Podcasts about Coronary

“We started Cleerly with the intent to make a comprehensive care pathway for evaluation, education, treatment and tracking for heart disease,” said Dr. Jim Min, the company’s founder and CEO. In this Vanguards of Health Care episode, Min sits down with BI analyst Matt Henriksson to discuss Cleerly and its comprehensive management platform that uses AI algorithms to boost the accuracy of interpreting CT scans, avoid false positives and make the diagnosis stage of treating the disease more efficient for doctors and hospitals. They also cover the need to drive the iterative process of clinical studies, including the TRANSFORM randomized trial for screening asymptomatic individuals with the aim of preventing sudden cardiac death.See omnystudio.com/listener for privacy information.

In this episode, Dr. Valentin Fuster discusses a study showing that elevated cardiac troponin levels after intense exercise in middle-aged recreational athletes are common but not linked to hidden coronary artery disease. The findings raise important questions about the origin and significance of these elevations, highlighting the need for long-term follow-up.

This episode covers:  Cardiology this Week: A concise summary of recent studies Coronary sinus reducer: promise in refractory angina Best strategies to reach LDL cholesterol goals in high-risk patients Snapshots Host: Susanna Price Guests: Carlos Aguiar, Rasha Al-Lamee, J. Wouter Jukema, Steffen Petersen Want to watch that episode? Go to: https://esc365.escardio.org/event/1807 Want to watch that extended interview on LDL management? Go to: https://esc365.escardio.org/event/1807?resource=interview Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Rasha Al-Lamee has declared to have potential conflicts of interest to report: speaker's fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. J. Wouter Jukema has declared to have potential conflicts of interest to report: J. Wouter Jukema/his department has received research grants from and/or was speaker (CME accredited) meetings sponsored/supported by Abbott, Amarin, Amgen, Athera, Biotronik, Boston Scientific, Dalcor, Daiichi Sankyo, Edwards Lifesciences, GE Healthcare Johnson and Johnson, Lilly, Medtronic, Merck-Schering-Plough, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, Shockwave Medical, the Netherlands Heart Foundation, CardioVascular Research the Netherlands (CVON), the Netherlands Heart Institute and the European Community Framework KP7 Programme. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Evaluating Coronary Access After TAVR With The 4th And 5th -generation Self-expanding Valves - The EPROMPT-CA Study

Impact of Intravascular Imaging Guidance on Percutaneous Coronary Intervention of Severely Calcified Lesions: The ECLIPSE Trial

Stratified Randomization Study to Compare Different Duration of Dual Antiplatelet Therapy After Coronary Stenting in Either High or Low Bleeding Risk Population

On this episode, we discuss chronic coronary syndrome (CCS) and describe its clinical presentation, underlying pathophysiology, and progression. We review current guidelines and evidence-based treatment strategies for managing CCS, including both pharmacological and non-pharmacological interventions. Our primary pharmacotherapy focus was on comparing and contrasting antianginal therapies, but we also touch on antiplatelet agents, and risk factor modification strategies. Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

With Damiano Fedele, University of Bologna, Bologna - Italy and University Medical Center Utrecht - The Netherlands, Marco Guglielmo, University Medical Center Utrecht, Utrecht - The Netherlands, and Anna Giulia Pavon, Cardiocentro Ticino Institute, Lugano - Switzerland. Link to editorial Link to paper 

Clopidogrel Versus Aspirin for Long-term Maintenance Monotherapy in Patients with High Ischemic Risk After Percutaneous Coronary Intervention

Is long been promoted that any activity is good for you. And in fact many people need to be doing more, but recent research indicates that not all types activity are good for you. In this episode, we discuss what types of activity may actually be harmful, what is the physical activity paradox, can you do too much activity and the biology behind it all. Select references cited in this podcast: The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults: https://academic.oup.com/eurheartj/article/42/15/1499/6213772 When Moving is the Only Option: The Role of Necessity Versus Choice for Understanding and Promoting Physical Activity in Low- and Middle-Income Countries: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4411302 Coronary artery calcification and high-volume physical activity: role of lower intensity vs. longer duration of exercise: https://academic.oup.com/eurjpc/article/31/12/1526/7656624

Incremental Prognostic Value Of Calcium Detection On The Lipid-rich Plaque Vulnerability: Development And Validation Of An Artificial Intelligence Algorithm For Coronary Calcium Detection With Clinica

N Engl J Med 1987; 314:1429-35Background Prior to the publication of this study, digoxin and diuretics were the mainstay of chronic heart failure management. No therapy had yet been shown to reduce mortality or improve heart failure outcomes in patients with severe disease. The results of the V-HEFT trial had been published in the prior year, which demonstrated that the vasodilator combination of hydralazine and isosorbide reduced death in patients with chronic, stable heart failure. CONSENSUS was the first study to test whether vasodilator therapy in general, and angiotensin converting enzyme inhibitors in particular could modify heart failure disease trajectory for those with severe disease when used as part of chronic disease management. The CONSENSUS trial was designed to test the hypothesis that Enalapril compared to placebo reduced mortality in patients with severe (NYHA IV) congestive heart failure.Patients Men and women with severe (NYHA IV) congestive heart failure and cardiomegaly based on heart size >600 ml/m2 in men or >550 ml/m2 in women were recruited from 35 centers in Finland, Norway and Sweden. Measurement of LV function was not required. Patients were excluded if they had 1) acute pulmonary edema, 2) hemodynamically important aortic or mitral valve stenosis, 3) MI within the previous 2 months, 4) unstable angina, 5) planned cardiac surgery, 6) right heart failure due to pulmonary disease, or 7) serum creatinine >3.4 mg/dL.It is not specified whether patients could be recruited from the inpatient or outpatient setting or both but prior to randomization, a 14-day period was allowed to stabilize patients on digoxin and diuretics. If during this period, their condition improved to NYHA class III or less they were not randomized.Baseline characteristics The majority of participants were male (70%) and their average age was 70. The average heart rate and blood pressure were 80 bpm and 120/75 mmHg and the average serum creatinine was about 1.5 mg/dL. Coronary artery disease was present in over 70% of participants and nearly 50% had suffered a previous heart attack. Hypertension and diabetes were present in over 20% and atrial fibrillation in 50%. The use of medications at baseline was evenly distributed between groups with nearly all patients being on digoxin and furosemide. About 50% of participants were also taking spironolactone as well as other vasodilator drugs. About 50% of patients had heart failure for more than 4 years.Procedures Treatment with enalapril or an identical placebo was initially started in the hospital with a dose of 5 mg twice a day. After 1 week it was increased to 10 mg twice a day if the patient did not have symptoms of hypotension or other side effects. According to the clinical response, a further increase in dosage could occur up to a maximum dose of 20 mg twice a day.Patients were evaluated after 1, 2, 3, 6, and 16 weeks, 6, 9, and 12 months and at the end of the study. In patients with worsening symptoms, additional vasodilator therapy with isosorbide dinitrate, hydralazine, or prazosin, in that sequence was recommended.Early in the trial the occurrence of symptomatic hypotension led to revision of the protocol after 67 patients had been randomized. No patient's treatment was unblinded but in patients with 1) serum sodium

Secrets to Achieving CAD Regression   Guest: Stephen Kopecky, M.D. Host: Sharonne Hayes, M.D.   Coronary artery disease regression can occur in lipid rich plaque. Calcified and fibrotic plaque are essentially scars and cannot regress; however, they also are not associated with plaque rupture, which can lead to myocardial infarction. Studies with invasive angiography or CT angiography that have shown successful regression of CAD have addressed risk factors including hypertension, smoking, hyperlipidemia, and diabetes. They also address lifestyle, including healthy diet such as DASH or Mediterranean diet, regular physical activity, and stress mitigation.   Topics Discussed: Can all types of coronary plaque (calcified, fibrotic, lipid rich) regress? How can we assess coronary artery disease regression? What have studies told us the best way to achieve CAD regression?    Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.

In this episode, Dr. Valentin Fuster dives into the complex and high-stakes world of cardiogenic shock, spotlighting new clinical trials, expert consensus guidance, and cutting-edge insights from machine learning. From evaluating the impact of intra-aortic balloon pumps to rethinking mechanical support strategies, the episode delivers a powerful update on one of cardiology's most urgent challenges.

Send us a textShort Summary: Heart health and the ketogenic diet, with expert insights from a cardiologist and researcher.About the guest: Matthew Budoff, MD, is a preventive cardiologist and professor of medicine at UCLA School of Medicine.Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.Episode Summary: Dr. Matthew Budoff discusses cholesterol, heart disease, and his study on the ketogenic diet's impact on lean, metabolically healthy individuals with high LDL cholesterol. He explains LDL, HDL, and triglycerides, debunking myths about their direct link to heart disease, and emphasizes the importance of coronary calcium scans to assess plaque buildup. Budoff also covers statins, dietary cholesterol, and personalized heart health strategies.Key Takeaways:LDL cholesterol is not a definitive predictor of heart disease; plaque buildup, assessed via coronary calcium scans, is a better indicator.Lean metabolically healthy people on a ketogenic diet may have high LDL without increased plaque progression after one year.Coronary calcium scans, costing ~$100, are recommended for men around age 40 and women around 45-50 to evaluate heart disease risk.Statins effectively lower LDL and can reverse soft plaque, but may be overprescribed for those without plaque buildup.Dietary cholesterol has minimal impact on blood cholesterol, as the liver produces ~85% of it.Ketogenic diet can aid weight loss & diabetes control but may cause high LDL in some lean individuals, known as lean mass hyper-responders.Plaque progression depends more on existing plaque than LDL levels in metabolically healthy ketogenic diet followers.Heart health varies widely due to genetics and other unknown factors, underscoring the need for personalized assessments.Related episode:M&M #158: Ketosis & Ketogenic Diet: Brain & Mental Health, Metabolism, Diet & Exercise, Cancer, Diabetes | Dominic D'AgoSupport the showAll episodes, show notes, transcripts, etc. at the M&M Substack Affiliates: Lumen device to optimize your metabolism for weight loss or athletic performance. Use code MIND for 10% off. Readwise: Organize and share what you read. Athletic Greens: Comprehensive & convenient daily nutrition. Free 1-year supply of vitamin D with purchase. KetoCitra—Ketone body BHB + potassium, calcium & magnesium, formulated with kidney health in mind. Use code MIND20 for 20% off any subscription. MASA Chips—delicious tortilla chips made from organic corn and grass-fed beef tallow. No seed oils or artificial ingredients. Use code MIND for 20% off. For all the ways you can support my efforts

Intravascular Lithotripsy or Mechanical Debulking for the Treatment of Complex Calcified Coronary Arteries: The Multicenter, Prospective Rolling-Stone Trial

CardioNerds (Drs. Daniel Ambinder and Eunice Dugan) join Dr. Namrita Ashokprabhu, Dr. Yulith Roca Alvarez, and Dr. Mehmet Yildiz from The Christ Hospital. Expert commentary by Dr. Odayme Quesada. Audio editing by CardioNerds intern, Christiana Dangas. This episode highlights the pivotal role of cardiac MRI and functional testing in uncovering coronary vasospasm as an underlying cause of MINOCA. Cardiac MRI is crucial in evaluating myocardial infarction with nonobstructive coronary arteries (MINOCA) and diagnosing myocarditis, but findings must be interpreted within clinical context. A 58-year-old man with hypertension, hyperlipidemia, diabetes, a family history of cardiovascular disease, and smoking history presented with sudden chest pain, non-ST-elevation on EKG, and elevated troponin I (0.64 µg/L). Cardiac angiography revealed nonobstructive coronary disease, including a 40% stenosis in the LAD, consistent with MINOCA. Eight weeks later, another event (troponin I 1.18 µg/L) led to cardiac MRI findings suggesting myocarditis. Further history revealed episodic chest pain and coronary vasospasm, confirmed by coronary functional angiography showing severe vasoconstriction, resolved with nitroglycerin. Management included calcium channel blockers and long-acting nitrates, reducing symptoms. Coronary vasospasm is a frequent MINOCA cause and can mimic myocarditis on CMRI. Invasive coronary functional testing, including acetylcholine provocation testing, is indicated in suspicious cases.  US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes - Coronary Vasospasm What are the potential underlying causes of MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)?  Plaque Rupture: Plaque disruption, which includes plaque rupture, erosion, and calcified nodules, occurs as lipids accumulate in coronary arteries, leading to inflammation, necrosis, fibrosis, and calcification. Plaque rupture exposes the plaque to the lumen, causing thrombosis and thromboembolism, while plaque erosion results from thrombus formation without rupture and is more common in women and smokers. Intravascular imaging, such as IVUS and OCT, can detect plaque rupture and erosion, with studies showing plaque disruption as a frequent cause of MINOCA, particularly in women, though the true prevalence may be underestimated due to limited imaging coverage.  Coronary Vasospasm: Coronary vasospasm is characterized by nitrate-responsive chest pain, transient ischemic EKG changes, and >90% vasoconstriction during provocative testing with acetylcholine or ergonovine, due to hyper-reactivity in vascular smooth muscle. It is a common cause of MINOCA, with approximately half of MINOCA patients testing positive in provocative tests, and Asians are at a significantly higher risk than Whites. Smoking is a known risk factor for vasospasm. In contrast, traditional risk factors like sex, hypertension, and diabetes do not increase the risk, and vasospasm is associated with a 2.5–13% long-term risk of major adverse cardiovascular events (MACE).  Spontaneous Coronary Artery Dissection: Spontaneous coronary artery dissection (SCAD) involves the formation of a false lumen in epicardial coronary arteries without atherosclerosis, caused by either an inside-out tear or outside-in intramural hemorrhage. SCAD is classified into four types based on angiographic features, with coronary angiography being the primary diagnostic tool. However, in uncertain cases, advanced imaging like IVUS or OCT may be used cautiously. While the true prevalence is unclear due to missed diagnoses, SCAD is more common in women and is considered a cause of MINOCA when i...

Electrosurgical Leaflet Modification to Prevent Coronary Obstruction During Transcatheter Aortic Valve Replacement in Failing Native and Bioprosthetic Valves: The TELLTALE Trial

Commentary by Dr. Jian'an Wang.

With Giovanni Donato Aquaro, University of Pisa - Italy, and Carmelo De Gori, Fondazione Monasterio, Pisa - Italy. Link to editorial Link to paper  

Commentary by Dr. Mayank Yadav.

Most people think heart disease happens suddenly—but it builds quietly over decades. In this episode, Ted reveals the simple, noninvasive test that helped him assess his heart disease risk and could potentially save your life. If you're over 40, this test might be the most important one you've never heard of. Listen now! 

Justin Coleman speaks with Kate Ziser, a pharmacist at the Princess Alexandra Hospital in Brisbane, about her paper on the role of triple antithrombotic therapy in patients with atrial fibrillation following coronary stent insertion. Kate explains when triple therapy is indicated, the duration of therapy, and the step-down approach to antithrombotic therapy. Read the full article by Kate and her co-authors in Australian Prescriber.

The Lancet 2002;360:743-751Background: The TACTICS-TIMI 18 trial showed that an early invasive strategy in beneficial in selected patients with unstable angina or non-ST-elevation myocardial infarction (NSTEMI). These positive findings contrasted the findings from some earlier studies.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The British Heart Foundation RITA 3 randomized trial sought to compare invasive vs conservative strategy in patients with unstable angina or NSTEMI, similar to the trial question of TACTICS-TIMI 18.Patients: Eligible patients had suspected cardiac chest pain at rest with at least one of the following: Evidence of ischemia on electrocardiogram (ST depression, transient ST elevation, old left bundle branch block, or T wave inversion), pathologic Q waves suggesting previous myocardial infarction, or documented coronary artery disease on prior coronary angiogram.Patients were excluded if they had evolving myocardial infarction in which reperfusion therapy was indicated. Patients were also excluded if creatine kinase or creatine kinase MB concentrations were twice the upper limit of normal before randomization, if they had myocardial infarction within a month, had percutaneous coronary intervention (PCI) in the previous 12 months, or coronary artery bypass grafting (CABG) at any time.Baseline characteristics: The trial randomized 1,810 patients – 895 randomized to the invasive strategy and 915 randomized to conservative strategy. Patients were recruited from 45 hospitals in England and Scotland.The average age of patients was 63 years and 62% were men. Approximately 35% had hypertension on drugs, 13% had diabetes and 28% had prior myocardial infarction.The majority (92%) of the patients were enrolled because they met the criteria for evidence of ischemia on electrocardiogram.Procedures: Patients were randomly assigned in a 1:1 ratio to undergo invasive vs conservative strategy.In the conservative arm, patients received aspirin and enoxaparin 1mg/kg subcutaneously twice a day for 2-8 days. Beta-blockers, other antiplatelets and glycoprotein IIb/IIIa inhibitors could also be used. Coronary angiography could be performed if patients had anginal symptoms at rest or with minimal exertion despite appropriate therapy or if they had ischemia on stress testing.Patients in the invasive strategy arm received similar medical therapy to the conservative arm. Coronary angiogram was to be performed as soon as possible after randomization and ideally within 72 hours. Revascularization was recommended for lesions of at least 70% stenosis or 50% or more if left main.Endpoints: The trial had two co-primary outcomes. The first was a composite of death from any cause, nonfatal myocardial infarction, or refractory angina at 4 months. The second was a composite of death from any cause or nonfatal myocardial infarction at 1 year.Analysis was performed based on the intention-to-treat principle. The estimated sample size to provide 80% power at 5% alpha, was 1,770 patients. This assumed that 12% of the patients in the conservative arm would experience the outcome of death or non-fatal myocardial infarction at 1-year, and that the invasive strategy would result in 33% relative risk reduction in this outcome.Results: In the invasive strategy, 97% of the patients underwent coronary angiogram at a median of 2 days after randomization, and 55.3% underwent PCI or CABG. In the conservative arm, 10.3% had revascularization during the index admission, and 17.3% had revascularization at 1-year. The median follow time was 2 years and 97% of the patients had at least 1-year of follow up.The first primary composite outcome of death from any cause, nonfatal myocardial infarction, or refractory angina at 4 months was lower with the invasive strategy (9.6% vs 14.5%, HR: 0.66, 95% CI: 0.51 – 0.85; p= 0.001). The second primary composite outcome of death from any cause or nonfatal myocardial infarction at 1 year was not significantly different between both groups (7.6% with invasive vs 8.3% with conservative, HR: 0.91, 95% CI: 0.67 – 1.25; p= 0.58). At 1-year, 4.6% patients died in the invasive arm compared to 3.9% in the conservative arm, and this was not statistically significant. Myocardial infarction at 1-year occurred in 3.8% of the patients in the invasive arm compared to 4.8% in the conservative arm, and this was not statistically significant as well.All bleeding occurred in 8.2% in the invasive arm and 3.5% in the conservative arm.Subgroup analysis showed that men benefited from an invasive strategy while women did not (p for interaction= 0.011). The endpoint of death or myocardial infarction at 1-year, in women, was 5.1% in the conservative arm and 8.6% in the invasive arm, while in men, the incidence of this endpoint was 10.1% in the conservative arm and 7.0% in the invasive arm.Conclusion: In patients with unstable angina or NSTEMI, an invasive strategy compared to conservative strategy, reduced refractory angina but not myocardial infarction or death at 1-year.The reduction in angina is a subjective endpoint, prone to bias and faith healing, as we have previously discussed in other trials of PCI. The reduction in this endpoint alone should not justify widespread adoption of invasive strategy for unstable angina or NSTEMI.A key distinction between this trial and TACTICS-TIMI 18—which demonstrated a reduction in myocardial infarction with an invasive approach—is that this study included patients with smaller myocardial infarctions. Only 41% of participants had ST depression or transient ST elevation, and patients were excluded if creatine kinase or creatine kinase MB levels were more than twice the upper limit of normal before randomization. This highlights the heterogeneity among patients with unstable angina and NSTEMI, where baseline risk and the extent of myocardial necrosis influence treatment effects. We encourage you to read again the subgroup interactions of TACTICS-TIMI 18.Additionally, in the current era, high-sensitivity troponin assays enable the detection of smaller myocardial infarctions, potentially limiting the applicability of older trial results to all present NSTEMI patients.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Antithrombotic Therapy in CCS

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on TIMI Frame Count and Coronary Function in Women With Suspected Ischemia and Nonobstructed Coronary Arteries

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Safety and Efficacy of Different Stent Strategies in Percutaneous Coronary Intervention: A Network Meta-Analysis

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Significance of Coronary Artery Calcifications and Ischemic Electrocardiographic Changes Among Patients Undergoing Myocardial Perfusion Imaging

Julien Dreyfus, MD, PhD, JACC: Case Reports Associate Editor, is joined by author Khalid Shakfeh, MD, discussing this study from Shakfeh et al presented at ACC.25 and published in JACC: Case Reports. A 56 year old man with chronic chest pain syndrome presented with sudden onset of weakness. Evaluation for a stroke revealed a large mass in the right atrium measuring approximately 2.2 x 2.0 cm immediately above the tricuspid valve annulus and adjacent to the atrio-ventricular groove on TTE. Cardiac MRI ruled out intracardiac mass, but rather demonstrated an RCA fusiform aneurysm. Coronary CTA characterized this as two fusiform RCA aneurysms. A LHC confirmed this. Giant coronary aneurysms appearing as a large space-occupying intracavitary cardiac mass are rarely diagnosed. Escalating multimodal imaging is essential for accurate diagnosis and surgical planning. Kawasaki disease can have a late presentation and should be considered in the differential diagnosis of coronary aneurysms. A multimodal imaging approach is essential for accurate diagnosis and management of giant coronary aneurysms.

Mirza Umair Khalid, MD, social media editor of JACC: Cardiovascular Interventions, and Alfonso Jurado-Román, MD, PhD, discuss a recently published randomized controlled trial comparing three forms of calcium modification strategies (rotational atherectomy, lithotripsy, and laser) for calcified coronary stenosis. View the video here.

Optimizing Cardiovascular Health with Dr. Stephen Hussey Guest: Dr. Stephen Hussey – Cardiovascular Health Expert, Chiropractor, Functional Medicine Practitioner, and Author. Episode Overview: In this insightful episode, Coach Debbie Potts sits down with Dr. Stephen Hussey to explore the root causes of cardiovascular disease, the role of structured water in heart health, and how lifestyle choices impact mitochondrial function and longevity. Dr. Hussey shares his research on oxidative stress, coronary artery disease, and the critical connection between grounding, infrared light, and mitochondrial health for optimal cardiovascular function. Topics Discussed: Structured Water & Cardiovascular Health – How structured water (EZ water) supports mitochondrial function, blood flow, and heart health. Infrared Light & Mitochondria – How exposure to infrared light enhances cellular energy production and reduces oxidative stress. Grounding & Heart Function – The benefits of direct contact with the earth to balance electrical charge, reduce inflammation, and improve heart health. Coronary Artery Disease & Oxidative Stress – Why heart disease is not just about cholesterol but also mitochondrial dysfunction and chronic inflammation. Longevity & Cardiovascular Optimization – Practical strategies for supporting heart function, improving metabolic health, and reducing disease risk. Key Takeaways: The heart functions beyond just a pump—it relies on structured water and electrical conductivity. Infrared light exposure (sunlight, saunas, red light therapy) enhances structured water formation, improving energy production and circulation. Grounding (walking barefoot, connecting with nature) reduces inflammation and supports cardiovascular health. Coronary artery disease is largely influenced by mitochondrial dysfunction and oxidative stress rather than solely cholesterol levels. Optimizing structured water, mitochondrial health, and lifestyle factors can significantly improve heart health and longevity. Watch the Full Episode on YouTube:

SCAD is the leading cause of heart attacks in women under 50, often caused by bleeding in the artery wall that leads to tearing SCAD is linked to genetic factors affecting collagen and tissue strength, with emotional stress being a common trigger Diagnosis can be challenging, as young women with chest pain aren't typically suspected of having heart attacks; troponin testing is crucial for detection Unlike atherosclerosis, SCAD is treated conservatively with beta blockers (preferably long-term) and limited use of antiplatelet therapy. The risk of recurrence is 20-30%, and prevention includes beta blockers, treating high blood pressure, and screening for fibromuscular dysplasia. Host: Dr David Lim | Total Time: 44 mins Experts: Dr Jason Kovacic, Clinical Cardiologist Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.

In this episode, Dr. Valentin Fuster summarizes the March 25, 2025, issue of the JACC, which focuses on advancements in electrophysiology. Highlights include groundbreaking studies on leadless pacemakers, atrial fibrillation treatments, and appropriate use criteria for cardiac devices, with key papers exploring the safety of pacemaker retrieval, the role of electrograms in ablation procedures, and long-term outcomes for left atrial appendage occlusion devices.

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309

LATE BREAKING CLINICAL SCIENCE: Comprehensive Radiation Shield Minimizes Operator Radiation Exposure in Coronary and Structural Heart Procedures

A groundbreaking new study confirms the benefits of coronary artery calcium (CAC) scoring in asymptomatic individuals, reinforcing the case for routine CT scans starting at age 40. This week, Dr. Kahn breaks down the findings and what they mean for heart health. Other topics include: The health benefits of dietary niacin and how it supports overall wellness. New research showing plant oils are a healthier choice than butter for heart and cancer outcomes. 

“I think everyone should have Lp(a) measured.”  Dr. Ann Marie Navar    Key Resources to Go Deeper:  - Dr. Ann Marie Navar  - Lp(a)  - Get a Free Test to Check Your Lp(a) Level   - Previous episode with Dr. Navar about ApoB  About This Episode:  Join us for an enlightening discussion about Lipoprotein(a), or Lp(a), a critical but often overlooked marker for cardiovascular health. In this episode, host Barbara Hannah Grufferman takes a deep dive with medical expert Dr. Ann Marie Navar from UT Southwestern Medical Center about why this single test could be vital for understanding your heart disease risk, especially if you have a family history of early cardiovascular disease.  Key Topics Covered:  - What Lipoprotein(a) is and how it differs from standard cholesterol measurements  - Why Lp(a) testing is particularly important for certain individuals  - The genetic nature of Lp(a) and its implications for family health  - Current treatment options and promising new therapies on the horizon  - Practical steps for discussing Lp(a) testing with your healthcare provider  Key Takeaways:  - Lp(a) is a distinct type of cholesterol particle not captured in routine lipid panels  - High Lp(a) levels significantly increase risk of heart disease and stroke  - Lp(a) levels are primarily determined by genetics and remain stable throughout life  - Current guidelines recommend universal Lp(a) testing for adults  - New treatments specifically targeting high Lp(a) levels are expected by 2026  - Managing other risk factors can help offset the risk of elevated Lp(a)  - Coronary artery calcium scoring can provide additional risk assessment  Learn More About Dr. Ann Marie Navar  Dr. Navar is a preventive cardiologist and epidemiologist at UT Southwestern Medical Center whose research focuses on cardiovascular disease prevention, risk prediction, and clinical decision-making. She is a leading expert in advanced lipid testing and cardiovascular risk assessment. This is Dr. Navar's second appearance on AGE BETTER, following her previous discussion about the ApoB test, which was one of the most down-loaded episodes in 2024.   Connect With Barbara:  Have ideas for future episodes? We'd love to hear from you!  - Email: agebetterpodcast@gmail.com  - Connect on Instagram HERE  Note: This episode is for informational purposes only and does not constitute medical advice. Please consult with your healthcare provider about your specific situation.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Editor's Summary by Linda Brubaker, MD, Deputy Editor of JAMA, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from March 1-7, 2025.

Today's Episode The final part of Dr. Raj's Cardiology/Acute Coronary Syndromes talk. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

With Federico Fortuni and Claudio Bernetti, University of Perugia, Perugia - Italy Link to paper Link to editorial

Today's Episode Part 6 of 7 from Dr. Raj's Cardiology/Acute Coronary Syndromes talk. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Guest Kristy Red-Horse is a biologist who specializes in coronary artery development and disease. She says the latest advances in treatment of blockages could do away with invasive bypass surgeries in favor of growing new arteries using molecules like CXCL12, known to promote artery regrowth in mice. Red-Horse explains how leaps forward in medical imaging, expanding atlases of gene expressions, and new drug delivery mechanisms could someday lead to trials in humans. But, before that day can arrive, much work remains, as Red-Horse tells host Russ Altman in this episode of Stanford Engineering's The Future of Everything podcast.Have a question for Russ? Send it our way in writing or via voice memo, and it might be featured on an upcoming episode. Please introduce yourself, let us know where you're listening from, and share your quest. You can send questions to thefutureofeverything@stanford.edu.Episode Reference Links:Stanford Profile: Kristy Red-HorseKristy's Lab: Red-Horse LabConnect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / FacebookChapters:(00:00:00) IntroductionRuss Altman introduces Kristy Red-Horse, a professor of biology at Stanford University.(00:03:46) Replacing Open-Heart SurgeryWhy bypass surgery is invasive, risky, and requires long recovery.(00:05:09) Challenges in Artery GrowthThe difficulty of targeting artery growth with medical interventions.(00:07:32) The Role of Collateral ArteriesDefinition and function of collateral arteries as natural bypass.(00:09:37) Triggers for Natural Bypass FormationGenetic factors that may influence the growth of these bypass arteries.(00:10:49) Unique Properties of Coronary ArteriesChallenges of ensuring artificial growth replicates natural artery function.(00:13:04) The Discovery of CXCL12A key molecule that stimulates collateral artery formation.(00:16:16) Precise Artery Growth ControlThe results of targeted CXCL12 injections into mice hearts.(00:17:32) CXCL12's Overlooked RoleThe molecule's role in the immune system and stem cells.(00:20:27) Guinea Pigs and Heart Attack ResistanceHow guinea pigs naturally develop collaterals.(00:23:19) Preventing Heart DiseaseUsing artery growth treatments to target early-stage coronary disease.(00:25:25) Breakthroughs in Imaging TechnologyNew technology that enables identification of collateral growth pathways.(00:27:07) How Collateral Arteries FormThe two mechanisms in which new arteries form.(00:28:48) The Future of Medical Artery GrowthThe possibility of eliminating bypass surgery with targeted artery growth. Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>>Twitter/X / Instagram / LinkedIn / Facebook

In this podcast, Dr. Valentin Fuster introduces a detailed review on managing coronary stent under-expansion, a critical issue that increases risks like restenosis and myocardial infarction. The discussion highlights the causes, challenges, and treatment strategies for under-expanded stents, emphasizing the importance of intravascular imaging and individualized approaches to optimize patient outcomes.

Section 1: Introduction (0:00 - 5:30) Dr. Valentin Fuster introduces a special issue on Prevention, covering societal and individual prevention aspects and key cardiovascular risk factors. He highlights issues like medication adherence, obesity, and the need for better education and healthcare systems. Section 2: Prevention in Society (5:30 - 35:30) Adherence to Medications The PURE trial shows low medication adherence (31% at follow-up) across 17 countries, despite technological advancements in diagnostics. Barriers include low health literacy and inadequate healthcare systems. Social Determinants of Health Social deprivation leads to worse cardiovascular outcomes, especially among sexual minorities in the U.S. The editorial calls for more equitable healthcare access and anti-stigma efforts. Environmental Factors: Aircraft Noise Higher aircraft noise exposure is linked to worse heart health, urging noise reduction policies for vulnerable populations. Section 3: Prevention in Individuals (35:30 - 55:30) Sedentary Behavior Even with exercise, high sedentary time (over 10.6 hours a day) increases cardiovascular risk. Reducing sedentary time can significantly lower heart disease risk. Intensive Lifestyle Interventions for Diabetes Weight loss and lifestyle changes improve cardiac biomarkers and reduce cardiovascular risk in type 2 diabetes patients. Section 4: Risk Factor Impacts (55:30 - 1:10:00) Hyperlipidemia & Obesity Hyperlipidemia and obesity management, including medications like semaglutide, play key roles in preventing cardiovascular disease. The 2024 ESC hypertension guidelines are also crucial in risk reduction.

Send us a textSeason 2, Episode 26Well January and February slots are getting full with some exciting guests so Martin & Patrick thought they would fit in one with themselves.The Boy's are on the road again and this episode has been recorded in their hotel room in Aylesbury the night prior to an interview with another exciting celebrity guest.Onto todays episode, the boys bring us up to date with their respective illnesses Heart Disease and Stage 4 lung Cancer.Cancer is a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs.Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked or reduced. This puts an increased strain on the heart, and can lead to: angina – chest pain caused by restricted blood flow to the heart muscle. heart attacks – where the blood flow to the heart muscle is suddenly blocked.Some interesting facts about the two illnesses and a discussion around these facts. Martin has been looking at his own security online, and thus discusses Scammers and how to be safe online and deal with emails or telephone calls that don't seem right. Some tips on passwords and what to look out for online.Finally we do get a chance for "Martins Joke of the week" it's quite a long one this time but please stick with it.#Stoma#HeartTransplant#EbsteinsAnomaly#RareCondition#HealthJourney#LifeChangingDiagnosis#MentalHealth#Vulnerability#SelfCompassion#PostTraumaticGrowth#MedicalMiracle#BBCSports#Inspiration#Cardiology#Surgery#Podcast#Healthcare#HeartHealth#MedicalBreakthrough#EmotionalJourney#SupportSystem#HealthcareHeroes#PatientStories#CardiologyCare#MedicalJourney#LifeLessons#MentalWellness#HealthAwareness#InspirationalTalk#LivingWithIllness#RareDiseaseAwareness#SharingIsCaring#MedicalSupport#BBCReporter#HeartDisease#PodcastInterview#HealthTalk#Empowerment#Wellbeing#HealthPodcast#ChronicIllnessCheck out our new website at www.whostomanddick.comCheck out our website at www.whostomanddick.com

A new study finds poor metabolic health and low HDL is a greater predictor of coronary artery calcium than LDL cholesterol.  Support your Intermittent Fasting lifestyle with the Berberine Fasting Accelerator  by MYOXCIENCE: https://bit.ly/berberine-fasting-accelerator  Use code podcast to save 12% Video & Links to study: https://bit.ly/3Zj56fA Time Stamps:  0:00 Intro 0:30 LDL does not correlate with the degree of coronary artery plaque. 1:02 HDL is protective against coronary artery disease and plaquing. 2:10 Triglycerides correlate with diabetes, coronary artery disease and plaquing. 3:45 HDL size is highly predictive. 5:15 LDL, vLDL, and IDL had no strong association. 8:00 LDL may be lower with prediabetes and diabetes, reflecting imbalance. 12:10 HDL is increased by lifestyle. 13:00 Plaquing is more common in diabetics. 15:47 High triglycerides increase odds of metabolic disease by 100%. 18:00 The smaller HDL particles become, the less protective they are. 19:13 Coronary artery calcium is associated with HDL size, concentration and composition. 21:20 High HDL with low triglycerides is linked with better metabolic health. 23:10 Exercise increases the size and number of your protective HDL.