MDedge Cardiocast

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 cardiovascular disease events. Getting high heightens stroke, arrhythmia risks Cannabis use or abuse among the young was associated with adverse cardiovascular consequences in two studies. Editor's note: This is the final episode of the MDedge Cardiocast. On behalf of Dr. Jim Dwyer and all of us at MDedge, thank you for supporting Cardiocast. For more MDedge podcasts, go to www.mdedge.com/podcasts.  Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 older diabetic patients, says expert ‘It’s not hyperglycemia that’s killing people; it’s heart disease and renal disease.’ *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 cerebrovascular events The incidence of cerebrovascular events was 65% lower in obese people who underwent bariatric surgery compared with those without surgery Intensive BP control cut dementia but increased brain atrophy and hurt cognitionThe small but significant ill effects worried some researchers at the Clinical Trials on Alzheimer's Disease conference. *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 CVD events Colchicine fulfilled the promise first seem in CANTOS that anti-inflammatory treatment can reduce cardiovascular disease events. Cardiac arrests peak with pollution in Japan The incidence of out-of-hospital cardiac arrests in Japan increased on days when counts of particulate matter spiked from the day before. *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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: https://www.surveymonkey.com/r/podcastsurveyOct2019 *  *  *   From the “picture that went around the world” of an all-female transcatheter aortic valve replacement team at Emory to advances in structural heart disease treatment, this interview includes expanding TAVR beyond the aortic valve and interventional heart failure treatment using “hooks and anchors and pulleys” to reshape the heart. Dr. Grubb is assistant professor in surgery and medicine at Emory University in Atlanta and surgical director of the Structural Heart and Valve Center at Emory Healthcare. On Twitter @KendraGrubb. She is an adviser, consultant, and/or speaker for Boston Scientific, Edwards, and Medtronic. She is also a principal investigator in Medtronic’s Optimize PRO trial and Ancora’s CorCinch PMVI studies. Dr. Isida Byku is an assistant professor at Emory University. On Twitter @IsidaByku. She has no disclosures.  *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 changing The results of the ISCHEMIA trial were emphatically declared practice changing by interventional cardiologists and noninterventionalists alike at the AHA meeting.  Bruce Jancin discusses the story. DAPA-HF: Dapagliflozin's HFrRF efficacy confirmed in nondiabetes The results in nondiabetics from the practice-changing DAPA-HF trial gives clinicians strong evidence that the diabetes drug dapagliflozin is equally effective at reducing cardiovascular death and acute exacerbations in heart failure patients regardless of diabetes status.  Mitchel L. Zoler discusses this report.  Weakness exposed in valsartan recall ED visits for hypertension in the month after the 2018 recall spiked 55%. The 2018 recall of generic forms of the antihypertensive drug valsartan exposed weaknesses in the recall systems for generics in both the U.S. and Canada that caused many patients who were on the drug to fall through the cracks.  Richard Mark Kirkner goes deeper into this story.  *  *  *   For full coverage of AHA 2019 visit MDedge Cardiology For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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 TWILIGHT of aspirin post-PCI for ACS? Patients do better post-PCI for non-ST-elevation ACS with ticagrelor monotherapy Weaknesses exposed in valsartan recall ED visits for hypertension in month after the 2018 recall spiked 55% *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 risk of CVD by 80% The effects were seen in those with genetic variants linked with low LDL cholesterol and systolic blood pressure. Statins in children cut long-term CVD risk in familial hypercholesterolemia There were no cardiovascular-related deaths and one event in treated patients who were followed for 20 years

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 * * * Metabolic 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 benefit in neutral PARAGON-HF The primary endpoint was neutral, but desperation for a HFpEF therapy highlights a subgroup analysis.  * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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 is shifting because cardiovascular deaths are way down in high-resource nations. Virtual visits may cut no-show rate for follow-up HF appointment No-show rates cut by about one-third for patients who met their clinician via video.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

Strong showing for TAVR after 5 years in PARTNER 2ATranscatheter 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 increased risk for AFib Atrial fibrillation was significantly more common among Native Americans than in other racial and ethnic groups. Certain diabetes drugs may thwart dementia Intriguing findings from a Danish national registry study   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeTweets

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.

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 remove some of the risk in value-based care arrangements that exist under current law. * * * Card Talk: Cardiologist brothers Jim and Jerry Dwyer welcome Jennifer N. Avari Silva, MD, and Berk Tas, to talk about an investigational system for electrophysiology procedures that displays holograms of patients’ anatomies in real time. The SentiAR system uses an augmented-reality head-mounted display that allows physicians to manipulate the data and enhance their understanding of the case.  Dr. Avari Silva, MD,  is assistant professor of pediatrics at Washington University in St. Louis and director of pediatric cardiac electrophysiology at St. Louis Children’s Hospital, where she leads the largest pediatric electrophysiology program in the midwest. Dr. Avari Silva has published numerous papers bringing new technologies to pediatric patients. Berk Tas is CEO and president of SentiAR. He has led development of emerging technologies and companies in Fortune 500, private equity, venture capital funded and privately held organizations.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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, just as surgeons do in SAVR. Moderate aortic stenosis just as deadly as severe AS The current echocardiographic definition of moderate aortic stenosis may greatly underestimate risk.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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 baby doesn’t always cure the hypertension.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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 failure risk approaching 20%. Daily polypill lowers BP, cholesterol in underserved population The regimen’s simplicity and low cost may overcome barriers to treatment.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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 angina in stable patients flags high risk The angina finding should immediately influence practice, expert says.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeCardio

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.   

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 hypertensionThe body mass index trend was not significant. New class of drug safely halved LDL cholesterol in ORION-11Inclisiran potently cut LDL cholesterol by inhibiting the PCSK9 enzyme with biannual injections.    

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 PCI fared a bit better and may be a target population for long-term DAPT therapy.   In PAD, dropping statins ups death risk 43% Statin adherence saves lives in peripheral arterial disease.    

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 adds to the cardiovascular risk in HIV-infected patients Hepatitis C virus and other injections were independently linked to the risk of having a cardiovascular event in HIV-infected patients. You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter at @MDedgeTweets. 

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 cardiovascular risk for up to 25 years. You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter at @MDedgeTweets.

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 increased risk of cardiovascular disease associated with osteoarthritis. Burnout gets personal for 68% of physicians Burden hits primary care more than specialties, younger more than older. You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter at @MDedgeTweets

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 inflammation in psoriasis patients on biologics. Acupuncture cuts attacks in chronic angina Chronic stable angina patients showed significant improvement with acupuncture over patients given shame or no acupuncture. You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter @MDedgeTweets  

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 associated with an increased risk of severe urinary tract infections. As patients, physicians fare nearly the same as everybody else Physicians do only slightly better than nonphysicians in adhering to guidelines "but not by much and not always." You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter at @MDedgeTweets.

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 is associated with increased cardiorespiratory mortality, particularly in lower-income areas. Exercise counters astronauts' dizziness after space flight Two hours of daily activity during space flight eliminated hypotension after landing.  You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter @MDedgeCardio  

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 cognitive decline. Vaping device marketers take aim at youth through social media More than a third of JUUL-related posts contained promotional content that highlighted ways to obtain products at reduced cost.  You can contact the Cardiocast by emailing us at podcasts@mdedge.com or interacting with us on Twitter @MDedgeCardio.  

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-fold increased risk of amputation that MVD or PAD. Court halts rule requiring drug list pricing in advertising Judge noted that the court understands what HHS wanted to do - but that it's up to Congress to enact such a requirement. You can contact the MDedge Cardiocast by emailing us at podcasts@mdedge.com or following us on Twitter @MDedgeCardio

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.    

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 DAPT DAPT with a twist: Continuing the P2Y12 inhibitor instead of aspirin. Do black patients with type 2 diabetes gain cardiac benefit from the SGLT2 and GLP-1 drugs? New findings suggest there is no effect on cardiovascular outcomes, although the analysis has limitations

This week's top stories in cardiology: Cognitive decline sped up after CHD Genetic analysis links PCSK9 inhibition and CV mortality Which antidiabetic for elderly patients? It depends on their CV risk Pivotal trial shows HFrEF benefits from baroreceptor stimulation You can contact the Cardiocast by emailing us at podcasts@mdedge.com or you can interact with us on Twitter @MDedgeCardio

This week's top stories in Cardiology. Updated systematic review of aspirin primary prevention shows benefits, risks GLP-1 RA dulaglutide yields cardiac gains, even in non–at-risk patients DOACs surpass warfarin in low-weight AFib patients Medicaid expansion associated with lower cardiovascular mortality You can email the show at podcasts@mdedge.com. 

You can find more of our podcasts at http://www.mdedge.com/podcasts This week in cardiology: FFR changes coronary management in one-third of patients MADIT-CHIC: CRT aids patients with chemotherapy-induced cardiomyopathy Lipoprotein(a) levels can guide CV risk assessment and treatment Cannabis: Doctors tell FDA to get out of the weeds Contact the show at podcasts@mdedge.com or interact with MDedge Cardiology on Twitter at @MDedgeCardio.  

You can find more of our podcasts on our website at http://www.mdedge.com/podcasts. This week in cardiology: Novel cardiogenic shock, PCI protocol nets 72% acute survival Energy drinks increase BP and disrupt the heart's electrical activity Syncope during pregnancy increases risk for poor outcomes Ethnicity seems to affect predisposition to components of metabolic syndrome  

You can find more of our podcasts on our website: http://www.mdedge.com/podcasts This week in cardiology news: SCAI releases first definition of cardiogenic shock CABANA: Heart failure patients got biggest bang from AFib ablation Elderly concussion patients who used statins had lower dementia risk BMI in male teens predicts cardiomyopathy risk You can email the show at podcasts@mdedge.com and you can interact with us on Twitter at @MDedgeCardio. 

Find more podcasts from MDedge on our website: https://www.mdedge.com/podcasts This week's top stories in cardiology: Risk score developed for cardiac-device infection AFib screening cuts hospitalizations and ED visits Arsenic exposure increases risk of left ventricular hypertrophy Ankylosing spondylitis patients taking COX-2 inhibitors may see fewer cardiovascular events You can contact the show be emailing us at podcasts@mdedge.com and you can interact with us on Twitter at @MDedgeCardio  

This week's top stories in clinical medicine: Single-center study outlines stoke risk, DOAC type in nonvalvular A-fib patients ACOG guidance addresses cardiac contributors to maternal mortality Higher serum leptin levels associated with PAD Employed physicians now outnumber independent doctors    

This week's top stories in clinical cardiology: Long-term antibiotic use may heighten stroke, CHD risk Noninvasive FFRCT called ADVANCE in chest pain assessment Does BMI affect outcomes after ischemic stroke? Cardiac PET/CT can guise CAD therapy. You can contact the show by emailing us at podcasts@mdedge.com and you can follow us on Twitter at @MDedgeCardio  

MDedge Cardiology editor Catherine Hackett hosts a conversation with Bruce Jancin and Mitch Zoler to talk about some of the research from the meeting as well as their general impressions.  You can contact the show by emailing us at podcasts@mdedge.com. 

This week in cardiology: Plant-based diet lowers risk of heart failure Medical societies endorse tiered certification for U.S. Heart-Valve care Ticagrelor doesn't beat clopidogrel in postfibrinolysis STEMI Cost gap widens between brand-name, generic drugs. You can contact the show at podcasts@mdedge.com    

This week in clinical cardiology. PCI reduces mortality after STEMI in older adults. Canagliflozin lowers kidney failure risk in T2D: CREDENCE. Poor response to statins hikes risk of cardiovascular events. Low LDL cholesterol may increase women’s risk of hemorrhagic stroke  

This week in clinical cardiology: Alirocumab reduces both type 1 and 2 MIs. Despite failed primary endpoint, MI alert device has predictive value. Look for alcohol septal ablation in the next HOCM guideline. FDA: Forty ARBs free of nitrosamines. You can contact the Cardiocast with ideas, suggestions, stories, or questions for Dr. Dwyer by emailing us at podcasts@mdedge.com and you can follow MDedge Cardiology on Twitter at @MDedgeCardio.

This week's top stories in clinical cardiology: Has radial access PCI been overhyped? Hospital TAVR volume matters to patient survival. Studies link TMAO to microbiome, reveal new heart disease target. More chest compression–only CPR leads to increased survival rates. You can contact the show by emailing us at podcasts@mdedge.com or you can follow MDedge Cardiology on Twitter at @MDedgeCardio.

This week, a novel drug that reverses ticagrelor’s effect looks promising, a new certification process for cardiologists is unveiled, intensive blood pressure monitoring may not help prevent a second stroke, and the FDA cautions against using paclitaxel coated devices.

Cardiovascular prevention guidelines downgrade aspirin, high coronary artery calcium scores carry greater risks, an Apple Watch algorithm predicts AFib, and TAVR overtakes surgery in "historic" trials.

This week in MDedge Cardiocast: A novel drug lowers LDL in on top of maximums statins, invasive cardiology is a top money maker for hospitals, a meta-analysis parses the heart and kidney benefits of new diabetes drugs, and the AHA warns that heart-harming toxins may hurt hookah smokers.