Interactions of Sleep Apnea with the Pathophysiology of Cardiovascular Disease, Part 1: JACC State-of-the-Art Review

In this episode, Dr. Valentin Fuster highlights the groundbreaking studies featured in the November 12, 2024 issue of the JACC, focusing on the emerging role of proteomics in understanding heart failure and hypertrophic cardiomyopathy. He discusses key findings on SGLT2 inhibitors, the efficacy of complete revascularization in myocardial infarction patients, and novel treatments for hypercholesterolemia, emphasizing the transformative potential of these insights for cardiovascular care.

In this episode, Dr. Valentin Fuster discusses groundbreaking research on SGLT2 inhibitors and their impact on heart failure, highlighting the validation of mechanistic proteomic signatures from a major clinical trial. The study reveals how empagliflozin influences over 2,000 proteins, promoting autophagy, enhancing mitochondrial health, and normalizing kidney function, offering new insights into therapeutic strategies for heart failure management.

In this episode, Dr. Valentin Fuster discusses groundbreaking research on hypertrophic cardiomyopathy (HCM), revealing dysregulated signaling pathways through comprehensive proteomic profiling of human myocardial tissue. The study identifies novel therapeutic targets, including the Ras MAPK pathway and the ubiquitin-proteasome system, while emphasizing the need for further exploration beyond obstructive cases to better understand the disease's molecular mechanisms.

In this episode, Dr. Valentin Fuster discusses a pivotal study on revascularization strategies in older patients with myocardial infarction, comparing complete versus culprit-only approaches. The findings suggest that physiology-guided complete revascularization significantly reduces adverse outcomes in both STEMI and non-STEMI patients, emphasizing its potential benefits across a diverse patient population.

In this episode, Dr. Valentin Fuster reviews two pivotal phase three trials from China assessing the efficacy of the new monoclonal antibody, Katisha, for treating non-familial hypercholesterolemia. With significant reductions in LDL cholesterol and a long-acting, flexible dosing regimen, these studies promise a novel therapeutic option for patients struggling with cholesterol management and adherence to traditional treatments.

In this episode, Dr. Valentin Fuster reviews two pivotal phase three trials from China assessing the efficacy of the new monoclonal antibody, Katisha, for treating non-familial hypercholesterolemia. With significant reductions in LDL cholesterol and a long-acting, flexible dosing regimen, these studies promise a novel therapeutic option for patients struggling with cholesterol management and adherence to traditional treatments.

In this episode, Dr. Valentin Fuster delves into the transformative potential of artificial intelligence (AI) in cardiovascular clinical trials, guided by a comprehensive review from leading experts. Highlighting both innovative applications and regulatory challenges, the discussion emphasizes AI's role in trial design, patient recruitment, and data analysis, while cautioning against risks like bias and data privacy concerns.

Author Robert W. Yeh, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss the results of the TARGET-IV NA trial. In the trial, 1720 patients with stable or acute coronary syndromes were randomized to undergo PCI with a BP-SES or any commonly used 2nd generation DES. At 12 months, BP-SES was non-inferior to control DES for the primary endpoint of Target Lesion Failure (cardiac death, target vessel-related myocardial infarction (MI), or ischemia-driven target lesion revascularization) which occurred in 3.4% of the BP-SES arm versus 3.3% in the control arm; p-value for non-inferiority. Secondary endpoints were also similar between groups.

In this episode of JACC, Author Suzanne Arnold, MD and JACC Associate Editor Dennis T. Ko, MD, discusses groundbreaking findings from the Tricatin-2 trial, the first clinical study on transcatheter tricuspid valve replacement. The results reveal significant improvements in quality of life for patients, particularly those with severe tricuspid regurgitation, highlighting the transformative potential of this procedure compared to traditional medical therapy.

Author Shao-Liang Chen, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss patients with simple and true coronary bifurcation lesions undergoing provisional stenting. Main vessel stenting with a DCB for the compromised side branch resulted in a lower 1-year rate of the composite outcome compared with an NCB intervention for the side branch. The high rates of periprocedural myocardial infarction, which occurred early and did not lead to revascularization, are of unclear clinical significance.