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JACC's November 25, 2025 issue kicks off Thanksgiving week with JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, reflecting on his editor's page and the day he became a doctor (0:12). For original research articles, he discusses a study on colchicine & clonal hematopoiesis, an exploratory study of the LoDoCo2 trial (1:10), and a paired editorial comment with more perspectives and a reminder of the upcoming COLCOT trial (4:33). Next, a study on Lp(a) and IL-6 (4:54) and an editorial (6:12), 30-year CVD risk percentiles based on the PREVENT equations (6:30), and an accompanying editorial from JACC Deputy Editor Erica Spatz, MD, on next-generation strategies to encourage healthier behaviors (7:35). Other studies and editorials include a fascinating look at alcohol and blood pressure (8:04) and reinforcing the WHO public health guidance (10:05); remnant cholesterol in young adults (10:38) and implications for cholesterol guidelines (12:36). We also include four brief reports on RSV vaccine (13:11), long Covid (13:43), Lp(a) levels (14:06), the predictive power of polygenic risk scores (14:58), a viewpoint on US veterans (15:36), and our regular Amara Yad image (15:53), which we're delighted to be able to continue to promote with JACC: Clinical Electrophysiology Editor-in-Chief Kalyanam Shivkumar, MD.
In the November 18, 2025 issue of JACC, Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, uses his editor's page to reflect on the evolving role of editors as partners with authors in strengthening cardiovascular science. The issue itself centers on adiposity, featuring multiple pooled analyses showing that waist-to-height ratio and waist circumference outperform BMI in predicting heart failure and mortality risk. Other highlights include a meta-analysis confirming GLP-1 receptor agonists' broad cardiovascular benefits, new insights into obesity's impact on biomarkers and disease interpretation, and several pieces, including state of the art reviews and viewpoints, on obesity-related conditions. Our issue focus on adiposity as a central driver of cardiometabolic disease shows the need for tailored, collaborative approaches to patient care and research. #stride #adipokinehypothesis
Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi, skąd nagrywam podcast Kardio Know-How. W tym odcinku rozpoczynam omawianie doniesień z tegorocznego kongresu TCT. Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi i prowadzę podcast Kardio-Know-How, część portalu edukacyjnego o tej samej nazwie. Niedomykalność mitralna dzieli się na pierwotną (degeneracyjną) i wtórną (czynnościową) — rozróżnienie to ma kluczowe znaczenie dla leczenia. Podstawą diagnostyki są badanie kliniczne, echokardiografia i ocena frakcji wyrzutowej lewej komory. W leczeniu wtórnej niedomykalności fundamentem jest terapia zgodna z wytycznymi (GDMT) dla niewydolności serca, obejmująca m.in. ARNI, MRA, flozyny i beta-blokery. W pierwotnej postaci leki łagodzą objawy, ale nie modyfikują przebiegu choroby. Terapia resynchronizująca (CRT) i leczenie migotania przedsionków mogą dodatkowo poprawić wyniki. W ciężkiej pierwotnej niedomykalności preferowana jest naprawa zastawki, a u pacjentów wysokiego ryzyka — przezcewnikowa naprawa (TEER, np. MitraClip). W przypadku zwapnienia pierścienia (MAC) coraz częściej rozważa się przezcewnikową wymianę zastawki, choć to technicznie trudne. Badanie SUMMIT-MAC testowało system Tendyne u pacjentów z ciężkim MAC — opisano go w Cardiology Journal (https://journals.viamedica.pl/cardiology_journal/article/view/99752) i JACC (https://www.jacc.org/doi/10.1016/j.jacc.2025.10.025). Wyniki wskazują na 94% skuteczności zabiegu, poprawę klasy NYHA i jakości życia przy 80% przeżyciu rocznym. To duży krok naprzód, ale metoda wciąż dla nielicznych — potrzebne są dalsze badania i porównania z klasyczną chirurgią. Szczegółowy TRANSKRYPT do odcinka.Podcast jest przeznaczony wyłącznie dla osób z profesjonalnym wykształceniem medycznym.
Commentary by Dr. Yutao Guo.
Commentary by Dr. Joon Ho Ahn.
Commentary by Dr. Tong Liu.
Commentary by Dr. Mert Kaskal.
Commentary by Dr. Xin Zhou.
Commentary by Dr. Anastasios Apostolos.
In this week's JACC podcast, Editor-in-Chief Dr. Harlan Krumholz explores how context, precision, and physiology converge to shape modern cardiovascular care. He opens with an editorial on "The Geography Gap," challenging the one-size-fits-all approach to cardiovascular risk models that ignore geographic variation in disease outcomes. Other featured studies in this issue include trials (OCEAN Mitral, PULSE), optimizing outcomes after transcatheter mitral repair, plus uncovering genetic links between placental malperfusion and congenital heart disease, evaluating CT angiography follow-up after left main PCI, and refining emergency triage with high-sensitivity troponin testing. Dr. Krumholz also speaks to editorials in this issue providing insight on the accompanying JACC articles, and a HeartBeat submission, with a reflection on balance and compassion in pediatric cardiology. Finally, he touches on our other JACC journal content, including new findings on blood groups and COVID-19 cardiovascular outcomes, and the first JACC: Basic to Translational Science Editor's page from the new editor-in-chief, Matthias Nahrendorf, MD, PhD, on the evolving landscape of translational science. This week in JACC highlights cardiology's movement toward more localized, integrated, and human-centered precision medicine.
Description Join host and Digital Education Committee Member, Danesh Kella, MBBS, FHRS and his guests Ratika Parkash, MD, MS, FHRS and Prashanthan Sanders, MBBS, PhD, FHRS at HRX Live 2025 in Atlanta, for this exciting discussion. The PRAGUE-25 trial, published in JACC in 2025, compared catheter ablation with a program of lifestyle modification plus antiarrhythmic drugs in obese patients (BMI 30–40 kg/m2) with symptomatic atrial fibrillation. At 12 months, freedom from atrial fibrillation was significantly higher with ablation (73%) than with lifestyle modification + AADs (35%), despite the latter group achieving greater weight loss and metabolic improvement. The findings suggest that while aggressive risk-factor control improves overall health, catheter ablation remains more effective for rhythm control in this population. Learning Objectives Describe the comparative effectiveness of catheter ablation versus lifestyle modification with antiarrhythmic drug therapy in obese patients with symptomatic atrial fibrillation. Discuss how weight reduction and risk-factor modification influence atrial fibrillation outcomes, while recognizing that catheter ablation provides superior rhythm control despite metabolic improvements achieved through lifestyle intervention. Article Authors Pavel Osmancik, Tomas Roubicek, Stepan Havranek, Jan Chovancik, Veronika Bulkova, Dalibor Herman, Martin Matoulek, Vladimir Tuka, Ivan Ranic, Jana Hozmanova, Marek Hozman, Lucie Znojilova, Adam Latinak, Jan Pidhorodecky, Milan Dusik, Jan Simek, Otakar Jiravsky, Bogna Jiravska-Godula, Frantisek Lehar, Michal Cernosek, Zuzana Hejdukova, Hana Zelinkova, Jiri Jarkovsky, and Klara Benesova Podcast Contributors Prashanthan Sanders, MBBS, PhD, FHRS Danesh Kella, MBBS, FHRS Ratika Parkash, MD, MS, FHRS All relevant financial relationships have been mitigated. Host Disclosure(s): D. Kella •Speaking/Teaching/Consulting: Zoll Medical Corporation, MBW Spectrum Contributor Disclosure(s): R. Parkash •Research: Abbott, Medtronic, Novartis • Membership on Advisory Committees: Medtronic P. Sanders •Membership on Advisory Committees: Medtronic PLC, Pacemate, CathRx, Boston Scientific, Abbott Medical • Research: Abbott, Becton Dickinson, Calyan Technologies, Ceryx Medical, Biosense Webster, CathRx, HelloAlfred, Medtronic, Inc., Abbott Medical Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Mirza Umair Khalid, MD, social media editor of JACC: Cardiovascular Interventions, and Jasmine Marquard discuss a recently published study examining PCI in multivessel disease during infarct-related cardiogenic shock.
Aaysha Cader, MD MSc, social media editor for JACC: Cardiovascular interventions and Christoph Ryffel, MD discuss the Long-term Outcomes of Patients with Moderate and Severe Aortic Stenosis According to Stages of Cardiac Damage, manucript published in the October 27 issue of the journal.
Aaysha Cader, MD MSc, social media editor for JACC: Cardiovascular interventions and Josep Rodés-Cabau, MD, PhD discuss the Impact of Early Hemodynamic Valve Deterioration on Long-term Outcomes Following Transcatheter Aortic Valve Replacement, published in the October 27 issue of the journal.
In this special episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz introduces the November 4, 2025 issue, entirely devoted to hypertension and the landmark 2025 HAC Multi-Society High Blood Pressure Guideline. He discusses key updates—from reaffirming lower blood pressure targets and expanding out-of-office monitoring to integrating hypertension within the cardio-kidney-metabolic framework. Dr. Krumholz highlights expert commentaries covering policy, technology, therapeutics, and prevention, emphasizing how this forward-looking issue aims to move beyond publication toward true implementation. The episode calls for a cultural shift—making uncontrolled hypertension a "never event" through better systems, teamwork, and innovation.
Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Robert Herman, MD, PhD discuss AI-Enabled ECG Analysis Improves Diagnostic Accuracy and Reduces False STEMI Activations: A Multicenter U.S. Registry, presented as a Late Breaking Clinical Trial at TCT 2025.
For over 20 years, the Jacklin Arts & Cultural Center, also known as The JACC, has brought the Post Falls community together through the transformative power of the arts. What began as a mission to save a historic building has blossomed into a thriving hub where creativity, connection, and culture flourish in the heart of Post Falls. Darla Dreyer has been the Executive Director for the last eight of those years, and she talks to us about the upcoming events, exhibits and classes happening there this fall and winter. To find out more visit thejacklincenter.org or on Facebook @JacklinArts.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Early Access to Tafamidis for Patients With Transthyretin Amyloid Cardiomyopathy.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Total Atrial Conduction Time as a Predictor of Left Atrial Functional Recovery in Atrial Fibrillation.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Outcomes of Telemedicine TAVR Preoperative Evaluations.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Impact of Food Desert Residence on Ischemic Stroke and Hospitalization Risk in Atrial Fibrillation Patients.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Role of Artificial Intelligence in Reducing Data Deluge From Cardiac Implantable Electronic Devices.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Sex Differences in Cardiovascular Health Status and Long-Term Outcomes in a Primary Prevention Cohort.
The FiltrateJoel Topf @kidneyboy.bsky.socialSwapnil Hiremath @hswapnil.medsky.socialNayan Arora captainchloride.bsky.socialSopia Ambruso @sophia-kidney.bsky.socialSpecial Guests Brendon Neuen @brendonneuen.bsky.social Associate Professor and Program Lead, Renal and Metabolic at The George Institute for Global Health. Nephrologist and Director of Kidney Trials at Royal North Shore Hospital.Neuen has had three prior appearances on Freely Filtered: EMPA Kidney, DUPLEX and Sparsentan in FSGS, FLOW and SemaglutideMuthiah Vaduganathan @mvaduganathan on X. Cardiologist at Brigham and Women's Hospital and Harvard Medical School. Assistant Professor of Medicine.Editing byJoel TopfThe Kidney Connection written and performed by Tim YauShow NotesDONATE to NephJC! Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes NEJM | NephJC SummaryFIDELIO Bakris et al, NEJM 2020 | NephJC Summary; subgroup throws doubt on efficacy of finerenone in patients on flozinsFIGARO Pitt et al, NEJM 2021; subgroups clearly shows finerenone works, flozins or notNEJM editorial (wrongly) saying do not use Flozins unless on RASi Don't use dual RAS blockade ONTARGET Yusuf et al, NEJM 2008; VA NEPHRON-D Fried et al NEJM 2013Why we cannot study finerenone in HFrEF (RALES Pitt et al NEJM 1999) Muthu is jealous of GFR slope and albuminuria surrogate endpoints and wants to borrow them for HFpEF (Inker et al EHJ 2025)Combination therapy and CV outcomes in hypertension (Wang et al JAMA Card 2024 on low dose combinations and BP; Egan et al Blood Pressure 2022 review of topic) CONFIRMATION HF trial registry entry (Finerenone and Empagliflozin in hospitalized patients with HF)23:20: Nayan and Swap miss a chance to say ‘de-flozination' to discuss stopping a flozin which would allow a patient to be included in the trial Finerenone is a CYP3A4 substrate (Heinig et al Clin Pharmacokinetics 2023); Useful list of CYP3A4 inducers and inhibitors Everyone should get an ABPM (Bugeja et al CMAJ 2022)EASiKIDNEY study design Albuminuria mediates CKD benefits with Finerenone (Agarwal et al Ann Intern Med 2023)GFR slope and Albuminuria and the FDA (Taylor et al eClin Med 2025) Dapagliflozin and Eplerenone combination crossover trial (Provenzano et al JASN 2022)Joel gets promoted! (PBFluids reflection) Bluesky NephJC Chat discussion on ‘renal remission' Withdrawal of Finerenone and worse outcomes from FINEARTS (Vaduganathan et al JACC 2025)Combination therapies Analysis from Brendan and Muthu (Neuen et al Circulation 2024)Do not use KFRE when GFR > 60 (KDIGO Practice Point 2.2.4: Note that risk prediction equations developed for use in people with CKD G3–G5, may not be valid for use in those with CKD G1–G2) Finerenone vs Spironolactone trial in Primary Aldosteronism (Hu et al Circulation 2025)FIND CKD trial design (Heerspink et al NDT 2025) FINE-ONE trial design (Heerspink et al Diab Res Practice 2023) Tubular SecretionsNayan keeping his chin up as Yankees lose and Mariners follow (MLB Playoffs)Sophia's adventures with Beekeeping (Royal Jelly?) Brendon loves listening to ‘Susan' by Raye Muthu is back into Taekwondo Swap is still reading Martha Wells (Witch King on GoodReads)Joel will be hiking the Laugavegur trail in Iceland
Commentary by Dr. Nicolas Palaskas & Dr. Keila Ostos-Mendoza.
Commentary by Dr. Vivek Narayan.
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Development of an Electronic Medical Record–Based Score for Heart Failure Prediction in Cancer Survivors.
Audio Summary of the October 2025 Issue by Dr. Jian'an Wang.
Commentary by Dr. Pavel Martinez-Dominguez.
Commentary by Dr. Bonnie Ky.
Commentary by Dr. Eli Muchtar.
Commentary by Yi Li, MA.
Dr. Harlan Krumholz introduces a JACC issue unified around the question of how low to target blood pressure, highlighting growing evidence that aiming near 120 mm Hg improves cardiovascular outcomes without harming quality of life. Several studies from the STEP and ESPRIT trials show that intensive blood pressure control widens retinal arterioles, lowers stroke risk, enhances well-being, and remains safe even in older adults. Long-term follow-up data demonstrate that early initiation of intensive therapy provides lasting cardiovascular protection, while new analyses using the PREVENT equations confirm that higher-risk patients gain the most absolute benefit. The issue underscores that intensive control is both safe and effective, and that the next challenge is implementing these proven strategies consistently in clinical practice.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, introduces the October 21, 2025 issue of JACC, which is devoted entirely to Dr. Milton Packer's adipokine hypothesis. Dr. Krumholz explains the rationale behind dedicating the issue to this bold conceptual framework, which proposes that dysfunctional visceral fat and its secreted adipokines drive HFpEF. We're also thrilled to present readers with 10 accompanying expert commentaries that explore, challenge, and contextualize the hypothesis.
This episode of JACC This Week, hosted by Harlan M. Krumholz, MD, SM, highlights key research and perspectives from the October 14, 2025 issue of JACC. It opens with a call to modernize physician certification by distinguishing core knowledge from clinical reasoning, emphasizing continuous, engaging learning over rote memorization. Featured studies in this week's issue include the cardiovascular risks linked to clonal hematopoiesis in older women, improved clotting outcomes with third-generation LVADs despite ongoing bleeding risks, and how dapagliflozin reduces heart failure events post-TAVI without improving perceived quality of life. The episode also explores inflammation as a target after myocardial infarction, the evolving role of drug-coated balloons in PCI, and cardiac CT's expanding use in prosthetic valve assessment—signaling a shift toward more precise, less invasive cardiovascular care. We also feature an article from JACC: Asia this week on cardiovascular Implications of lipoprotein(a) and its genetic variants in patients from the Middle East.
In the September 22 episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz explores the concept of "computable quality" in healthcare, advocating for real-time, data-driven improvement in clinical care. He reviews original research on pop-up cardiovascular screenings in pharmacies and sporting events, AI-driven echocardiographic automation, and anticoagulation in pulmonary arterial hypertension. The episode also features a three-part debate on transcatheter aortic valve replacement (TAVR) in low-risk patients, highlighting evolving evidence, clinical implications, and calls for guideline reassessment. Tune in for insights on innovation, equity, and the future of cardiovascular care.