This Week in Cardiology

The limits of knowing coronary artery disease anatomy, fish oil and AF risk, a new drug for PSVT, and maybe I was wrong about a drug for AF conversion (the RAFF4 trial). These 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 Prediction of CAD is hard — even if you have anatomy CCTA in Prediction of First Coronary Events https://jamanetwork.com/journals/jama/fullarticle/2841255 II Fish Oil and AF (and as a bonus we learn again about analytic flexibility) Are Fish Oils on the Hook for AF Risk? https://www.medscape.com/viewarticle/995290 Omega-3 and Fish Oil Use With Risk of AF  https://www.ahajournals.org/doi/full/10.1161/JAHA.125.043031 Effect of Long-Term Marine Omega-3 Fatty Acids on the Risk of AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 RESPECT-EPA Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065520 Association Between Omega-3 Fatty Acids and AF: Meta Analysis https://link.springer.com/article/10.1007/s10557-021-07204-z Fish Oil Supplements and Risk of AF https://academic.oup.com/eurjpc/article/29/14/1911/6679610 Editorial: Fish Oil Supplements and AF Risk https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057464 III A New Drug for PSVT FDA Approval https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-type-abnormally-fast-heart-rhythm RAPID trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00776-6/fulltext IV AF Conversion with Vernakalant RAFF4 Trial https://www.bmj.com/content/391/bmj-2025-085632.long Editorial: Rapid Cardioversion for Acute AF https://www.bmj.com/content/391/bmj.r2264 VI A Quick Note on HFpEF Med Op-Ed: Avalanche Survival, HFpEF Skepticism, and More https://www.medscape.com/viewarticle/med-op-ed-avalanche-survival-hfpef-skepticism-and-more-2026a1000012 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]

The MI paradox of risk scores, the CELEBRATE trial of a new subcutaneous glycoprotein IIb/IIIA inhibitor (with its funny endpoint), the SURPASS CVOT trial, and the bad story of andexanet alfa 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 What do risk scores mean for individuals? Or perhaps a better question: Is a first MI preventable? Limitations of Screening in Predicting First MI https://www.jacc.org/doi/10.1016/j.jacadv.2025.102361 Sudden Death Due to Cardiac Arrhythmias https://www.nejm.org/doi/abs/10.1056/NEJMra000650 UMC Amsterdam group (EHJ) https://academic.oup.com/eurheartj/article/46/38/3762/8181058 II CELEBRATE Trial CELEBRATE Trial https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500268 III SURPASS CVOT Trial Published Aug 01, 2025 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1002781 SURPASS-CVOT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2505928 REWIND Trial 10.1016/S0140-6736(19)31149-3 External Link IV FDA Pulls Andexanet Alfa From the Market ANNEXA 4 https://www.nejm.org/doi/10.1056/NEJMoa1814051 ANNEXA I https://www.nejm.org/doi/full/10.1056/NEJMoa2313040 Richard Buka Tweet https://x.com/richardbuka/status/2001045834050216327?s=20 V Mandrola's Top Cardiovascular Stories of 2025 https://www.medscape.com/viewarticle/mandrolas-top-10-cardiovascular-stories-2025-2025a1000yuh 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]

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]