Health and income, high BP in the hospital, and more on subclinical AF and when to use anticoagulants 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. Health and Income

A Cash Giveaway to Improve Health

https://www.medscape.com/viewarticle/cash-giveaway-improve-health-2024a1000dhf?form=fpf

• JAMA RCT https://jamanetwork.com/journals/jama/fullarticle/2821454
• NBER RCT https://www.nber.org/papers/w32711
• Have We Missed the Hidden Cause of Medical Overuse? https://www.medscape.com/viewarticle/908309
• Mar 17, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/989775

Other References

• Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120
• Rand Link https://www.rand.org/pubs/reports/R3055.html
• The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/
• Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576
• Full Coverage for Preventive Medications after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmsa1107913
• Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial InfarctionThe ARTEMIS Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2720024

II. Elevated BP in the hospital

• JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821364

III. Short-duration Subclinical AF

Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA

https://www.medscape.com/viewarticle/998379

• ARTESiA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234
• ARTESiA CHADSVASC Subgroup https://www.jacc.org/doi/10.1016/j.jacc.2024.05.002
• NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062
• EHJ NOAH subanalysis https://doi.org/10.1093/eurheartj/ehae225
• Stroke: Prolonged Heart Rhythm Monitoring After Stroke https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.045843
• EHRA Analysis https://esc365.escardio.org/EHRA-Congress/sessions/10668

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Vulnerable plaque and scientific method; industry payments to trainees; tirzepatide or semaglutide; trial interpretation; and PFA 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. Non-invasive Imaging for Vulnerable Plaque

PET Imaging Finds Vulnerable Plaques That Cause MI

https://www.medscape.com/viewarticle/pet-imaging-finds-vulnerable-plaques-cause-mi-2024a1000cm2

• JACC paper https://doi.org/10.1016/j.jacc.2024.03.419
• Original JAMA-Card paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2806690

II. Industry Payments to Fellows

• JAMA Network Letter https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821267

III. GLP-1a Class Effect?

Semaglutide Significantly Improves Chronic Kidney Disease

https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9

Mounjaro Beats Ozempic, So Why Isn’t It More Popular?

https://www.medscape.com/viewarticle/mounjaro-beats-ozempic-so-why-isnt-it-more-popular-2024a1000ckd

• JAMA-Internal Medicine: Semaglutide vs Tirzepatide https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080
• SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
• FLOW trial https://www.nejm.org/doi/full/10.1056/NEJMoa2403347
• SURPASS-CVOT – Rationale https://doi.org/10.1016/j.ahj.2023.09.007

IV. Colchicine and Trial Interpretation in the Lancet

• CONVINCE https://doi.org/10.1016/S0140-6736(24)00968-1

V. PFA

Pulsed Field Ablation for AF: Are US Electrophysiologists Too Easily Impressed?

https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v

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Venous closure devices, GLP1-s linked to blindness and cancer, resisting the urge to do an ECG, and transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation are the topics discussed 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 Listener Feedback

• Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study https://doi.org/10.1093/europace/euae105

II GLP1-s and Blindness

• Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255
• Locke Twitter https://x.com/doc_BLocke/status/1808972226655629610
• When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808

III GLP1-s and Cancer

• Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820833

IV Screening ECG

• Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adultshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820721
• Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP) https://doi.org/10.1016/S0140-6736(21)01637-8
• Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study) https://doi.org/10.1016/S0140-6736(21)01698-6

IV TEER for Secondary Mitral Regurgitation

• Randomized investigation of the MitraClip device in heart failure: Design and rationale of the RESHAPE-HF2 trial design https://doi.org/10.1002/ejhf.3247
• Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure: Baseline characteristics of patients in the RESHAPE-HF2 trial and comparison to COAPT and MITRA-FR trials https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3286
• Jun 21, 2024 This Week in Cardiology Podcast
• https://www.medscape.com/viewarticle/1001237
• Stats Blog https://www.r-bloggers.com/2023/07/the-benjamini-hochberg-procedure-fdr-and-p-value-adjusted-explained/

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Screening echo, multivitamins, wasteful research, another PA sensor for HF, vascular closure devices, and GLP-1 marketing as science research are the topics John Mandrola, MD, discusses 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. Screening for Valvular HD in the Elderly

• EHJ-CV Imaging Paper https://doi.org/10.1093/ehjci/jeae127

II. Vitamins and Wasteful Research

Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https:// www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv

May 10, 2024 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1000772

• Multivitamin Paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820369
• Physicians Health Study II https://jamanetwork.com/journals/jama/fullarticle/1389615

III. FDA Has Approved Another PA Sensor

• Link to slides https://c212.net/c/link/?t=0&l=en&o=4104690-1&h=4197477262&u=https%3A%2F%2Fendotronix.com%2FEndotronix-PROACTIVE-HF-LBCT-THT-2024.pdf&a=here

IV. Vascular Closure Devices in Electrophysiology.

• Vascular Closure Devices Study https://onlinelibrary.wiley.com/doi/full/10.1111/jce.16345

V. SURMOUNT-OSA

• SURMOUNT OSA Paper https://www.nejm.org/doi/full/10.1056/NEJMoa2404881
• SELECT https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
• June 21, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001237
• JAMA Systematic Review and Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2643307
• SAVE https://www.nejm.org/doi/full/10.1056/NEJMoa1606599
• Norwegian study https://doi.org/10.1016/j.hrthm.2022.06.016

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MRAs in HF with renal dysfunction, coronary autoregulation, the hubris of US doctors, NSTEMI in older patients, survival after STEMI, and new leaders at JACC are discussed by John Mandrola, MD.

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

• Combined analysis (Matsumoto)

II Coronary artery autoregulation with increasing stenosis

• NEJM Paper https://www.nejm.org/doi/full/10.1056/NEJMc2402216

III RECOVER IV Trial

• Gregg Stone, MD Tweet https://x.com/GreggWStone/status/1803583552354742416
• DANGER-Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572
• Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659

IV NSTEMI Elderly

• Main Paper
• Datamethods https://discourse.datamethods.org/t/random-vs-fixed-effects-meta-analysis/7361
• O’Fee Paper https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

V MI Survival

Danish Paper https://doi.org/10.1016/j.jacc.2024.04.025

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Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF 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

• ASPIRE AF https://classic.clinicaltrials.gov/ct2/show/NCT03968393
• Butala paper: Stroke After TAVR With and Without EPD https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697
• PROTECTED TAVR
• Heuts meta-analysis: EPD During TAVR https://heart.bmj.com/content/110/11/757

II. Statin Eligibility

• JAMA-IM: Data Analytic Choices and Predicting Vascular Events https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819821
• Zeraatker Specification Analysis Paper https://doi.org/10.1016/j.jclinepi.2024.111278
• PCE https://www.mdcalc.com/calc/3398/ascvd-atherosclerotic-cardiovascular-disease-2013-risk-calculator-aha-acc

III. Heterogenous Treatment Effect

• Weisberg and Dailey-Higgs
• DANISH

IV. Heart Failure and MRAs

• RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001
• EMPHASIS https://www.nejm.org/doi/full/10.1056/NEJMoa1009492
• Combined analysis (Matsumoto)

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Cannabis and CV outcomes, post-CABG AF, embolic protection devices, emulation of randomization, and a preview heterogenous treatment effects 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. Cannabis

It Sure Looks Like Cannabis Is Bad for the Heart, Doesn't It?

https://www.medscape.com/viewarticle/1000250

Cannabis Use Tied to Increased Cardiovascular Risk

https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk

https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk-2024a10000sc

• Cannabis for Chronic Pain and CV Safety https://doi.org/10.1093/eurheartj/ehad834
• Editorial https://academic.oup.com/eurheartj/article/45/6/485/7500073
• Response to Letter https://doi.org/10.1093/eurheartj/ehae314
• UCLA paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819559
• Lifetime Cannabis Use and Mortality https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819635

II. Post Cardiac Surgery AF

• Meta-analysis https://doi.org/10.1093/eurheartj/ehae267

III. Embolic Protection devices

Clear Stroke Benefit Eludes Embolic Protection: PROTECTED TAVR

https://www.medscape.com/viewarticle/980978

• Embolic Protection and Stroke Prevention With TAVR https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697
• PROTECTED TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2204961

IV. Preview of HTE

Paper https://doi.org/10.1016/j.ahj.2024.04.020

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The FLOW trial of semaglutide, the DANCAVAS CV screening trial, non-invasive tests for chest pain, and conflicts of interest on social media are the topics John Mandrola, MD, discusses 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. Semaglutide for CKD

Semaglutide Significantly Improves Chronic Kidney Disease

https://www.medscape.com/viewarticle/semaglutide-significantly-improves-chronic-kidney-disease-2024a10009w9

• FLOW Trial

II. CV Screening

Judicious CVD Screening May Work in Men: DANCAVAS

https://www.medscape.com/viewarticle/980153

• DANCAVAS 6-Year Outcomes https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004403
• DANCAVAS Main Trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2208681

III. Non-invasive Cardiac Testing in Chest Pain

• Circulation Outcomes Paper https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.123.010457
• Scot Heart https://www.nejm.org/doi/full/10.1056/NEJMoa1805971

IV. COI and Social Media

• JAMA letter https://jamanetwork.com/journals/jama/fullarticle/2816900

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