSSEY PCSK9 inhibitor trial in print, new bradycardia guidelines, echocardiography, and an AHA preview are the topics discussed in this week’s podcast.

CV outcomes in patients with type 2 diabetes, canagliflozin, cardiorespiratory fitness, the value of randomized trials, and the most important paper of 2018 are reviewed in this week’s podcast.

Oxygen supplementation, PCSK9 inhibitor pricing, rapid troponin testing, cardio-oncology and joint commission accreditation are discussed in this week’s podcast.

Low-dose rivaroxaban for CAD/PAD, hypertension management in the community, research misconduct, cyber-security in cardiac devices, and bariatric surgery are discussed in this week’s podcast.

Timing of aortic valve replacement, rivaroxaban failure post TAVR, statins beyond CVD, conflicts of interest, and post-stent antithrombotic management are discussed in this week’s podcast.

The COAPT MitraClip trial, high dose omega-3 fatty acids, the VEST trial in print, renal denervation for resistant hypertension, and competing coronary stents are discussed in this TCT-heavy podcast.

ASA, polypharmacy, statins and obesity treatments are the topics discussed by Dr John Mandrola in this week’s podcast

The Apple Watch EKG, ablate/pace strategies, chronic total occlusion-PCI, assisted reproduction strategies and CV health, and remembering Ron Victor, MD are the topics for this week’s podcast.

High sensitivity troponin, radial access (a good news story!), stroke care, rivaroxaban in CAD and PAD, and the components of a healthy diet are discussed in this week’s podcast.

The salt wars, drug costs and vaule, Takotsubo syndrome, carb intake, and the upcoming European Society of Cardiology congress are discussed in this week’s podcast

Screening athletes, AF ablation complications, physician gender and MI mortality, the rise of chronic kidney disease, and the rosuvastatin lawsuit are discussed in this week's podcast.

AF screening, atrial flutter, palliative care in heart failure, and LDL-C lowering are discussed in this week's podcast

Aspirin dosing, a potential new drug for SVT, apixaban in patients with ESRD, TAVR, and saunas, are discussed in this week's podcast

Leadless pacing, AF detection, coronary calcium, BP control and omega-3 fatty acids are discussed in this week's podcast.

Questionable ICD use, ambulatory blood pressure monitoring, multivitamins and cardiovascular health, and end-of-life care are discussed in this week's podcast

Dr John Mandrola discusses controversy over the ISCHEMIA trial, AAA screening, PCSK9i in diabetes, cardiac arrest and Twitter in this week’s podcast

PREDIMED (again), malpractice concerns in CAD testing, alcohol, stroke care in the elderly, and genetic testing are the topics discussed by Dr John Mandrola in this week’s podcast

Nutrition education for docs, PREDIMED retraction, recommendations for ECG screening of healthy adults, and MOC studies are discussed in this week's podcast.

Better equations for CV risk prediction, a drug for bradycardia, illicit drugs and MI in the young, EHR woes, and vitamins for CV risk reduction are discussed in this week's podcast.

Surgical left atrial appendage occlusion, renal denervation, a substudy of ORBITA, FFR and hypertension guidelines are discussed in this week's podcast.

Device-related thrombosis with Watchman left atrial appendage closure, debulking atrial fibrillation after ablation, rivaroxaban for stroke prevention, alteplase, and Lp(a) are discussed this week.

The CABANA trial on catheter ablation in patients with atrial fibrillation is discussed in this week’s podcast recorded at the Heart Rhythm Scientific Sessions.

AHA rescinds sections of the stroke guidelines, thrombectomy for pulmonary embolism, Mitra-clip, nuts and AF, and blood pressure measurements are discussed in this week's podcast.

Lipid-lowering and baseline LDL-C, the CV safety of NSAIDs, 'metabolically healthy' obesity, PCI for chronic total occlusions, and wearable tech are discussed in this week's podcast.

Ambulatory BP measurements, advanced practice providers, medical marijuana for sleep apnea, Barbara Bush's comfort care, and apixaban for cardioversion are the topics discussed in this week's podcast.

Atrial fibrillation after cardiac surgery, long QT syndrome, exercise for CV prevention, a new risk factor for mothers, and coronary obstruction post TAVR are discussed in this week's podcast.

Beta-blockers in diabetes, ACE inhibitors vs ARBs, cardiac implantable electronic device infections, alcohol and AF, and strengthening the p value threshold are discussed in this week's podcast.

Dr. John Mandrola discusses heart failure care, methamphetamine, AF ablation, lead extraction, and myocardial injury after noncardiac surgery in this week's podcast.

His-bundle pacing, Factor Xa reversal, heart failure quality measures, predicting prognosis after cardiac arrest, and myocarditis after cancer immunotherapy are discussed in this week's podcast.

ODYSSEY, VEST, mSTOPS, CANTOS, and the Black barbershop blood pressure study are among the presentations from the 2018 American College of Cardiology meeting reviewed in this week's podcast.

Obesity in young people, type-2 diabetes, the risks of varicose veins, on-pump vs off-pump coronary artery bypass surgery and an ACC preview are the topics discussed in this week's podcast.

Vegetarian vs Mediterranean diets, a clarithromycin alert, a new stent, best choice of IV fluid, and early work in prevention Type I diabetes are discussed in this week's podcast.

Atrial fibrillation after cardiac surgery, radial vs ulnar cath access, aspirin for heart failure, VTE prophylaxis and low-fat vs high-carb diets are discussed in this week's podcast.

ICD use in patients with CKD, PFO and peri-operative stroke, LV assist devices, guideline-directed medical therapy after revascularization, and upcoming trials in 2018 are discussed in this week's podcast.

Genetic risk scores and early onset CAD, ECGs in athletes, the ripple effect of weight loss, troponin in sepsis, and fish oil for CVD prevention are the topics discussed in this week's podcast.

Loperamide abuse, heart failure quality measures, and the CASTLE-AF ablation study are discussed in this week's podcast.

Surgical left atrial appendage closure, the effects of smoking and influenza on CV risk, acute stroke care, and why cardiologists are an unhappy bunch are discussed by Dr Mandrola this week.

MRI in patients with cardiac devices, bariatric surgery, statins, the LifeVest wearable defibrillator, and spontaneous coronary dissection are the topics discussed in this week's podcast.

Exercise effects on left ventricular compliance, CT in stable angina, MRI in patients with cardiac devices, a win for pharma, and ECG screening in adults are discussed in this week's podcast.

Noninvasive VT ablation, Riata leads, NOAC/DOAC therapies, HDL-C and infection risk, and fibrosis in triathletes are discussed in this week's podcast.

Mobile ECGs, PFO closure for migraine, AF care, lytic and mechanical removal of VTE and the PSCK9 inhibitor evolocumab are discussed in this week's podcast.

Sports preparticipation screening, cell therapy in PAD, exercise, supplements, and US healthcare policy are reviewed in this week’s podcast.

New hypertension guidelines, BP measurement, DOACs during device surgery, a CANTOS substudy, and conflicting data on the heart-failure readmissions reduction program are discussed this week.

Dr John Mandrola discusses PCI in stable CAD, MR, exercise, AHA preview, and celebrities at medical meetings in this week's podcast.

The ORBITA sham-control PCI study, Watchman, revascularization in cardiogenic shock, Absorb BVS, quality-of-life outcomes after PCI or bypass, and chronic total occlusion PCI are discussed in this week's podcast.

Statins tied to diabetes risk and reduced bacterial infections, a novel use for hs-troponin, mitral-regurgitation management, and His-bundle pacing are reviewed in this week's podcast.

Secondary AF, Heart failure statistics, DOAC bleeding rates, uncontrolled hypertension and stroke risk factors are discussed by John Mandrola in this week's podcast.

Noninvasive tests for chest pain evaluation, the obesity epidemic, the costs of cardiac device recalls, and DOAC-drug interactions are reviewed in this week's podcast.

Stopping aspirin, TAVR durability, meditation, triathlon risk, and BP control in low-income patients are discussed by Dr Mandrola in this week's podcast.

Oxygen therapy in stroke, physical activity, hospital rankings, MRI labeling of cardiac devices, and PFO closure are discussed in this week's podcast.

PCSK9 drugs and diabetes, allegations against St Jude Medical, trends in carotid interventions, food as medicine, and death with dignity are discussed by Dr John Mandrola in this week's podcast.

PFO closure for recurrent stroke prevention, hormone replacement in women, DAPT, obesity, and fentanyl are discussed in this week's podcast.