Feb 20 2026 This Week in Cardiology
Feb 20, 2026•25 min
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Summary
John Mandrola reviews the 6-year EVOLUT Low Risk trial data, raising concerns about reintervention rates and methodological issues in TAVR for low-risk patients, supported by recent meta-analyses. He then delves into the ethical complexities and poor documentation of unilateral Do-Not-Resuscitate orders in hospitals. The podcast also critiques the persistent, evidence-lacking use of targeted hypothermia post-cardiac arrest, while celebrating a new HFpEF device trial for its robust sham-controlled design. Finally, Mandrola explores the promising observational evidence for GLP-1 agents like semaglutide in treating atrial fibrillation, suggesting a significant future role.Episode description
EVOLUT Low Risk data, a provocative meta-analysis, DNR orders, targeted hypothermia, good news in HFpEF evidence, and GLP-1s as AF drugs 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:
I EVOLUT Low Risk 6-year Results and a 5-year Meta-Analysis of TAVR vs SAVR
- 6-Year Outcomes of TAVR vs SAVR https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063
- EVOLUT Low Risk Trial at 2 years https://www.nejm.org/doi/full/10.1056/NEJMoa1816885
- EVOLUT Low Risk Trial at 3 years https://www.jacc.org/doi/10.1016/j.jacc.2023.02.017
- EVOLUT Low Risk Trial at 4 years https://www.jacc.org/doi/10.1016/j.jacc.2023.09.813
- Nonproportional Hazards for Time-to-Event Outcomes in Clinical Trials https://www.jacc.org/doi/10.1016/j.jacc.2019.08.1034
- TAVR vs SAVR 5-Year Outcomes - Systematic Review https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092
- TAVR vs SAVR Updated Meta-Analysis of RCTs https://www.jacc.org/doi/10.1016/j.jacc.2024.12.031
- UK TAVI Trial https://jamanetwork.com/journals/jama/fullarticle/2792251
- Dr David Cohen on X https://x.com/djc795/status/2023556582030852172?s=46&t=zXMCUoVjSsdyemzWlzeBjA
II DNR in the Hospital
- Inadequate Documentation of Unilateral DNR Orders https://jamanetwork.com/journals/jama/fullarticle/2829203
- GeriPal Blog Unilateral DNR Orders https://geripal.org/unilateral-dnr-gina-piscitello-erin-demartino-will-parker/
III Yet another failure of Targeted Hypothermia
- 2-Year Follow-Up of TTM2 Trial https://jamanetwork.com/journals/jamaneurology/fullarticle/2845193
- TTM2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2100591
IV Good news in HFpEF Evidence
- ALT-FLOW II Trial https://doi.org/10.1093/ejhf/xuaf016
V GLP-1 as AF drugs
- Semaglutide as Adjunctive Therapy in Obesity-Related PAF https://doi.org/10.1093/europace/euag018
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