ISCHEMIA trial hailed as practice changing The largest-ever RCT of initial invasive versus conservative management of stable ischemic heart disease makes waves. DAPA-HF: Dapagliflozin’s HFrEF efficacy confirmed in nondiabetics Further analyses from the DAPA-HF trial showed dapagliflozin cut death and heart failure events in HFrEF patients with no diabetes. Colchicine cut post-MI CVD events Colchicine fulfilled the promise first seem in CANTOS that anti-inflammatory treatment can reduce cardiovas...
Dec 27, 2019•8 min•Ep. 230
Vascepa approved for cardiovascular risk reduction The FDA’s decision on cutting events in high-risk patients was based primarily on the REDUCE-IT trial. ENGAGE AF-TIMI: Insulin linked to greater risk for stroke, CV death, bleeding Novel oral anticoagulants may be preferred over warfarin in patients with diabetes and AFib. HHS drug importation proposals aim to address high costs Trump administration drops key health care proposal on day of impeachment vote. End ‘therapeutic nihilism’ in care of ...
Dec 20, 2019•8 min•Ep. 84
Women have fewer cardiovascular events after non–ST-segment elevation ACS But they also remain undertreated with guideline-directed therapies. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * FDA panel rejects vernakalant bid for AFib cardioversion indication Eleven years after the first attempt of the antiarrhythmic agent, the FDA panel voted resoundingly against approval. Bariatric surgery tied to fewer cer...
Dec 13, 2019•7 min•Ep. 83
Icosapent ethyl cost effective in REDUCE-IT analysis Treatment with the fish-derived drug Vascepa for CV event reduction is more effective and less costly than placebo. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * DAPA-HF: Dapagliflozin benefits regardless of age, HF severity The SGLT2 inhibitor had similar efficacy in the elderly and across the spectrum of baseline symptom status. Colchicine cut post-MI ...
Dec 06, 2019•7 min•Ep. 82
This week’s Cardiocast is devoted entirely to Card Talk with cardiologist brothers Jim and Jerry Dwyer. They welcome two structural interventionalists at the Structural Heart and Valve Center at Emory Healthcare, Kendra J. Grubb, MD , and Isida Byku, MD . Both followed a unique track, training in both cardiac surgery and interventional cardiology and practicing in the fast-moving field of structural heart disease. * * * Help us make this podcast better! Please take our short listener survey: htt...
Nov 29, 2019•43 min•Ep. 81
In this special meeting edition of the Cardiocast, MDedge Cardiology editor Catherine Hackett is joined by MDedge reporters Mitchel L. Zoler, Bruce Jancin, and Richard Mark Kirkner. The MDedge cardiology team reviews three big stories from the 2019 annual scientific sessions of the American Heart Association in Philadelphia. * * * Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * ISCHEMIA trial hailed as practice c...
Nov 26, 2019•32 min•Ep. 80
ISCHEMIA trial hailed as practice changing The largest-ever RCT of initial invasive versus conservative management of stable ischemic heart disease makes waves. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * DAPA-HF: Dapagliflozin’s HFrEF efficacy confirmed in nondiabetics Further analyses from the DAPA-HF trial showed dapagliflozin cut death and heart failure events in HFrEF patients with no diabetes. The ...
Nov 22, 2019•9 min•Ep. 79
Getting high heightens stroke, arrhythmia risks Cannabis use or abuse among the young was associated with adverse cardiovascular consequences in two studies. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Bempedoic acid cuts LDL by 15% in patients with high levels despite maximal treatment CLEAR Wisdom may fill a niche for patients who can't get levels down. Low LDL-C and blood pressure can reduce lifetime ...
Nov 15, 2019•8 min•Ep. 78
Closing the missing link between childhood risk factors and adult cardiovascular outcomes Prescient childhood cohort studies launched in the 1970s are paying off. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Metabo lic signs of adult diabetes apparent in very young children Disturbed HDL cholesterol metabolism may be one of the earliest features of type 2 diabetes. Sacubitril/valsartan suggests HFpEF bene...
Nov 08, 2019•9 min•Ep. 77
Patients frequently drive too soon after ICD implantation Many patients didn’t recall ever receiving instruction about when to drive again. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * One-third of CVD disease in blacks linked to hypertension A large analysis suggests intervention throughout all ages could have substantial impact. Cancer overtakes CVD as cause of death in high-income countries The balance...
Nov 01, 2019•8 min•Ep. 76
Strong showing for TAVR after 5 years in PARTNER 2A Transcatheter and surgical aortic valve replacement had similar rates of death or disabling stroke. * * * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Patiromer allows more CKD patients to continue on spironolactone After 12 weeks, 86% of the patiromer patients remained on spironolactone, vs. 66% of the placebo patients. Native Americans appear to be at increa...
Oct 25, 2019•8 min•Ep. 75
MDedge reporters discuss the latest in practice-changing data from the 2019 annual congress of the European Society of Cardiology in Paris. Join Mitchel L. Zoler , Bruce Jancin , Kari Oakes , and MDedge Cardiology editor Catherine Hackett as they discuss what they reported from the annual meeting.
Oct 22, 2019•42 min•Ep. 74
Statin use linked to risk of skin and soft tissue infections Use of statins was associated with increased risk of SSTIs at an average of 91, 182, and 365 days. Rivaroxaban trends toward higher thrombotic risk than vitamin K antagonists in APS Patients who took rivaroxaban experienced almost two times as many thrombotic events as patients who took dose-adjusted vitamin K antagonists. HHS floats Stark/anti-kickback revisions to support value-based care Health law attorneys say reforms should remov...
Oct 18, 2019•42 min•Ep. 73
Novel cardiac troponin protocol rapidly rules out MI Three-quarters of patients who presented with suspected acute coronary syndrome were safely discharged from ED without hospital admission. Study questions preemptive TEVAR for extended type A dissections Interim results from a single-center study show that preemptive TEVAR may not be necessary for type A aortic dissections. TAVR, SAVR share same infective endocarditis risk Be aware, be careful, and provide appropriate antibiotic prophylaxis, j...
Oct 11, 2019•9 min•Ep. 72
Smoking and inactivity are the most powerful lifestyle risk factors after an MI Insufficient activity beats out obesity or above-target LDL cholesterol. Ticagrelor monotherapy tops DAPT for high-risk PCI patients TWILIGHT findings support move to shorter dual-antiplatelet therapy. Panel releases guidelines for red meat, processed meat consumption "This assessment may be excessively pessimistic; indeed, we hope that is the case." Remember that preeclampsia has a ‘fourth trimester’ Delivering the ...
Oct 04, 2019•9 min•Ep. 71
Cardiology dead last as women’s IM subspecialty choice Women in internal medicine residencies were more likely than men to report that they had never considered cardiology as a career choice. Beta-blockers effective, safe for HFrEF with renal dysfunction Their role is solidified for essentially all such heart failure patients, regardless of their renal function. Heart failure score derived from machine learning predicts risk in diabetes patients Highest WATCH-DM scores linked to 5-year heart fai...
Sep 27, 2019•8 min•Ep. 70
Prasugrel bests ticagrelor in ACS in surprise findings ISAR-REACT 5 was the first-ever direct head-to-head look at two potent P2Y12 inhibitors in this setting. European cholesterol guidelines push LDL targets below 55 mg/dL PCSK-9 inhibitors are elevated to a top-tier recommendation in very-high-risk patients. Drug doses for heart failure could possibly be halved for women Women reached the highest level of drug efficacy at half the doses of ACE inhibitors or ARBs and beta-blockers. Post-MI angi...
Sep 20, 2019•9 min•Ep. 69
MDedge reporters discuss the latest in practice-changing data from the 2019 annual congress of the European Society of Cardiology in Paris. Join Mitchel L. Zoler , Bruce Jancin , Kari Oakes , and MDedge Cardiology editor Catherine Hackett as they discuss what they reported from the annual meeting.
Sep 16, 2019•22 min•Ep. 68
We introduce a brand new format with Jerome Dwyer, MD, brother of our host, Jim Dwyer, MD, for a new segment that we're calling 'Card Talk' where Dr. Jim and Dr. Jerry talk about the current clinical state of cardiology and take a peek into the future. This week in cardiology news: Survival at ‘overweight’ BMI surpasses ‘normal’ Data from more than 142,000 middle-aged people worldwide show those with a BMI of 25-29 outlast those at 20-24. Visceral fat linked to sixfold increase in masked hyperte...
Sep 13, 2019•41 min•Ep. 67
DAPA-HF results transform dapagliflozin from antidiabetic to heart failure drug Proof that dapagliflozin significantly helped heart failure patients without diabetes recategorizes the drug as a major agent for treating heart failure. New hypertension cases halved with community-wide salt substitution Social marketing principles achieved near-universal salt replacement, village by village, in rural Peru. Ticagrelor: Modest benefit, bigger bleed risk in diabetes plus stable CAD Patients with prior...
Sep 06, 2019•10 min•Ep. 66
This week in cardiology: PCSK9 inhibition cuts events in very-high-risk groups ODYSSEY OUTCOMES analyses peg prior CABG and polyvascular disease as targets for alirocumab. Cardiovascular cost of smoking may last up to 25 years Past smokers face an elevated cardiovascular risk for up to 25 years after they quit. Impact of climate change on mortality underlined by global study This may be the largest study ever to assess the effects of inhalable particulate matter around the world. HCV coinfection...
Aug 30, 2019•8 min
TAVR valves now FDA approved for low-risk patients The FDA's decision will expand TAVR access to younger, healthier patients. FDA approves baroreflex activation for advanced HF A phase 4 trial will investigate impact on hospitalizations and mortality. Top line results: Dapagliflozin meets primary endpiont in DAPA-HF AstraZeneca announces preliminary results in first heart failure trial in an SGLT2 inhibitor. Cardiovascular cost of smoking may last up to 25 years Past smokers face an elevated car...
Aug 23, 2019•8 min•Ep. 64
The top news in cardiology: Midlife hypertension linked to dementia risk Elevated blood pressure in midlife is associated with risk of subsequent dementia, but whether the risk is treatable is unclear. Ambulatory BP slightly better than in-office measures for predicting cardiovascular outcomes It’s probably best to save these techniques for specific patients. NSAIDs a significant mediator of cardiovascular risk in osteoarthritis NSAID use could be responsible for a significant proportion of the ...
Aug 16, 2019•8 min•Ep. 63
The top stories in cardiology: Artificial intelligence technology meets AFib detection An AI-enabled ECG model suggests clinical implications for early identification of atrial fibrillation. Older patients who stop statins may be increasing their cardiovascular risk Discontinuation of statins was associated with an increased risk of hospital admission for a cardiovascular event. Psoriasis patients on biologics show improved heart health Novel imaging biomarker identifies reduced coronary inflamm...
Aug 09, 2019•10 min•Ep. 62
The top news in cardiology: Meeting just 2 of 7 ‘simple’ goals lowers HF risk American Heart Association recommendations seem to lower risk even if only a couple of the 'Simple 7' are mastered. Increased cardiovascular risk seen early on with testosterone replacement therapy Testosterone replacement therapy for low testosterone is linked to an early increase in the risk of cardiovascular and cerebrovascular events. No increase in UTI risk with SGLT-2 inhibitors SGLT-2 inhibitors are not associat...
Aug 02, 2019•8 min•Ep. 61
Statins crush early seizure risk poststroke Statin initiation upon hospitalization for acute ischemic stroke was linked to a major antiseizure benefit in a Japanese study. Atherosclerotic disease risk persists after smoking cessation Clinicians should reinforce smoking cessation with awareness that risk for several atherosclerotic diseases remains significant for decades. Air pollution levels correlated with cardiorespiratory mortality; reduced life expectancy Fine particulate matter pollution i...
Jul 26, 2019•9 min•Ep. 60
This week in cardiology: Systolic, diastolic BP each tied to adverse CV outcomes Diastolic hypertension can't be ignored, though systolic ultimately has a larger impact. Almost half of sudden cardiac deaths linked to prior silent MI Prior silent MIs were detected in nearly half of sudden cardiac deaths in people with no coronary artery disease. How does uncontrolled hypertension play into dementia? Findings from a French cohort suggest that a vascular pathway, independent of amyloid, bears on co...
Jul 19, 2019•9 min
The top stories in cardiology: New findings cast more doubt on fat-but-fit theory Patients who are obese and metabolically healthy face higher cardiac risk Higher omega-3 fatty acid levels cut heart failure risk A large multi-ethnic cohort study shows significantly higher levels of EPA in adults without heart failure. Microvascular disease: An independent and exacerbating risk factor for amputation The presence of microvascular disease plus peripheral artery disease resulted in a more than 20-fo...
Jul 12, 2019•8 min
This week's top stories in cardiology: Lipoprotein(a) levels, genes boost ischemic stroke risk Could some elderly skip statins based on negative risk markers? Cardiac events jump after COPD exacerbation CAROLINA findings reaffirm linagliptin’s safety, free glimepiride of CV-risk stigma You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter at @MDedgeTweets ....
Jul 05, 2019•9 min•Ep. 57
This week's top stories in cardiology: FDA Panel: Continue using paclitaxel-eluting PAD Devices, with caveats. Although the benefits of the devices were clear, the panel felt there should be a label change to warn of the late mortality signal seen in a key meta-analysis. Many cardiac cath, electrophysiology lab directors receive big industry payments These payments were substantially higher than those made to local interventional cardiologists and electrophysiologist. Two trials support shorter ...
Jun 28, 2019•8 min•Ep. 56
