This Week in Cardiology

Listener feedback, multiple studies in AF ablation, a DANISH trial substudy of ICDs in NICM, and more data on eye complications of GLP-1 agonists 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. CCTA Feedback * Foy meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 * DANCAVAS https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 II. Listener Feedback on my negative take of the OPTION Trial. * Option trial https://www.nejm.org/doi/pdf/10.1056/NEJMoa2408308 * My Preview https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz * 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 III. AF Ablation  PVI Add-Ons Provide Better Control of Persistent AF https://www.medscape.com/viewarticle/pvi-add-ons-provide-better-control-persistent-af-2024a1000lcm * VENUS https://jamanetwork.com/journals/jama/fullarticle/2772281 * PROMPT AF https://jamanetwork.com/journals/jama/fullarticle/2826710 * STAR AF 2 https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 * CRRF-PeAF https://pmc.ncbi.nlm.nih.gov/articles/PMC9241129/ * CAVAC trial https://doi.org/10.1161/CIRCEP.124.012917 * CRRF-PeAF from multiple centers in Japan (not published) IV. DANISH Trial Substudy * Danish Trial Substudy https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.124.071777 * Danish Main https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 * MADIT-2 EF Substudy https://doi.org/10.1016/S0002-9149(01)01729-5 * SCD-HeFT subgroup https://www.nejm.org/doi/full/10.1056/NEJMoa043399 * Appraisal of ICD to Prevent SCD https://doi.org/10.1016/j.jacc.2008.05.058 V. Eye disease and GLP-1 Agonists Jul 26, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001384 * Semaglutide vs No Semagutide and Eye Disease https://link.springer.com/epdf/10.1186/s40942-024-00620-x * Semaglutide vs SGLT- Inhibitors and Eye Disease https://www.medrxiv.org/content/10.1101/2024.12.09.24318574v1.full-text 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 news@medscape.net

US doc's pay, the ticagrelor controversy and new RCTs, clopidogrel beats ASA, holding antiplatelets for non-cardiac surgery, and Prof Cleland and ASA dogma 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. US Healthcare Mandrola’s Top 10 Stories in 2024 https://www.medscape.com/viewarticle/mandrolas-top-10-stories-2024-2024a1000mxe?_gl=1*dcvmkh*_gcl_au*MTgzOTY2ODQ0Ni4xNzI5MjU4NjUz * CMS Proposal II. Ticagrelor Controversy New Investigation Casts Doubt on Landmark Ticagrelor Trial https://www.medscape.com/viewarticle/new-investigation-casts-doubt-landmark-ticagrelor-trial-2024a1000n1d * Doshi Review https://www.bmj.com/content/387/bmj.q2550 * PLATO https://www.nejm.org/doi/full/10.1056/NEJMoa0904327 * ISAR REACT 5 https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 * Bates Review https://www.ahajournals.org/doi/epub/10.1161/JAHA.123.031606 * Victor Serebuany and Dan Atar Editorial https://doi.org/10.1093/eurheartj/ehp545 III. New Ticagrelor vs Clopdiogrel trial * Preprint: https://www.medrxiv.org/content/10.1101/2024.11.06.24316875v1.full-text IV. Clopidogrel Better Than ASA Even in HBR * Substudy Long-Term Aspirin vs Clopidogrel After Coronary Stenting by Bleeding Risk and Procedural Complexity * HOST-EXAM 10.1016/S0140-6736(21)01063-1 * HOST-EXAM-Extended https://doi.org/10.1161/CIRCULATIONAHA.122.062770 V. ASA During Non-Cardiac Surgery * ASSURE DES https://doi.org/10.1016/j.jacc.2024.08.024 VII. Professor Cleland on ASA for Secondary Prevention * Cleland Editorial https//jamanetwork.com/journals/jamacardiology/article-abstract/2827201 * ASA Meta-analysis 10.1016/S0140-6736(09)60503-1 * AMIS https://jamanetwork.com/journals/jama/fullarticle/368745 * SAPAT 10.1016/0140-6736(92)92619-Q 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 news@medscape.net

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 news@medscape.net

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 news@medscape.net

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 news@medscape.net