This Week in Cardiology

Another knock against the antiplatelet/anticoagulant combo, polypills in HF, the physical exam of the future, and the problem of underpowered trials that even Bayesian analyses cannot rescue 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 Listener Feedback * Trends Study https://www.heartrhythmjournal.com/article/S1547-5271(11)00496-6/fulltext II Another knock against the Antiplatelet/Anticoagulation combination “Antiplatelet Plus Oral Anticoagulant Lowers Stroke, Raises Bleeding Risk” https://www.medscape.com/viewarticle/antiplatelet-plus-oral-anticoagulant-lowers-stroke-raises-2025a1000re0 * ATIS-NVAF Trial https://jamanetwork.com/journals/jamaneurology/fullarticle/2839511 * AQUATIC trial https://www.nejm.org/doi/abs/10.1056/NEJMoa2507532 III Polypill for HFrEF * A Multilevel Polypill for Patients With HFrEF https://www.jacc.org/doi/10.1016/j.jacadv.2025.102195 IV The Physical Exam of the Future * Point-of-Care Ultrasound https://doi.org/10.1016/j.jchf.2025.102707 V More on Underpowered Trials – GA vs Moderate Sedation in IV stroke * SEGA Trial https://jamanetwork.com/journals/jamaneurology/fullarticle/2839838 * Bayesian Analyses of CV Trials https://doi.org/10.1016/j.cjca.2021.03.014 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

GLP-1 use in HFrEF, left atrial posterior wall isolation during AF ablation, peri-device leaks for LAAO, new findings in post-cardiac surgery AF, and imaging before AF ablation 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. Listener Feedback HYPERION trial https://www.nejm.org/doi/10.1056/NEJMoa2508170 ZENITH trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415160 II GLP1 Use in HFrEF Effects of GLP-1s in Patients With HFrEF https://doi.org/10.1016/j.jchf.2025.102573 FIGHT Study https://jamanetwork.com/journals/jama/fullarticle/2540402 FIGHT Study Post-hoc Analysis https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14862 Substudy of EXSCEL Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.041659 III LA Posterior Wall Isolation Saga Failure of PW Wall Isolation by PFA with Epicardial Mapping https://doi.org/10.1016/j.jacep.2025.08.017 IV Peridevice Leaks After LAAO IMPRESSION LAAC Study https://doi.org/10.1016/j.jacep.2025.08.014 V Post Cardiac Surgery AF Monitoring of New-Onset AF After CABG https://jamanetwork.com/journals/jama/fullarticle/2839710 PACES trial https://clinicaltrials.gov/study/NCT04045665 VI TEE vs ICE Before AF ablation ICE vs TEE Study https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370 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

Two great stories of translation science leading to beneficial drugs in terrible diseases of the heart and the Sisyphean task of predicting the need for pacing after TAVI 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 Sotatercept * HYPERION Trial https://www.nejm.org/doi/10.1056/NEJMoa2508170 * ZENITH Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415160 * Evidence report on treatment for PAH https://icer.org/news-insights/press-releases/icer-publishes-final-evidence-report-on-treatment-for-pulmonary-arterial-hypertension/ * PAH Sotatercept Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2503944 II Acoramidis and ATTR Cardiomyopathy * ATTRIBUTE-CM Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2305434?logout=true * ATTRIBUTE-CM Analysis - Substudy https://www.jacc.org/doi/10.1016/j.jacc.2025.09.013 * Tafamadis Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1805689 III Pacing After TAVI * Prophylactic pacemaker after TAVI https://www.jacc.org/doi/10.1016/j.jacep.2025.07.028 * PROMOTE study https://doi.org/10.1016/j.hrthm.2024.12.019 * Evaluation of ESC criteria on RBBB patients undergoing TAVI https://doi.org/10.1016/j.hrthm.2024.11.030 * Editorial on Heart Rhythm journal papers https://www.heartrhythmjournal.com/article/S1547-5271(25)00114-6/abstract 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

A bold trial in valvular heart disease, a CV prevention trial whose message is humility, VTE dogma challenged, more news on oral GLP-1 agonists, and a few public service announcements 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 DOUBLE-CHOICE: Minimalist Approach to TAVI May Be as Good as Standard of Care https://www.medscape.com/viewarticle/double-choice-minimalist-approach-tavi-may-be-good-standard-2025a1000pp7 * Patient & Physician Perspectives on CV Risk https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011837 II KP Vaccinate Trial * KP Vaccinate Trial https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500208 * IAMI trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057042 * Increasing Flu Vaccinations in Patients With Chronic Disease https://jamanetwork.com/journals/jama/fullarticle/2824956 * MI FREEE Trial https://www.nejm.org/doi/full/10.1056/NEJMsa1107913 III Hi PRO Trial * Apixaban for Extended Treatment of VTE https://www.nejm.org/doi/full/10.1056/NEJMoa2509426 * Recurrent VTE in Patients with Provoked VTE https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/226140 IV Oral GLP-1 Agonists * ATTAIN 1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511774 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

More trials at ESC, including PARACHUTE HF, DAPA ACT HF-TIMI 68, AMALFI, and a super-interesting modeling study of when to start oral anticoagulants in AF, 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 PARACHUTE HF First Evidence of Treatment Benefit in Chagas Heart Failure https://www.medscape.com/viewarticle/first-evidence-treatment-benefit-chagas-heart-failure-2025a1000oem * PARACHUTE-HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 II SGLT2i Early Initiation — DAPA ACT HF-TIMI 68 Trial Trial Data Support In-Hospital Initiation of SGLT2 Inhibitors for Heart Failure https://www.medscape.com/viewarticle/trial-data-support-hospital-initiation-sglt2-inhibitors-2025a1000o5q * DAPA ACT HF-TIMI 68 https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076575 III AMALFI Trial of AF Screening Remote ECG Screening Ups Atrial Fibrillation Detection ‘Modestly’ https://www.medscape.com/viewarticle/remote-ecg-screening-ups-atrial-fibrillation-detection-2025a1000myx * AMALFI Trial https://jamanetwork.com/journals/jama/article-abstract/2838482 * STROKESTOP Trial https://www.thelancet.com/article/S0140-6736(21)01637-8/fulltext * LOOP Trial 10.1016/S0140-6736(21)01698-6 External Link IV Finding that Sweet Spot of Stroke Risk Threshold for Starting DOAC therapy * Stroke Risk Threshold for non-Vitamin K Antagonist OAC in AF https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012090 * Variations in Rates of Stroke Across Patients With AF https://www.ahajournals.org/doi/10.1161/circulationaha.116.024057 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