Medmastery's Cardiology Digest Medmastery

Welcome to the latest episode of Cardiology Digest, where we chart a course through groundbreaking studies that are shaping cardiology practice!  
STUDY #1: First, we discuss the nuanced world of drug interactions involving diltiazem and direct-acting oral anticoagulants like apixaban and rivaroxaban. Tune in as we scrutinize the study's limitations and practical implications for your patients with atrial fibrillation. 
Ray, WA, Chung, CP, Stein, CM, et al. 2024. Serious bleeding in patients with atrial fibrillation using diltiazem with apixaban or rivaroxaban. JAMA. 18: 1565–1575. (https://jamanetwork.com/journals/jama/article-abstract/2817546)
STUDY #2: Next, we turn our attention to a case-control study examining the bleeding risks associated with the combination of selective serotonin reuptake inhibitors and anticoagulants in patients with atrial fibrillation. Are the bleeding risks substantial enough to rethink this combination therapy, or are there scenarios where the benefits outweigh the dangers? We'll leave no stone unturned.
Rahman, AA, Platt, RW, Beradid, S, et al. 2024. Concomitant use of selective serotonin reuptake inhibitors with oral anticoagulants and risk of major bleeding. JAMA. 3: e243208. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816687)
STUDY #3: Finally, we explore a fascinating meta analysis that looked at renal denervation and its long-term efficacy in controlling blood pressure. See how renal denervation stacks up against traditional antihypertensive medications and what you need to consider when thinking about incorporating it into your treatment arsenal.
Sesa-Ashton, G, Nolde, JM, Muente, I, et al. 2024. Long-term blood pressure reductions following catheter-based renal denervation: A systematic review and meta-analysis. Hypertension. 6: e63–e70. (https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22314)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
Learn more with these courses:
Atrial Fibrillation Essentials (1 CME): 
Pacemaker Essentials (5 CME)
Pacemaker Essentials Workshop (1 CME)
Get a Basic or Pro account, or, get a Trial account.
Show notes:
Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode of Cardiology Digest, we delve into three pivotal papers to help us navigate modern cardiology and patient care strategies. 
STUDY #1: First, we explore findings from a Swedish study that questions the blanket application of beta-blockers after an acute myocardial infarction in patients with normal left ventricular ejection fraction. Are we witnessing the end of an era in how we manage these patients? The complexities and nuances of this study are thought-provoking! 
Yndigegn, T, Lindahl, B, Mars, K, et al. 2024. Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. 15: 1372–1381. (https://doi.org/10.1056/NEJMoa2401479)
Steg, PG. 2024. Routine beta-blockers in secondary prevention—On injured reserve. N Engl J Med. 15: 1434–1436. (https://doi.org/10.1056/NEJMe2402731)
STUDY #2: Next, the integration of artificial intelligence in healthcare takes center stage, with a groundbreaking approach that uses AI in combination with routine chest x-rays. Could this offer a novel way to assess elevated risks for major adverse cardiovascular events, especially in settings where detailed clinical data might be lacking? The implications could transform patient screenings and prognostic assessments.
Weiss, J, Raghu, VK, Paruchuri, K, et al. 2024. Deep learning to estimate cardiovascular risk from chest radiographs: A risk prediction study. Ann Intern Med. 4: 409–417. (https://doi.org/10.7326/M23-1898)
STUDY #3: Lastly, we’ll look into an exciting advancement in interventional cardiology with the introduction of drug-coated balloons. Fresh from their recent FDA approval in March of this year, these innovative devices represent a significant breakthrough for treating patients with in-stent restenosis, especially those who haven’t responded well to multiple drug-eluting stents.
Yeh, RW, Shlofmitz, R, Moses, J, et al. 2024. Paclitaxel-coated balloon vs uncoated balloon for coronary in-stent restenosis: The AGENT IDE randomized clinical trial. JAMA. 12: 1015–1024. (https://doi.org/10.1001/jama.2024.1361)
Kundu, A and Moliterno, DJ. 2024. Drug-coated balloons for in-stent restenosis—Finally leaving nothing behind for US patients. JAMA. 12: 1011–1012. (https://doi.org/10.1001/jama.2024.0813)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
Learn more with these courses:
Chest X-Ray Essentials (7 CME)
Chest X-Ray Essentials Workshop (1 CME)
Get a Basic or Pro account, or, get a Trial account.
Show notes:
Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode of Medmastery’s Cardiology Digest, we delve into a trio of intriguing cardiology studies that raise as many questions as they answer. Whether you're a seasoned clinician or a medical student, these studies have implications that could influence your approach to patient care.
STUDY #1: First, we turn our attention to the role of GLP-1 agonists in cardiovascular disease prevention among non-diabetic patients who are overweight or obese. With a focus on injectable semaglutide this study examines its cost-effectiveness and potential side effects. The findings might alter how we manage cardiovascular risk in these patients! 
Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 Nov 11; [e-pub]. (https://doi.org/10.1056/NEJMoa2307563)
STUDY #2: Next, we’ll explore a compelling meta-analysis that could sway future guidelines and recommendations. They evaluated the outcomes of physiologic guidance and intravascular imaging in percutaneous coronary interventions (PCI), to see if these techniques improve patient outcomes beyond what’s possible with angiographic guidance alone.
Kuno T et al. Comparison of intravascular imaging, functional, or angiographically guided coronary intervention. J Am Coll Cardiol 2023 Dec 5; 82:2167. (https://doi.org/10.1016/j.jacc.2023.09.823)
STUDY #3: Finally, we’re going to examine the nuances of anticoagulation in patients with subclinical atrial fibrillation. The balance between preventing strokes and avoiding bleeding complications is a delicate one. With new data suggesting nuanced approaches, this segment will provide valuable insights for us when we’re prescribing or considering anticoagulation therapies.
Healey JS et al. Apixaban for stroke prevention in subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMoa2310234)
Svennberg E. What lies beneath the surface — Treatment of subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMe2311558)
Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions.
Learn more with these courses:
Percutaneous Coronary Intervention Essentials (6 CME)
Percutaneous Coronary Intervention Essentials Workshop (6 CME)
Show notes:
Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode of Medmastery’s Cardiology Digest, we bridge the gap between academic research and clinical practice, exploring three cardiology studies that provide important insights, some of which may even challenge what you think you know.
STUDY #1: First, we explore a study from JAMA Internal Medicine that sheds light on the intricate relationship between chronic inflammation and cardiovascular health in patients with rheumatoid arthritis (RA). The big question is whether there’s a link between RA and the development of aortic stenosis, and if so, what does it mean for the future of patient care? 
Johnson TM et al. Aortic stenosis risk in rheumatoid arthritis. JAMA Intern Med 2023 Jul 31; [e-pub]. (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2807944)
STUDY #2: Next, we tackle a meta-analysis from the British Journal of Sports Medicine that reveals practical insights about the best form of exercise to reduce blood pressure. The conclusion may surprise you, offering a fresh perspective on exercise regimens and their role in combating hypertension. But to grasp the full scope of these revelations, you'll have to tune in.
Edwards JJ et al. Exercise training and resting blood pressure: A large-scale pairwise and network meta-analysis of randomized controlled trials. Br J Sports Med 2023 Jul 25; [e-pub]. (https://bjsm.bmj.com/content/57/20/1317)
STUDY #3: Lastly, we discuss a study that assesses the risks associated with subsequent pregnancies in women who have experienced peripartum cardiomyopathy (PPCM). We find out the magnitude of the potential for adverse events, including death.
Pachariyanon P et al. Long-term outcomes of women with peripartum cardiomyopathy having subsequent pregnancies. J Am Coll Cardiol 2023 Jul 4; 82:16. (https://www.jacc.org/doi/10.1016/j.jacc.2023.04.043)
Each of these studies offers a piece of the larger puzzle of cardiovascular health, challenging us to rethink strategies for prevention, monitoring, and treatment. Don't miss this episode, where curiosity meets clinical expertise, unlocking new horizons in cardiology.
Learn more with these courses:
Hypertension Mini: https://www.medmastery.com/courses/hypertension-mini
Cardiac MRI Essentials: https://www.medmastery.com/courses/cardiac-mri-essentials
Echo Masterclass—The Valves: https://www.medmastery.com/courses/echo-masterclass-valves
Show notes:
Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

This week on Medmastery’s Cardiology Digest, we're peeling back the layers of three enlightening studies that are pushing the boundaries of what we know about cardiac care.
STUDY #1: First, we revisit the use of an everyday medication to check if it’s doing more harm than good in the elderly. Aspirin, long touted for its preventative benefits, is under scrutiny for its role in anemia. Should we rethink the use of aspirin in primary prevention, especially among the older population?
McQuilten, ZK, Thao, LTP, Pasricha, S-R, et al. 2023. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: A secondary analysis of the Aspirin in Reducing Events in the Elderly trial. Ann Intern Med. 7: 913–921. (https://www.acpjournals.org/doi/10.7326/M23-0675)
STUDY #2: Then, we shift focus to a comparison of approaches to mitral valve repair: the less-invasive minithoracotomy versus the conventional median sternotomy. Patient outcomes and success rates are put under the microscope, so we can tease apart what truly makes a difference in the final result. Is it the size of the incision or the skill of the hands making it? 
Akowuah, EF, Maier, RH, Hancock, HC, et al. 2023. Minithoracotomy vs conventional sternotomy for mitral valve repair: A randomized clinical trial. JAMA. 22: 1957–1966. (https://jamanetwork.com/journals/jama/fullarticle/2805908)
STUDY #3: Lastly, we wrap up with an insightful discussion on compression stockings after acute DVT, to see if they can prevent post-thrombotic syndrome. Do we have enough evidence to make confident recommendations on the real benefits and drawbacks of compression wearables? And how long should patients use them? We delve into the practical aspects of incorporating the findings of this paper into patient care.
Meng, J, Liu, W, Wu, Y, et al. Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials. Thromb Res. 225: 79–86. (https://www.thrombosisresearch.com/article/S0049-3848(23)00090-7/fulltext)
Join us as we dig into the actionable insights from these studies, so we can all better optimize our patients’ outcomes! 
Learn more with these courses:
Cardiac MRI Essentials:  https://www.medmastery.com/courses/cardiac-mri-essentials
Echo Masterclass—The Valves: https://www.medmastery.com/courses/echo-masterclass-valves
Show notes:
Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

Today we dive into three cardiology papers with important insights for cardiac care.
STUDY #1: We explore an analysis that compares Coronary CT Angiography (CCTA) with stress modalities like SPECT-MPI. We see if CCTA has the potential to reduce the need for invasive angiography, and how it stacks up against other testing strategies.
Zito, A, Galli, M, Biondi-Zoccai, G, et al. 2023. Diagnostic strategies for the assessment of suspected stable coronary artery disease: A systematic review and meta-analysis. Ann Intern Med. 6: 817–826. (https://www.acpjournals.org/doi/10.7326/M23-0231)
STUDY #2: We discuss the approval of a dual-chamber leadless pacemaker system by the FDA. Although this study supports the efficacy of this innovative approach in certain scenarios, it also raises important concerns. 
Knops, RE, Reddy, VY, Ip, JE, et al. 2023. A dual-chamber leadless pacemaker. N Engl J Med. 25: 2360–2370. (https://www.nejm.org/doi/10.1056/NEJMoa2300080)
STUDY #3: We look at a comprehensive retrospective study that evaluates aggressive management of hypertension in hospitalized adults. What are the ramifications of minimizing the use of BP-lowering agents, particularly intravenous ones, in certain inpatient scenarios?
Anderson, TS, Herzig, SJ, Jing, B, et al. 2023. Clinical outcomes of intensive inpatient blood pressure management in hospitalized older adults. JAMA Intern Med. 7: 715–723. (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2805021)
Join us as we dissect these studies, unpacking their methodologies, outcomes, and the intriguing questions they raise. 
For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast
Learn more with these courses:
Pacemaker Essentials: https://www.medmastery.com/courses/pacemaker-essentials
Pacemaker Essentials Workshop: https://www.medmastery.com/workshops/pacemaker-essentials-workshop
Coronary Angiography Essentials: https://www.medmastery.com/courses/coronary-angiography-essentials