Podcast appearances and mentions of Kevin Carroll

Episode 116: Checking In With Supervisor Kevin Carroll (Matoaca District) On the latest episode of Chesterfield Behind the Mic, we talk to Kevin Carroll of the Chesterfield County Board of Supervisors to talk about the last year on the board, some of the big items facing the county in 2025, and a number of updates on projects in the Matoaca District.   Credits: Director: Martin Stith Executive Producer: Teresa Bonifas Producer/Writer/Host: Brad Franklin Director of Photography/Editor: Matt Boyce Producer/Camera Operator: Martin Stith and Matt Neese Graphics: Debbie Wrenn Promotions and Media: J. Elias O'Neal, Katie Cominsky, and Lina Chadouli   Music: Hip Hop This by Seven Pounds Inspiring Electronic Rock by Alex Grohl   Guest: Kevin Carroll, Chesterfield County Board of Supervisors (Matoaca District)   Recorded in-house by Communications and Media   Chesterfield.gov/podcast     Follow us on social media! On Facebook, like our page: Chesterfield Behind the Mic. On Twitter, you can find us at @ChesterfieldVa and on Instagram it's @ChesterfieldVirginia. And you can also watch the podcast on WCCT TV Thursday through Sunday at 7 p.m. as well as on weekends at noon on Comcast Channel 98 and Verizon Channel 28.

Longtime Buffalo News Bills writer Mark Gaughan, who recently announced his retirement, shares stories from 35 years on the Bills beat through the Super Bowl era, the drought and the current success.  Gaughan joins Kevin Carroll and Andy Young to talk about how the business has changed over the years, and his thoughts on the present-day club and the moves this offseason.

The Buffalo Bills have added to their wide receiver group with former Browns and Jets wide receiver Elijah Moore, shortly after General Manager Brandon Beane rebuked perceived criticism that the club has not done enough to address the position. Spectrum News 1's Andy Young and Kevin Carroll discuss what Moore brings to the offense, and how the wide receiver corps is shaping up heading into the season with Joshua Palmer, Khalil Shakir, Keon Coleman, Curtis Samuel and others.

The Bills addressed a number of needs of the defensive side of the ball in the 2025 NFL Draft. The team focused on cornerback and the defensive line. Kevin Carroll and Andy Young discuss early picks Maxwell Hairston, T.J. Sanders and Landon Jackson, as well as needs and outlook coming out of the draft, on the latest Buffalo End Zone podcast.

General Manager Brandon Beane and the Buffalo Bills add speed to the defensive backfield with Maxwell Hairston out of Kentucky. Kevin Carroll and Andy Young give their thoughts on the pick and look ahead to day 2 of the draft on the latest Buffalo End Zone podcast.

"How much of the game is mental... and how much are you training it?"That simple question from Dr. Michael Gervais, the world's leading high performance psychologist, rang in my ears back in 2011. Its impact has echoed through my life ever since.Today, Best Coast Media is proud to welcome back Dr. Gervais to the Y-Option podcast, presented by our founding partner 76.In a wide-ranging conversation, we dive into the heart of college football. From navigating the transfer portal to becoming a millionaire at 19, from what Athletic Directors should prioritize when hiring a head coach, to mastering the pressures of high performance as the stage gets bigger. We also have a powerful, heartfelt exchange about youth sports.Put simply: this episode is fire.If you believe in the mental game - or even if you're just curious - pull out your journal. There are gems worth capturing.Back in 2009, I met Dr. Michael Gervais. As the son of two therapists, I've always believed in the power of mindset and mental skills. Two years later, during the 2011 NFL Lockout, we shared stages around the country alongside leaders like then-Seattle Seahawks Head Coach Pete Carroll, Nike Executive Matt James, and author Kevin Carroll.We traveled the nation, speaking to high school coaches about building a philosophy. We made memories. Hopefully, we made an impact.But there's one moment I'll never forget.Dr. Gervais would ask a question we'd all heard before: “How much of the game is mental?”No matter the region, the answer was the same: “90%.”Then he'd follow up: “How much time do you spend training the mental game?”Again, the answer was consistent—and disappointing: “Less than 10%.”Fast forward to today: Dr. Gervais is the leading voice in high performance psychology. He's spent decades coaching the best in sport, business, science, and the arts. His work with the Seattle Seahawks is legendary, he's been an integral part of our Elite 11 quarterback development for the past 18 years with his company and podcast Finding Mastery is a must listen for all seeking to unlock their potential within.Since 2016, he's joined my podcast once a year. Every time, I walk away a better man - a more connected father, an inspired husband, a more present broadcaster, and hopefully, a better friend.My hope? This conversation lands with you too. And helps you get just 1% better, especially when it comes to your mental game.Much love and stay steady,YogiP.S. This week we will take a deep dive into the Oregon Ducks with their Offensive Coordinator Will Stein in advance of broadcasting their spring game, as well as share thoughts on the current college football transfer portal, the turnover at Cal and retiring numbers in Boulder. Be sure to subscribe to the Y-Option newsletter and share it with a friend as we bring you thoughtful dialogue in College Football from the West Coast.This episode is executive produced by Jim Thornby and edited by Victor RenThis podcast is a Best Coast Media production This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.y-option.com/subscribe

General Manager Brandon Beane met with the media one last time ahead of the 2025 NFL Draft. The Bills' GM discussed team needs, what they value and more. Kevin Carroll and Andy Young touch on that and hold their own mock draft as well as team workouts getting underway on the latest Buffalo End Zone podcast.

Mike Organ talks Lipscomb hiring Kevin Carroll and Terry McCormick talks the Titans potentially drafting Cam Ward

Former Bills wide receiver Stevie Johnson joins Kevin Carroll to discuss what the NFL draft process was like for him, the position the Bills should target this year and his thoughts on some of the Bills top draft picks not named Josh Allen. All that and more on the latest Buffalo End Zone podcast.

With the NFL Draft fast approaching, CBS Sports analyst Chris Trapasso joins Andy Young and Kevin Carroll to discuss the Buffalo Bills' biggest needs and players who could be on General Manager Brandon Beane's radar come draft weekend.

Former Bills wide receiver Stevie Johnson joins Kevin Carroll to discuss the Bills offseason — from extensions, free agent signing, roster needs, the draft and more. All that on the latest Buffalo End Zone podcast.

As the NFL Draft approaches, Kevin Carroll and Andy Young from Buffalo End Zone rate General Manager Brandon Beane's draft picks for the Bills with their choices for each round. The guys also discuss the Bills' offseason and biggest needs heading into the draft, as well as old friend Stefon Diggs signing with the AFC East-rival New England Patriots.

So the first hour kicks off with Tech Gremlins and then Jeff chats with Kevin Carroll.

Kevin Carroll shows up and gives Jeff a rundown of what's going on in Chesterfield.

The Buffalo Bills have made a host of moves this offseason, from free agent signings, to trades and new contracts for key players. That includes a reworked deal for veteran linebacker Matt Milano. With the NFL Draft still a month away, Spectrum News 1's Andy Young and Kevin Carroll discuss what the club has done so far and what it still needs to do in pursuit of a Super Bowl. 

The Buffalo Bills are starting to fill roster holes with the start of free agency. Edge rusher Joey Bosa tops the list of recent signings. Kevin Carroll and Andy Young discuss how these new players fit in and more on the latest Buffalo End Zone podcast.

The NFL's new league year kicks off on Wednesday, March 12, and that's when free agents can officially sign with new teams. Who should the Buffalo Bills chase in free agency and which players of their own should they try to keep? Spectrum News 1's Andy Young and Kevin Carroll preview the upcoming free agency period with some names to keep an eye on. Talking points include Amari Cooper, Mack Hollins, Ty Johnson, Rasul Douglas, Dawuane Smoot, Damar Hamlin, Davante Adams, Chris Godwin, DK Metcalf, Dionte Johnson, Christian Kirk, Hollywood Brown, Darius Slayton, Khalil Mack, Myles Garrett and more. 

In his second term in office, President Donald Trump has already taken sweeping measures on immigration, the environment, the U.S. military, and the structure of the federal government.With so many executive orders, policy changes, and novel actions, it's easy to wonder, “What just happened?” In this podcast mini-series we help to answer exactly that question. On each episode of “What Just Happened,” we'll talk with leading experts, from former government officials to professors – the people who understand how government works from the inside and have studied the issues for years. They will explain the legal background and implications of how the Trump administration's actions affect how the U.S. government operates in Washington, across the country, and around the world. This is not a political podcast. We are explaining the meaning and consequences of policy changes that may not be immediately apparent. Any opinions expressed are those of the speaker.Today, we are looking at a relatively narrow example of the Trump administration's broad policies of eliminating federal jobs and eliminating what it considers to be DEI efforts from federal agencies. Specifically, we will talk about a small number of seasoned intelligence officers who were fired because one of their duties involved agency DEI efforts. They have sought an injunction against their termination in federal court in the Eastern District of Virginia. After a brief administrative stay, a federal judge denied their application for a temporary restraining order while the case proceeds.  Our guest today is the fired officers' attorney, Kevin Carroll. Kevin is a partner at the Fluet law firm in Northern Virginia. Kevin is a retired Army Colonel and a former CIA case officer. He also served as a senior counsel to Republican congressman Peter King of New York and a political appointee in the first Trump administration, and later as a surrogate for the 2024 Kamala Harris campaign. Show Notes: David Aaron (LinkedIn – X – Bluesky)Kevin Carroll (LinkedIn)Paras Shah (LinkedIn – X)Just Security's coverage of the Trump administration's executive actions Music: “Broken” by David Bullard from Uppbeat: https://uppbeat.io/t/david-bullard/broken (License code: OSC7K3LCPSGXISVI)

Kevin Carroll and Andy Young are at the 2025 NFL Combine. The Bills were busy to start the week, extending WR Khalil Shakir. We talk James Cook and his contract, coaching news, a look at the upcoming draft class and more on the latest Buffalo End Zone podcast.

Welcome to the award-winning FCPA Compliance Report, the longest-running podcast in compliance. In this episode, Tom welcomes Kevin Carroll, now a partner at Fluet, to discuss national security issues to date under the Trump Administration. Kevin Carroll discusses his move to Fluet Law, a national security law firm. He delves into the ongoing chaos in national security, ranging from employees' concerns over legal processes at the Agency for International Development and the FBI to the unprecedented moves of the Trump administration in reprioritizing enforcement efforts. Kevin emphasizes the criticality of maintaining international alliances and intelligence-sharing, especially amidst controversial DOJ staffing and enforcement decisions. They also touch on the potential ramifications for U.S. companies engaged in foreign trade and anti-corruption enforcement. Don't miss Kevin's expert insights on the delicate balance of national security and legal frameworks in uncertain times. Key highlights: 00:11 Kevin's New Professional Chapter 00:35 National Security Concerns 02:11 Law Enforcement Priorities 04:52 International Relations and Security 14:04 Corporate Legal Risks Abroad 17:15 USAID and Export Control Resources: Kevin Carroll on LinkedIn Fluet  Kevin Carroll on Fluet Law Tom Fox Instagram Facebook YouTube Twitter LinkedIn For more information on the Ethico Toolkit for Middle Managers, available at no charge, click here. Learn more about your ad choices. Visit megaphone.fm/adchoices

The Buffalo Bills need help on the defensive line and pass-rusher Myles Garrett wants out of Cleveland. Is it realistic for the Bills to to trade for the Browns superstar? Veteran wide receiver Cooper Kupp could be on the move, as well. Plus, the Super Bowl is this Sunday! Kevin Carroll and Andy Young talk all that and more on the latest Buffalo End Zone podcast.

Buffalo Bills General Manager Brandon Beane and Head Coach Sean McDermott on Thursday addressed the 2024 season, the AFC championship game loss, the plan to keep fighting to get to the Super Bowl and what's ahead this offseason. Kevin Carroll and Andy Young break it all down on the latest Buffalo End Zone podcast.

The Buffalo Bills come up short of the Super Bowl once again, falling at the Kansas City Chiefs 32-29 in the AFC Championship game. Kevin Carroll and Andy Young take a look at how it all went down and look at what's next on the latest Buffalo End Zone podcast.

Greg Pogue with Trevecca Mens Basketball Coach Kevin Carroll.

Five college students from Assumption University in Worcester, Massachusetts, appeared in court Thursday, accused of luring a man to their campus through a dating app and attacking him in what police say was an attempt to stage a "Catch a Predator" scenario popularized on TikTok. The students, Kelsy Brainard, 18; Easton Randall, 19; Kevin Carroll, 18; Isabella Trudeau, 18; and Joaquin Smith, 18, were arraigned on charges of conspiracy and kidnapping. A sixth defendant, a juvenile, is facing separate charges. All five defendants entered not-guilty pleas, and they are scheduled to return to court for a pre-trial conference on March 28. Police say that the victim, a 22-year-old active-duty military service member, was visiting Worcester in October to attend his grandmother's funeral. According to the police report, he was seeking company and turned to Tinder, where he matched with a woman whose profile identified her as 18. She invited him to campus, where she greeted him and led him into a basement lounge. There, a group of students emerged, accusing him of being a pedophile and wanting sex with underage girls. "The group started calling me a pedophile, and I just didn't know what was going on," the victim later told police. "Before I knew it, they were chasing me to my car." The victim managed to break free, but he was chased by the group and assaulted. "I was punched in the head, and my car door was slammed on me as I tried to get away," he said. Surveillance footage from the campus shows the students filming the incident with their phones, laughing and high-fiving, while they continued to accuse him of being a predator. Randall later told police that the group had been inspired by the “Catch a Predator” trend on TikTok. The group had used the dating app to lure the man to campus, then spread word through their dormitory chat group, claiming they had caught a predator on campus. After the incident, Brainard falsely reported to police that the man was a sexual predator, claiming that he had arrived uninvited and that she had texted a friend to chase him away. Surveillance footage from the campus, however, contradicted her account. "There was no evidence that he was seeking sexual relations with underage girls," the police report stated. “The whole thing was staged.” Brainard, who faces an additional charge of witness intimidation, was also accused of trying to silence others involved in the incident. A male student involved in the assault faces an additional charge of assault and battery with a dangerous weapon. The group is due back in court for further proceedings. After the court appearance, attorneys for the defendants remained firm in their defense. Christopher Todd, Brainard's lawyer, stated, “We're just looking forward to having the process play out.” Robert Iacovelli, the lawyer for Trudeau, filed a motion seeking dismissal of the charges against her, claiming there was no probable cause for the allegations. The students were ordered not to have any contact with the victim as they await their next court date in March. The case has drawn attention due to the disturbing trend of internet-driven stunts and the serious criminal charges the students now face.    Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on The Downfall of Diddy, The Trial of Karen Read, The Murder Of Maddie Soto, Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Delphi Murders: Inside the Crime, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Malevolent Mormon Mommys, The Menendez Brothers: Quest For Justice, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, The Murder Of Sandra Birchmore, and much more! Listen at https://www.truecrimetodaypod.com 

Five college students from Assumption University in Worcester, Massachusetts, appeared in court Thursday, accused of luring a man to their campus through a dating app and attacking him in what police say was an attempt to stage a "Catch a Predator" scenario popularized on TikTok. The students, Kelsy Brainard, 18; Easton Randall, 19; Kevin Carroll, 18; Isabella Trudeau, 18; and Joaquin Smith, 18, were arraigned on charges of conspiracy and kidnapping. A sixth defendant, a juvenile, is facing separate charges. All five defendants entered not-guilty pleas, and they are scheduled to return to court for a pre-trial conference on March 28. Police say that the victim, a 22-year-old active-duty military service member, was visiting Worcester in October to attend his grandmother's funeral. According to the police report, he was seeking company and turned to Tinder, where he matched with a woman whose profile identified her as 18. She invited him to campus, where she greeted him and led him into a basement lounge. There, a group of students emerged, accusing him of being a pedophile and wanting sex with underage girls. "The group started calling me a pedophile, and I just didn't know what was going on," the victim later told police. "Before I knew it, they were chasing me to my car." The victim managed to break free, but he was chased by the group and assaulted. "I was punched in the head, and my car door was slammed on me as I tried to get away," he said. Surveillance footage from the campus shows the students filming the incident with their phones, laughing and high-fiving, while they continued to accuse him of being a predator. Randall later told police that the group had been inspired by the “Catch a Predator” trend on TikTok. The group had used the dating app to lure the man to campus, then spread word through their dormitory chat group, claiming they had caught a predator on campus. After the incident, Brainard falsely reported to police that the man was a sexual predator, claiming that he had arrived uninvited and that she had texted a friend to chase him away. Surveillance footage from the campus, however, contradicted her account. "There was no evidence that he was seeking sexual relations with underage girls," the police report stated. “The whole thing was staged.” Brainard, who faces an additional charge of witness intimidation, was also accused of trying to silence others involved in the incident. A male student involved in the assault faces an additional charge of assault and battery with a dangerous weapon. The group is due back in court for further proceedings. After the court appearance, attorneys for the defendants remained firm in their defense. Christopher Todd, Brainard's lawyer, stated, “We're just looking forward to having the process play out.” Robert Iacovelli, the lawyer for Trudeau, filed a motion seeking dismissal of the charges against her, claiming there was no probable cause for the allegations. The students were ordered not to have any contact with the victim as they await their next court date in March. The case has drawn attention due to the disturbing trend of internet-driven stunts and the serious criminal charges the students now face.    Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on The Downfall of Diddy, The Trial of Karen Read, The Murder Of Maddie Soto, Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Delphi Murders: Inside the Crime, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Malevolent Mormon Mommys, The Menendez Brothers: Quest For Justice, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, The Murder Of Sandra Birchmore, and much more! Listen at https://www.truecrimetodaypod.com 

Five college students from Assumption University in Worcester, Massachusetts, appeared in court Thursday, accused of luring a man to their campus through a dating app and attacking him in what police say was an attempt to stage a "Catch a Predator" scenario popularized on TikTok. The students, Kelsy Brainard, 18; Easton Randall, 19; Kevin Carroll, 18; Isabella Trudeau, 18; and Joaquin Smith, 18, were arraigned on charges of conspiracy and kidnapping. A sixth defendant, a juvenile, is facing separate charges. All five defendants entered not-guilty pleas, and they are scheduled to return to court for a pre-trial conference on March 28. Police say that the victim, a 22-year-old active-duty military service member, was visiting Worcester in October to attend his grandmother's funeral. According to the police report, he was seeking company and turned to Tinder, where he matched with a woman whose profile identified her as 18. She invited him to campus, where she greeted him and led him into a basement lounge. There, a group of students emerged, accusing him of being a pedophile and wanting sex with underage girls. "The group started calling me a pedophile, and I just didn't know what was going on," the victim later told police. "Before I knew it, they were chasing me to my car." The victim managed to break free, but he was chased by the group and assaulted. "I was punched in the head, and my car door was slammed on me as I tried to get away," he said. Surveillance footage from the campus shows the students filming the incident with their phones, laughing and high-fiving, while they continued to accuse him of being a predator. Randall later told police that the group had been inspired by the “Catch a Predator” trend on TikTok. The group had used the dating app to lure the man to campus, then spread word through their dormitory chat group, claiming they had caught a predator on campus. After the incident, Brainard falsely reported to police that the man was a sexual predator, claiming that he had arrived uninvited and that she had texted a friend to chase him away. Surveillance footage from the campus, however, contradicted her account. "There was no evidence that he was seeking sexual relations with underage girls," the police report stated. “The whole thing was staged.” Brainard, who faces an additional charge of witness intimidation, was also accused of trying to silence others involved in the incident. A male student involved in the assault faces an additional charge of assault and battery with a dangerous weapon. The group is due back in court for further proceedings. After the court appearance, attorneys for the defendants remained firm in their defense. Christopher Todd, Brainard's lawyer, stated, “We're just looking forward to having the process play out.” Robert Iacovelli, the lawyer for Trudeau, filed a motion seeking dismissal of the charges against her, claiming there was no probable cause for the allegations. The students were ordered not to have any contact with the victim as they await their next court date in March. The case has drawn attention due to the disturbing trend of internet-driven stunts and the serious criminal charges the students now face.    Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on The Downfall of Diddy, The Trial of Karen Read, The Murder Of Maddie Soto, Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Delphi Murders: Inside the Crime, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Malevolent Mormon Mommys, The Menendez Brothers: Quest For Justice, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, The Murder Of Sandra Birchmore, and much more! Listen at https://www.truecrimetodaypod.com 

Kevin Carroll and Andy Young are joined by Spectrum News Kansas City's Leif Lisec to discuss the upcoming AFC championship game between the Buffalo Bills and Kansas City Chiefs. It's Josh Allen vs. Patrick Mahomes, Sean McDermott vs. mentor Andy Reid and much more. All that and more on the latest Buffalo End Zone Podcast.

The Buffalo Bills are one win away from the Super Bowl after defeating the Baltimore Ravens 27-25 to advance to the AFC championship game against the Chiefs for the first time since 2020. Spectrum News 1's Kevin Carroll and Andy Young discuss how the Bills limited Lamar Jackson and Derrick Henry while forcing three Ravens turnovers. Josh Allen played mistake-free football while rushing for two touchdowns while Ray Davis added another on the ground. Next stop, Kansas City.

The Buffalo Bills are looking to advance past the AFC divisional round for the first time since 2020. To do so, they will have to get past a tough Ravens team led by Lamar Jackson and Derrick Henry on offense and a solid defense. Josh Allen and company have come a long way since Weeks Four's 35-10 loss in Baltimore. Kevin Carroll and Andy Young touch on all that and more on the latest Buffalo End Zone podcast.

James Cook, Josh Allen, Ty Johnson and Curtis Samuel starred offensively, while the Bills defense held the Broncos to just 2 of 9 on third downs. Kevin Carroll and Andy Young break down the wild-card win and look ahead to their showdown with the Ravens.

Is this the year the Buffalo Bills finally go all the way? They open the playoffs with the Denver Broncos at home in the wild-card round and then the road could get tougher. Kevin Carroll, Andy Young, Stevie Johnson and special guests get you ready from Big Ditch Brewing Company in downtown Buffalo on the latest Buffalo End Zone podcast.

The Buffalo Bills will host the Denver Broncos in a wild-card matchup this Sunday. Players hit a number of milestones in a 23-16 loss to the Patriots to close the 2024 regular season. Kevin Carroll and Andy Young take a look at all that and more on the latest Buffalo End Zone podcast.

With their eyes on the playoffs, playing time takes center stage with the Bills closing out the regular season at the Patriots. The team's wild card opponent is still up in the air and Josh Allen and Dion Dawkins get Pro Bowl nods with eight players listed as alternates. Kevin Carroll and Andy Young have the latest on the Bills and more on the latest Buffalo End Zone podcast.

The Buffalo Bills finished the regular season undefeated at home and locked up the No. 2 seed in the AFC in a dominant 40-14 win over the New York Jets. Kevin Carroll and Andy Young discuss Josh Allen's latest case for NFL MVP, a defensive demolition of Aaron Rodgers and the Jets' offense, big plays for Amari Cooper, Keon Coleman, James Cook, Tyrell Shavers, Christian Benford, Jordan Phillips, Von Miller, Greg Rousseau, Ed Oliver, A.J. Epenesa and others.

Our initial review of the PLATO trial, published in April 2024, was based on the data available to us at that time. We have since became aware of new information that reduces our confidence in the PLATO results. This new information has major implications for clinical practice. Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Despite representing only 6.9% of the total P2Y12 inhibitor prescriptions among Medicare beneficiaries in 2020, Ticagrelor accounted for nearly two-thirds of total Medicare spending on these drugs in the same year. We summarize important points below but you can refer to this investigation at BMJ for more details.1. Unexplained Regional Variation: In our original review, we highlighted the treatment effect interaction based on region of enrollment, where ticagrelor was less effective compared to clopidogrel for patients enrolled in North America. It appeared to be a strong signal and was associated with a p-value for the interaction of 0.05. However, we were cautious in our interpretation since overall, patients enrolled in North America represented a relatively small fraction of total patients and we could not think of a reasonable explanation.Information in the BMJ investigation now sheds new light on these findings. In our review, we only presented data contained in the supplement accompanying the PLATO trial manuscript, which categorized patients based on region of enrollment but did not provide country specific information. The BMJ report notes that in a separate subgroup analysis, based on country of randomization, the primary outcome was numerically higher with ticagrelor in the United States (12.6% vs 10.1%, HR: 1.27, 95% CI: 0.92 – 1.75). This subgroup represented 7.6% of the total trial participants. Overall, 9.7% of trial participants were enrolled from North America. This means the US data drove the findings from the North American subgroup.The explanation provided by AstraZeneca (the manufacturer of ticagrelor) to explain the observed treatment effect heterogeneity was that aspirin dosing in the United States was higher than in other countries. It even led the FDA to issue a black box warning to avoid an aspirin maintenance dose of >100 mg in patients taking ticagrelor. An extensive statistical analysis of the regional variation in PLATO yielded four interesting points. First what was the prior likelihood of observing a ticagrelor vs clopidogrel HR of > 1.25 in the US, when the overall HR was actually equal to 0.84? That probability is ≤ 0.01. This alone suggests more than chance. Second point: a strong US/nonUS interaction was noted for each of the 3 components of the primary endpoint—CV death, MI, stroke. Third: they found a very strong interaction between treatment and median aspirin dose, and, importantly, the aspirin interaction effect was similar in US and nonUS settings. Fourth, an analysis of contract research organization (CRO) vs sponsor monitoring of the site accounted for 61% of the treatment-by- region interaction. The authors downplayed this finding because of the four countries monitored by a CRO (Israel, US, Georgia and Russia), the US made up the majority and thus is confounded by the aspirin interaction. Noteworthy was a lack of direct analysis of CRO vs sponsor test for interaction. One problem though: the BMJ investigation found that the lead author, Kevin Carroll was the head statistician at AstraZeneca and had worked at the company for 20 years. Carroll presented the PLATO results at the FDA advisory meeting. The paper lists Carroll as having no conflicts. Carroll told the BMJ that he had disposed of all conflicts of interest before submitting that analysis. But, in our opinion, the aspirin explanation does not pass muster because of biologic implausibility. See next section: How would a higher dose of aspirin reduce the efficacy of ticagrelor?The primary composite endpoint was vascular death, MI or stroke. If the higher aspirin dose impacted this, we would hypothesize that it caused more major bleeding in the ticagrelor group with some events resulting in vascular death, type 2 MI and hemorrhagic stroke, driving the treatment effect in favor of clopidogrel. But there is no evidence of this.The figure below is from the original subgroup plots provided in the PLATO supplement. The difference in the treatment effect for the primary endpoint for North American patients is striking but there is no difference for major bleeding.In our opinion and the opinion of others, the role of supervision of the centers could be important. Most centers were monitored by the sponsor. Four countries (Israel, US, Georgia and Russia) were monitored by a contract research organization. All four of these countries had numerically higher rates of the primary outcome in the ticagrelor group. This has major implications and we do not take them lightly. Essentially, it suggests malfeasance on the part of the sponsor. So is there anything else to support such a claim? Well, yes. 2. Concerns about event adjudication. Based on a report from Victor Serebruany, an adjunct faculty member at Johns Hopkins University, and the BMJ investigation, FDA records indicated that site reports documented 504 myocardial infarctions in patients who received ticagrelor compared to 548 in patients who received clopidogrel. However, after adjudication, the count increased only for the clopidogrel group, reaching 593. There was also some imbalance among groups in adjudicating death. These imbalances raise concerns about potential unblinding and result tampering. We read many of the authors' replies and we did not find a clear explanation of why all readjudicated extra MIs were in the clopidogrel group (45 clopidogrel; ticagrelor 0). 3. There were also concerns about the accuracy of death records as sites death records did not always match the FDA records.We cite from the BMJ: The BMJ's analysis also found omissions in PLATO's landmark publication. The paper, published in NEJM and reported as an intent-to-treat analysis, reports 905 total deaths from any cause among all randomized patients. An internal company report states, however, that 983 patients had died at this point. While 33 deaths occurred after the follow-up period, the NEJM tally still leaves out 45 deaths “discovered after withdrawal of consent.” The BMJ obtained some records for patients whose deaths were not reported in NEJM (see table 1) and asked the journal for a response.NEJM editor in chief Eric Rubin told The BMJ that “for older manuscripts, correction is not necessarily appropriate unless there would be an effect on clinical practice,” concluding that “it does not appear that correcting this 15-year-old article is going to have any impact.”It is noteworthy that the United States Department of Justice launched a formal investigation into the PLATO trial in 2013; however, the probe was closed in 2014. The BMJ column cited a spokesperson for the US attorney's office who said…”we determined that the allegations lacked sufficient merit such that it was not in the best interests of the US to intervene in the suit.” 4. Mortality reduction in PLATO defies explanation: Shortly after PLATO was published, Drs. Victor Serebruany and Dan Atar wrote an editorial in the European Heart Journal titled: The PLATO trial: do you believe in magic? They noted that the overall HR for all-cause death ticagrelor vs clopidogrel was 0.78 (95% CI: 0.69 - 0.89; p< 0.001). There were 107 more lives saved with ticagrelor vs clopidogrel. To explain the surprise of this massive effect size, they compared it to the COMMIT trial of clopidogrel vs placebo in patients with acute MI. In COMMIT, 119 lives were saved with clopidogrel (vs placebo), but COMMIT had three-fold more patients than PLATO—and the gain was vs placebo. They tempt the reader to ask: how could ticagrelor fare that well against a drug that crushed placebo? We note two other reasons to be concerned about the outsized mortality reduction in PLATO. One is plausibility. The all-cause mortality benefit exceeded the reduction in MI, CV death or stroke. Given the numerically higher rate of bleeding, how else does ticagrelor reduce death vs clopidogrel? The second reason is the lack of such a signal in Phase 2 studies, such as this one. 5. PLATO results are on outlier: Multiple observational studies have failed to replicate the benefits of ticagrelor observed in the PLATO trial. While observational studies are inherently limited by confounding factors and are inferior to randomized trials, their findings warrant a re-evaluation of ticagrelor's benefits. Furthermore, two randomized trials—one conducted predominantly in Japanese patients and another in South Korea—did not demonstrate the superiority of ticagrelor, instead showing higher bleeding rates and a numerical increase in ischemic events.Ticagrelor also significantly underperformed against another new antiplatelet drug, prasugrel. In the non-industry-funded ISAR-REACT 5 trial, which enrolled patients with acute coronary syndrome, the primary event of death, MI, or stroke was 36% higher in the ticagrelor arm (9.3% vs 6.9%, HR 1.36, 95% CI: 1.09 - 1.70). Major bleeding was also numerically higher in the ticagrelor arm. 6. PLATO authors have responded to these arguments.We provide links to four of the authors responses. * Thrombosis and Hemostasis https://www.wellesu.com/10.1160/TH11-03-0162* Stroke https://www.ahajournals.org/doi/10.1161/strokeaha.111.000514* Inter J of Cardiol https://doi.org/10.1016/j.ijcard.2014.06.029* Circulation https://doi.org/10.1161/CIRCULATIONAHA.111.047498Conclusion These are vitally important revelations regarding PLATO and ticagrelor. The FDA advisory committee recommended that FDA require a confirmatory trial. This was not done. As such, ticagrelor gained serious market share in the non-clopidogrel antiplatelet market for more than a decade. Yet no other compelling evidence for its benefit over clopidogrel has come to light. It clearly underperformed vs prasugrel. These old and new revelations have changed our positive view of ticagrelor. We no longer have confidence in this drug. We strongly agree with the recommendation for another properly controlled trial. We also believe this highlights the benefits of having either two regulatory trials or a single regulatory trial combined with a mandated post-approval trial. These revelations also emphasize the benefits of robust critical appraisal and skeptical but not cynical approaches to surprising evidence. 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

The Buffalo Bills look to remain in the running for the top seed in the AFC with a home game against the struggling New England Patriots. The team will look to avoid a letdown after a big win in Detroit in Week 15. Kevin Carroll and Andy Young get you ready for Sunday on the latest Buffalo End Zone podcast.

The Buffalo Bills knocked off one of the NFL's best with a 48-42 win over the Detroit Lions in a game many believed could be a Super Bowl preview. Kevin Carroll and Andy Young discuss another historic performance from Josh Allen, with help from the likes of James Cook and Ty Johnson among others offensively. On defense, Ed Oliver fended off criticism for a big game to lead the defensive front, while backups played a big role in the Bills secondary.

The 10-3 Bills are back on the road this week at the NFC-leading Detroit Lions. Both teams are at the top of the league in scoring on offense and both have questions on defense going into the game. The top seed still is in reach in the AFC if the Bills play well down the stretch, but they will need help. Kevin Carroll and Andy Young discuss all this and more on the latest Buffalo End Zone podcast.

The Buffalo Bills dropped to 10-3 with a wild 44-42 loss to the Los Angeles Rams. The Buffalo defense had no answers for LA's Matthew Stafford or Puka Nacua, while Josh Allen rallied his team with six total touchdowns in defeat. Spectrum News 1's Kevin Carroll and Andy Young break down what went wrong including Sean McDermott's decision making and special teams errors.

Kevin Carroll and Andy Young are back to discuss the Bills bringing back veteran Micah Hyde to the practice squad with five games remaining in the regular season. The team is getting healthier for the stretch run with the top seed in the AFC still in play. And they go from snowy Buffalo to sunny LA for a game with the Rams coming up on Sunday. All that and more on the latest Buffalo End Zone podcast.

Josh Allen's case for MVP continues to grow following the Buffalo Bills' 35-10 win over the San Francisco 49ers. The Bills quarterback accounted for four touchdowns on a snowy Sunday night. Kevin Carroll and Andy Young go over the win, what's ahead and more on the latest Buffalo End Zone Podcast.

The 9-2 Buffalo Bills are back at it this week as they host the San Francisco 49ers on Sunday night. The Bills are getting healthier on both sides of the ball as the team enters December, while the 49ers have questions at quarterback going in. Kevin Carroll and former Bills wide receiver Stevie Johnson take a look ahead and more on the Buffalo End Zone podcast.

The Buffalo Bills handed the Kansas City Chiefs their first loss of the season in a critical AFC rivalry showdown. Josh Allen's late TD and Terrel Bernard's interception sealed the deal for the Bills, who improve to 9-2 on the season. Spectrum News 1's Kevin Carroll and Andy Young discuss the ramifications of the win for Buffalo.

The Buffalo Bills are back home to host the unbeaten Kansas City Chiefs Sunday evening. The Bills are looking for their sixth straight win to get to 9-2. Kevin Carroll and Andy Young take a look at the matchup, Allen vs. Mahomes reaching Brady vs. Manning status, what a Bills win would mean for the playoff picture, injuries and more.

The Buffalo Bills improved to 8-2 for the first time since 1993 with a 30-20 win in Indianapolis over the Colts. Spectrum News 1's Kevin Carroll and Andy Young break down a four-takeaway effort by the Buffalo defense, while Josh Allen and the offense overcame struggles to surge past Indy. 

Nicolle Wallace is joined by Mike Schmidt, Rev. Al Sharpton, Matt Dowd, Kevin Carroll, David Folkenflik, Amanda Zurawski, Mini Timmaraju, Tara Setmayer, Renee Montgomery, Alexander Vindman, and David Jolly.

It's a dead heat. A brand-new NBC News poll has Vice President Harris and Trump tied in a head-to-head matchup. All eyes are on make-or-break swing states like Pennsylvania. Symone Sanders Townsend, Michael Steele and Alicia Menendez talk to Pennsylvania Sen. Bob Casey about his crucial state and his reelection race. Plus, President Biden heads to Florida to assess the damage after Hurricane Milton. Olivia Troye and Kevin Carroll join to discuss.

Guests: Alexi McCammond, Rep. Summer Lee, Kevin Carroll, Secretary Pete ButtigiegThe first campaign event for the 44th president. Tonight: the Obama case against Trump. Then, how one MAGA lawmaker is now backtracking on her own lies. Plus, Pete Buttigieg joins live on the ongoing hurricane recovery efforts.  Want more of Chris? Download and subscribe to his podcast, “Why Is This Happening? The Chris Hayes podcast” wherever you get your podcasts.

This past weekend marked the beginning of a slate of scheduled interviews for VP Harris and Gov. Walz. Plus, an overview of the past year and a look into the current situation in the Middle East one year after Hamas' brutal Oct 7th attack on Israel. And, Florida braces for another powerful storm as Hurricane Milton threatens to hit less than two weeks after Helene's destruction. Peter Baker, Susan Glasser, Mark Leibovich, Natalie Sanandaji, Martin Fletcher, Hagar Chemali, Yair Rosenberg, and Kevin Carroll join the 11th Hour this Monday.