This Week in Cardiology

An elegant study in post-TAVI atrioventricular block, a PSA for my structural colleagues, revascularization in women, and a CTO PCI trial 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 AV Block After TAVR

Heart Blocks During vs After TAVR Show Distinct Patterns

https://www.medscape.com/viewarticle/heart-blocks-during-vs-after-tavr-show-distinct-patterns-2025a1000ypp

• Mechanisms Underlying Alterations in Cardiac Conduction After TAVR https://jamanetwork.com/journals/jamacardiology/fullarticle/2842748

II Related PSA Announcement to My Structural Colleagues

III Revascularization Strategies in Women with Severe Chronic CAD

Women With Chronic Severe CAD Fare Better With CABG vs PCI

https://www.medscape.com/viewarticle/women-chronic-severe-cad-fare-better-cabg-vs-pci-2025a1000ygd

• PCI vs CABG in Women With Chronic CAD https://doi.org/10.1093/eurheartj/ehaf806
• PCI vs CABG - Meta-Analysis of 4 RCTs https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02334-5/abstract
• CABG vs Drug-Eluting Stent Implantation for CAD - Meta-Analysis https://www.jacc.org/doi/10.1016/j.jcin.2016.10.008
• RECHARGE trial https://therechargetrial.com/

IV A CTO PCI RCT – But don't get your hopes up

• Early vs Late-Staged PCI After Subintimal Tracking and Re-entry for CTO https://doi.org/10.1016/j.jacc.2025.09.1598
• DECISION CTO trial https://pubmed.ncbi.nlm.nih.gov/30813758/
• National Inpatient Sample Database PCI CTO Associated With Higher Mortality https://pubmed.ncbi.nlm.nih.gov/37356643/

V Mandrola's Top 10 Stories

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 [email protected]

Less is more after PCI, the TARGET-FIRST trial, a negative blood pressure trial that is actually positive, aspirin vs OAC for bleeding, AEDs, and Factor XI is not dead yet are the topics discussed by John Mandrola, MD, on 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 Less is More: TARGET-FIRST

• TARGET-FIRST Trial https://www.nejm.org/doi/10.1056/NEJMoa2508808
• STOPDAPT-2 ACS Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2789701

II A Negative Trial That Is Actually Positive

• The RETREAT-FRAIL Study https://www.nejm.org/doi/full/10.1056/NEJMoa2508157

III Major Bleeding With Aspirin vs Apixaban

• Subanalysis of ARTESiA https://jamanetwork.com/journals/jamacardiology/fullarticle/2841075
• ARTESiA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2310234
• AVERROES Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1007432

IV High Value Interventions – The AED

• Experts Call for AED Placement on All Commercial Aircraft https://www.medscape.com/viewarticle/experts-call-aed-placement-all-commercial-aircraft-2025a1000xzf

• In-Flight Sudden Cardiac Arrest and AED Use 10.1016/j.cjca.2025.10.010 External Link

V Factor XI Inhibitors – OCEANIC STROKE trial

• Bayer Press Release on Asundexian https://www.bayer.com/en/us/news-stories/oceanic-stroke

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 [email protected]

Listener feedback, huge news in the world of carotid disease with the CREST-2 publication, prasugrel beats ticagrelor again, and a big coffee trial 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

• Complete Revascularization for Acute MI Meta-analysis https://doi.org/10.1016/S0140-6736(25)02170-1

II A Sea Change in the Treatment of Carotid Artery Disease — CREST-2 Published

• ECST-2 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00107-3/fulltext
• SPACE-2 https://pubmed.ncbi.nlm.nih.gov/36115360/
• CREST-2 Trial www.nejm.org/doi/full/10.1056/NEJMoa2508800
• CREST Protocol paper https://pmc.ncbi.nlm.nih.gov/articles/PMC5987521/

III Prasugrel Beats Ticagrelor in High-Risk Patients With Diabetes After PCI https://www.medscape.com/viewarticle/prasugrel-beats-ticagrelor-high-risk-patients-diabetes-after-2025a1000wbt

• PLATO trial https://www.nejm.org/doi/full/10.1056/NEJMoa0904327
• Ticagrelor or prasugrel vs clopidogrel in PCI https://eurointervention.pcronline.com/article/ticagrelor-or-prasugrel-versus-clopidogrel-in-patients-undergoing-percutaneous-coronary-intervention-for-chronic-coronary-syndromes
• ISAR-REACT 5 trial https://www.nejm.org/doi/full/10.1056/NEJMoa1908973

IV Another Coffee and AF study

Can Coffee Cut the Risk for Atrial Fibrillation?

https://www.medscape.com/viewarticle/can-coffee-cut-risk-atrial-fibrillation-2025a1000w11

A Coffee a Day to Keep the AFib Away? The DECAF Trial Discussed https://www.medscape.com/viewarticle/coffee-day-keep-afib-away-decaf-trial-discussed-2025a1000v5z

• DECAF trial https://jamanetwork.com/journals/jama/fullarticle/2841253

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 [email protected]

Listener feedback on the PISCES trial, AHA news (including a big PCSK9i trial), beta-blockers post MI, LAAC, and post-AF ablation OAC use 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

Why I Believe Fish Oil's Big CV Benefit in Dialysis Patients https://www.medscape.com/viewarticle/why-i-believe-fish-oils-big-cv-benefit-dialysis-patients-2025a1000uzg

• PISCES trial https://www.nejm.org/doi/full/10.1056/NEJMoa2513032

II PCSK9 Inhibitor News

In Global Trial, PCSK9 Inhibitor Provides Major Protection Against First CV Event https://www.medscape.com/viewarticle/global-trial-pcsk9-inhibitor-provides-major-protection-2025a1000uzp

• VESALIUS-CV trial https://www.nejm.org/doi/full/10.1056/NEJMoa2514428
• ODYSSEY trial https://www.nejm.org/doi/full/10.1056/NEJMoa1801174
• FOURIER https://www.nejm.org/doi/full/10.1056/NEJMoa1615664
• Anish Koka Tweet on LDL-lowering https://x.com/anish_koka/status/1987280506937909326?s=20

III Beta-Blockers After MI and John Cleland

• Beta-Blockers after MI with normal EF https://www.nejm.org/doi/full/10.1056/NEJMoa2512686
• REBOOT-CNIC trial https://www.nejm.org/doi/full/10.1056/NEJMoa2504735
• REDUCE AMI trial https://academic.oup.com/ehjcvp/article/9/2/192/6895544?login=false
• ABYSS trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204
• CAPITAL RCT trial https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199347
• Beta-Blockers after MI with mildly reduced EF https://pubmed.ncbi.nlm.nih.gov/40897190/
• John Cleland Clinical Outlook https://www.nature.com/articles/s41569-025-01228-w

IV Left Atrial Appendage Closure – The CLOSURE-AF trial

Percutaneous LAAC in AF Falls Short Again in CLOSURE-AF https://www.medscape.com/viewarticle/percutaneous-left-atrial-appendage-closure-af-falls-short-2025a1000uzu

• Prague-17 Trial https://www.jacc.org/doi/10.1016/j.jacc.2020.04.067
• OPTION trial https://www.nejm.org/doi/full/10.1056/NEJMoa2408308

V Oral AC after AF ablation – the OCEAN Trial

Anticoagulation After AF Ablation: The OCEAN Trial Still Leaves Questions https://www.medscape.com/viewarticle/anticoagulation-after-af-ablation-ocean-trial-still-leaves-2025a1000v4t

• OCEAN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509688
• ALONE-AF trial https://jamanetwork.com/journals/jama/fullarticle/2838294

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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 [email protected]

Listener feedback on non-culprit PCI in STEMI, a major cardiac result in patients on hemodialysis, news on GLP-1 agonists, a dubious stroke trial, and an AHA preview 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

• Meta-analysis of MI as a surrogate https://pubmed.ncbi.nlm.nih.gov/34694318/
• Compare Acute Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1701067
• DANAMI-3–PRIMULTI 10.1016/S0140-6736(15)60648-1 External Link
• CULPRIT-SHOCK https://www.nejm.org/doi/full/10.1056/NEJMoa1710261

II Huge Cardiac News for Patients with ESRD PISCES article EMBARGOED Till 1130 AM EST

• PISCES Trial www.nejm.org/doi/full/10.1056/NEJMoa2513032
• REDUCE-IT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1812792
• STRENGTH Trial https://jamanetwork.com/journals/jama/fullarticle/2773120
• FISH trial https://jamanetwork.com/journals/jama/fullarticle/1150094

III Obesity Agents

• White House announces deal with Lilly and Novo on GLP-1 drugs https://www.reuters.com/business/healthcare-pharmaceuticals/novo-lilly-shares-rise-trump-obesity-drug-deal-nears-2025-11-06/

Amylin Agonists

• Amylin Analog Eloralintide Reduces Weight in Phase 2 Trial

https://www.medscape.com/viewarticle/amylin-analog-eloralintide-reduces-weight-phase-2-trial-2025a1000uqf

• Eloralintide Phase 2 Study https://doi.org/10.1016/S0140-6736(25)02155-5

GLP-1 Comparisons

• SURMOUNT-5 Trial https://www.nejm.org/doi/10.1056/NEJMoa2416394
• Tirzepatide vs Semaglutide in 10-year CVD Risk Reduction https://doi.org/10.1093/ehjopen/oeaf117

IV A Problematic Trial in Stroke Care

• LAMP trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2840370

V AHA Preview

AHA 2025: Mandrola's Four Trials to Look For https://www.medscape.com/viewarticle/aha-2025-mandrolas-four-trials-look-2025a1000u80

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 [email protected]