In this episode, Dr. Harlan Krumholz introduces the September 16, 2025 issue of JACC, which features studies that challenge conventional clinical thinking, including a detailed ECMO physiology study showing that higher ECMO flow does not uniformly raise pulmonary capillary wedge pressure, suggesting the need for individualized management. A novel analysis of the ISCHEMIA trial revealed distinct angina symptom trajectories, emphasizing that recovery is not binary and supporting a more personalized approach to treatment and monitoring. A landmark target trial emulation found that statins significantly reduce cardiovascular risk in patients with type 1 diabetes—filling a key evidence gap. Additional highlights include a call to redefine early cardiogenic shock, a nuanced review of moderate secondary mitral regurgitation, and an editorial reaffirming JACC's commitment to independent, transparent science in alignment with new "Gold Standard Science" principles.
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