Monotherapy in HBR Patients: What STOPDAPT-3 Tells Us | JACC Baran

In this episode of JACC This Week, Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC spotlights major electrophysiology research and clinical insights from the July 8 issue of JACC. This week’s issue features new findings on left atrial appendage occlusion techniques, comparisons of atrial fibrillation stroke prevention guidelines across regions, and device-related complications such as pacemaker lead perforation and device embolization. You'll also hear highlights from JACC: Clinical Electrophysiology, including striking Amara Yad anatomical visuals and real-world clinical scenarios.

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Nobuhiro Ikemura, MD, welcome Yuki Obayashi, MD, of Leiden University Medical Center, to discuss findings from the STOPDAPT-3 trial. Dr. Obayashi highlights that, among ACS patients—including those with HBR or STEMI—aspirin and clopidogrel monotherapy after 1 month of DAPT resulted in similar rates of ischemic and bleeding events. These results support flexible, patient-centered antiplatelet strategies beyond the acute phase.

As the podcast series created by Editor Emeritus Valentin Fuster, MD, PhD, MACC, comes to an end and the new series from current Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC is launched, JACC is pleased to feature an interview between the two legendary thought leaders, discussing the past and future of the journal's podcasts. The interview honors Dr. Fuster for his enduring contributions to the JACC podcast, highlighting his dedication, consistency, and global impact even after stepping down as Editor-in-Chief. This frank and heartfelt conversation serves as the bridge for JACC podcasts, as Dr. Fuster expresses confidence in the future of JACC under Dr. Krumholz's leadership.

In this heartfelt reflection on their first year as editor of JACC, Harlan Krumholz shares how listening—to authors, reviewers, readers, and the broader medical community—has revealed a deep yearning for connection, trust, and purpose in cardiovascular science. It’s a call to action: to shape the future of medicine with integrity, inclusivity, and hope, and to lead not just with data, but with values that inspire and unite.

In this debut episode of JACC This Week with Editor-in-Chief Dr. Harlan Krumholz, we explore groundbreaking studies and timely insights from the July 1st issue. Highlights include the impact of wildfire smoke on heart failure risk, new hemodynamic data on mechanical circulatory support in cardiogenic shock, and sobering cardiovascular mortality trends over the past 25 years. Plus, updates on aspirin use, cognitive impairment in CVD, ACC/AHA performance measures, and a leadership reflection from ACC President Dr. Christopher Kramer.

In this issue of JACC, we explore the evolving landscape of cardiovascular care, where one-size-fits-all approaches are giving way to precision strategies rooted in individual variation. From redefining diagnostic thresholds to tailoring surveillance based on genetics and patient context, these studies illuminate a future where nuance, not averages, drives better outcomes. Join us as we unpack the science behind a more personalized, data-informed vision of heart health.

In this episode, Dr. Valentin Fuster presents new research revealing that fewer than one-third of patients with hypoplastic left heart syndrome survive 35 years without a transplant, though many adults report good to excellent quality of life after stage reconstructive surgery. Highlighting expert insights, he underscores the urgent need for innovative treatments and dedicated care teams to improve long-term outcomes in this high-risk congenital heart disease.

In this episode, Dr. Valentin Fuster discusses a major study on Loeys-Dietz syndrome (LDS), revealing that extra-aortic arterial aneurysms are both common and clinically significant across a broad vascular spectrum. The findings emphasize the need for comprehensive, head-to-pelvis imaging in LDS patients to detect and monitor potentially life-threatening aneurysms beyond the thoracic aorta.

In this episode, Dr. Valentin Fuster discusses a landmark study from the Montalcino Aortic Consortium revealing how genetic differences in Marfan syndrome, Loeys-Dietz syndrome, and vascular Ehlers-Danlos syndrome distinctly influence the risk and location of arterial events. The findings highlight gene-specific patterns—thoracic aortic complications in Marfan and Loeys-Dietz, and peripheral arterial issues in Loeys-Dietz and Ehlers-Danlos—paving the way for personalized surveillance and management strategies.

In this episode, Dr. Valentin Fuster discusses a study showing that elevated cardiac troponin levels after intense exercise in middle-aged recreational athletes are common but not linked to hidden coronary artery disease. The findings raise important questions about the origin and significance of these elevations, highlighting the need for long-term follow-up.