Caring for Patients: Cardiogenic Shock Survivorship, Masters Athletes, Medicare Spending on Semaglutide, GDMT and Veterans

In this week's View, Dr. Eagle examines early surgery for asymptomatic patients with severe aortic stenosis. He then reviews evidence linking blood pressure trajectories and rapid control to significantly improved outcomes. Finally, he compares percutaneous coronary intervention with medical therapy for chronic total occlusion in patients with chronic coronary disease.   Subscribe to Eagle's Eye View   

In this week's View, Dr. Eagle explores four recent articles that examine how we care for patients. First, Dr. Eagle looks at a new state-of-the-art review that outlines a multidisciplinary framework for cardiogenic shock survivorship. He then analyzes the new Joint Clinical Statement focusing on Masters athletes with abnormal cardiovascular findings, followed by details on a study of how participation in the BALANCE Model will impact Medicare spending on semaglutide. Finally, Dr. Eagle discusses how modifiable barriers may improve access to quadruple guideline-directed medical therapy for veterans with heart failure with reduced ejection fraction.    Subscribe to Eagle's Eye View   

In this week's View, Dr. Eagle highlights trials from the recently held ACC Scientific Sessions which took place in New Orleans, March 28-30. Important studies discussed include:   CHAMPION-AF: Left atrial appendage closure vs. anticoagulation for AFib   VESALIUS-CV: Evolocumab reduces CV risk in diabetic patients without ASCVD  Ez-PAVE: Hitting lower LDL-C target reduces major CV events   PRO-TAVI: Should high-risk patients undergo PCI before TAVI?   SMART-DECISION: Discontinuing beta-blockers safe 1 year post MI For stable patients  GoFreshRx: How home-delivered DASH groceries improve blood pressure (BP) and LDL-C  THRIVE: Exploring the positive effects of a culturally tailored "food-is medicine" program on lowering BP      

In this week's View, Dr. Eagle looks at data from the STS/ACC TVT Registry on off-label transcatheter valve interventions that demonstrate reduced residual tricuspid regurgitation (TR) and improved quality of life. He then explores the REVNOVATE-COMPLEX-PCI study that investigates the benefits of intravascular imaging guidance for five years. Finally, Dr. Eagle summarizes the ACC/AHA's newly released clinical guidelines for managing dyslipidemia.     Subscribe to Eagle's Eye View    

In this week's View, Dr. Eagle looks at the differential effect of bisoprolol versus verapamil in nonobstructive hypertrophic cardiomyopathy (HCM) treatment. He then explores lower heart failure (HF) hospitalization risk in patients with type 2 diabetes, comparing GLP-1RAs to DPP-4 inhibitors and similar outcomes with SGLT-2 inhibitors. Dr. Eagle then examines the use of shared decision-making and decision aids in percutaneous left atrial appendage occlusion (LAAO).  Finally, the iModern trial, which compares immediate percutaneous coronary intervention (PCI) guided by instantaneous wave-free ratio (iFR) and deferred PCI guided by cardiac stress magnetic resonance imaging (MRI) in patients with STEMI and multivessel disease, is discussed.   Subscribe to Eagle's Eye View    

In this week's View, Dr. Eagle looks at increased one-year mortality in younger patients undergoing transcatheter aortic valve replacement (TAVR). He then explores the PREDIMED trial which found that adherence to the Mediterranean diet plus moderate wine intake was associated with reduced cardiovascular risk and mortality. Finally, Dr. Eagle examines 20-year outcomes for pulmonary vein isolation (PVI) in patients with drug-refractory paroxysmal atrial fibrillation (AFib).   Subscribe to Eagle's Eye View    

In this week's View, Dr. Eagle looks at findings from the Evolut Low Risk trial in which self-expanding transcatheter aortic valve replacement (TAVR) versus surgery at six years in low-risk patients with aortic stenosis (AS) is considered. He then explores the TUXEDO-2 Trial evaluating ticagrelor versus prasugrel in percutaneous coronary intervention patients with diabetes and multivessel coronary disease (MVD). Finally, Dr. Eagle examines the first-ever release of the AHA/ACC guideline for treatment and management of acute pulmonary embolism (PE) in adults.    Subscribe to Eagle's Eye View   

In this week's View, Dr. Eagle looks at the ORBITA-2 trial and how percutaneous coronary intervention (PCI) may lead to greater symptom relief in older adults. He then explores the EQUAL trial that investigated how Apple smartwatch monitoring improves atrial fibrillation (AFib) detection. Finally, Dr. Eagle examines revelations from the EMPEROR-Preserved trial regarding interaction between SGLT2 inhibitors and baseline magnesium levels in treating patients who have either heart failure (HF) or HF with preserved ejection fraction (HFpEF).   Subscribe to Eagle's Eye View   

In this week's View, Dr. Eagle looks at exercise systolic blood pressure (SBP) during stress testing related to cardiovascular (CV) events. He then explores the novel Navitor transcatheter heart valve (THV) and its safety and effectiveness in younger patients requiring transcatheter aortic valve replacement (TAVR). Finally, Dr. Eagle examines the value of 18F-FAPI PET/CT imaging and its role in assessing risk in patients with pulmonary arterial hypertension (PAH).   Subscribe to Eagle's Eye View   

In this week's View, Dr. Eagle comments on the recently published JACC Cardiovascular (CV) Statistics report which evaluates the management of CV risk factors in the United States. He then explores the use of semaglutide and its association with reduced hospital admissions and length of stay. Finally, Dr. Eagle examines the multicenter, multinational ADJUST-DVT study on the age-adjusted use of D-dimer cut-offs for patients with suspected deep vein thrombosis.      Subscribe to Eagle's Eye View