This Week in Cardiology

Tirzepatide vs semaglutide in obesity; GLP1a use is complicated; HF outcomes; the misuse of meta-analyses in HF; and a breakthrough in HF care 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. SURMOUNT 5 Clinicaltrials.gov https://clinicaltrials.gov/study/NCT05822830 Press Release   II. Access to GLP-1 Agonist Drugs CMS statement https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-medicare-advantage-and-medicare-part-d-prescription-drug III. SUMMIT TRIAL commentary Has Tirzepatide Scaled the HFpEF/Obesity SUMMIT? https://www.medscape.com/viewarticle/has-tirzepatide-scaled-hfpef-obesity-summit-2024a1000m2h IV. Blank Spot in HF Evidence – All cause hospitalizations   Sayed and colleagues What Is Success in HF Trials? https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827168 EMPEROR-Preserved https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 Mayo Observational Study 10.1016/j.mayocp.2016.11.009 DIG Trial https://jamanetwork.com/journals/jama/fullarticle/195990 V. Misuse of Meta-analysis by HF Community Lu and colleagues PARAGON/PARADIGM Meta-analysis https://jamanetwork.com/journals/jamacardiology/fullarticle/2823259 Desai 2004 https://jamanetwork.com/journals/jama/fullarticle/199995 PARADIGM HF https://www.nejm.org/doi/full/10.1056/NEJMoa1409077 PARAGON HF https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 VI Integration of Palliative Care Into HF Care Chuzi and colleagues Palliative Care in HF 10.1016/j.cardfail.2024.10.435 Kotecha and colleagues Beta-blocker Metaanalysis 10.1016/S0140-6736(14)61373-8 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 AHA review: the OPTION, SUMMIT, VANISH 2, SARAH, and CLEAR 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. OPTION Trial For AF, LAA Rivals Anticoagulants After Ablation https://www.medscape.com/viewarticle/af-laa-rivals-anticoagulants-after-ablation-2024a1000l7n 4 Reasons to Question Percutaneous Left Atrial Appendage Closure After AF Ablation https://www.medscape.com/viewarticle/4-reasons-question-percutaneous-left-atrial-appendage-2024a1000l0u OPTION in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2408308 II. SUMMIT Trial Tirzepatide Reduces Heart Failure Events in HFpEF With Obesity https://www.medscape.com/viewarticle/tirzepatide-reduces-heart-failure-events-hfpef-obesity-2024a1000kx5 SUMMIT in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2410027 III. VANISH Trial New Trial Result Pushes Past Antiarrhythmic Therapy After MI https://www.medscape.com/viewarticle/new-trial-result-pushes-past-antiarrhythmic-therapy-after-mi-2024a1000l08 VANISH 2 https://www.nejm.org/doi/full/10.1056/NEJMoa2409501 VANISH 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 IV. Cardioprotection Common Heart Failure Drugs Ease Heart Damage During Chemo https://www.medscape.com/viewarticle/common-heart-failure-drugs-ease-heart-damage-during-chemo-2024a1000l14 Strain Imaging Review Article https://www.jacc.org/doi/10.1016/j.jcmg.2024.07.011 V. CLEAR trial Spironolactone Shows Mixed Results in Acute MI https://www.medscape.com/viewarticle/spironolactone-shows-mixed-results-acute-mi-2024a1000l41 Routine Colchicine or MRA Post-MI: No CLEAR Benefit https://www.medscape.com/viewarticle/routine-colchicine-or-mra-post-mi-no-clear-benefit-2024a1000la2 CLEAR-Spironolactone https://www.nejm.org/doi/full/10.1056/NEJMoa2405923 CLEAR-Colchicine https://www.nejm.org/doi/full/10.1056/NEJMoa2405922 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]

Tirzepatide, AF screening, and an AHA preview, including VT ablation, LAAC at the time of AF ablation, BP targets, and GLP1 agonists in HF 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. Tirzepatide SURMOUNT 1 – Three-year results https://www.nejm.org/doi/full/10.1056/NEJMoa2410819 II. AF Screening GUARD AF https://www.jacc.org/doi/10.1016/j.jacc.2024.08.019 LOOP 10.1016/S0140-6736(21)01698-6 STROKE STOP 10.1016/S0140-6736(21)01637-8 III. LAAC with AF ablation  Mandrola Previews the OPTION Trial, the Most Worrisome Study at AHA 2024 https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz The OPTION Trial Rationale https://doi.org/10.1016/j.ahj.2022.05.003 IV. Blood Pressure Targets BPROAD https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13411 ACCORD - https://www.nejm.org/doi/full/10.1056/NEJMoa1001286 V. GLP1a for HFpEF SUMMIT at Clinicaltrials.gov https://clinicaltrials.gov/study/NCT04847557 VI. VT Ablation VANISH2 Rationale https://doi.org/10.1016/j.ahj.2024.04.009 VANISH 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 VII. Spironolactone Results of CLEAR-SYNERGY  Nov 08, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001865 'No Hint of Benefit' in Large Colchicine Trial https://www.medscape.com/viewarticle/no-hint-benefit-large-colchicine-trial-2024a1000ko4 CLEAR SYNERGY Rationale https://pubmed.ncbi.nlm.nih.gov/38936755/ 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 EARLY TAVR trial, colchicine after MI, and the TRISCEND II trial of tricuspid valve replacement 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 TAVR EARLY TAVR https://www.acc.org/latest-in-cardiology/clinical-trials/2024/10/24/14/42/early-tavr Rationale https://doi.org/10.1016/j.ahj.2023.11.019 AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 RECOVERY https://www.nejm.org/doi/full/10.1056/NEJMoa1912846 FAME 2 https://www.nejm.org/doi/full/10.1056/NEJMoa1205361 Rajkumar; Faith Healing in Unblinded Trials https://pubmed.ncbi.nlm.nih.gov/29530888/ PARTNER 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307447 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec II. Colchicine Meta-analysis https://doi.org/10.1016/j.eclinm.2024.102835 Clear-Synergy Rationale https://pubmed.ncbi.nlm.nih.gov/38936755/ COLCOT (post MI) https://www.nejm.org/doi/full/10.1056/NEJMoa1912388 LoDoCo (Chronic CAD) https://www.nejm.org/doi/full/10.1056/NEJMoa2021372   III. TRISCEND II Trial TRISCEND II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2401918 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 PFA and STEMI/NSTEMI paradigm, oral semaglutide, symptomatic vs asymptomatic AF, and the win-ratio 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 18, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001769 Pulsed Field Ablation https://www.hrsonline.org/guidance/safety-alerts/boston-scientific-cardiac-cryoablation-system STEMI/NSTEMI https://doi.org/10.1016/j.jacadv.2024.101314 II. Oral Semaglutide Press Release: https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=171480 Rationale Paper SOUL trial III. Symptomatic vs Asymptomatic AF Meta-analysis in EHJ   Meta-analysis of rate vs rhythm-control strategies https://doi.org/10.1016/j.jacep.2024.03.006 IV. The Win Ratio Pocock and colleagues https://doi.org/10.1093/eurheartj/ehae647 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 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]