Podcasts about Myocardial infarction

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Targeting Investigation and Treatment in Type 2 Myocardial Infarction: A Pilot Randomized Controlled Trial.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Risk of Myocardial Infarction in Patients With Aortic Stenosis: Insights From the VALVENOR Registry.

Send us a textWelcome back Rounds Table Listeners! Today we're introducing a new format—the first episode in our Clinical Practice Guidelines series. This week, Drs. Mike and John Fralick discuss the 2025 ACC/AHA Clinical Practice Guidelines for Acute Coronary Syndrome. Here we go!2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes (0:00 - 18:56)Mike's interview with Dr. Jeff Carson:Episode 110 - Restrictive versus Liberal Transfusion in Myocardial Infarction with Dr. Jeff CarsonThe Good Stuff:Egg cracking tips! (18:57 - 19:47)Jerro (19:48 - 20:47)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this episode, Dr. Raquel Faria hosts a discussion with Professors David Isenberg and Murray Urowitz from the Lupus Academy Steering Committee. They delve into two historic cases: one involving Lupus and Myocardial Infarction, and the other focusing on Lupus Nephritis.Disclaimer: During Lupus Academy podcast episodes, participants may refer to off-label use of medicines for patients with lupus. Lupus Academy does not make anyrecommendations about using a medicine outside the terms of its approved license for use.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Association of Intramyocardial Hemorrhage With Inflammatory Biomarkers in Patients With ST-Segment Elevation Myocardial Infarction.

In this podcast, Dr. Valentin Fuster discusses a pivotal study on the benefits of early acetamide initiation combined with statins after a myocardial infarction, showing improved cardiovascular outcomes. The study's findings suggest that early combination therapy reduces the risk of major cardiovascular events, urging healthcare pathways to adopt this approach as standard practice for better patient outcomes.

In this episode, we discuss the very early stages of drug targets and drug development with Dr. Mohd Shahid, PhD. Dr. Shahid's research involves the IER3 gene, which is an important modulator of the body's inflammatory response via its action in major immune cells, including macrophages and T-cells, and plays a role in metabolic disorders such as obesity, diabetes, and atherosclerosis, revealing a previously unknown function of this protein. Key Concepts Drug development is a multi-decade journey – human clinical trials occur very late in the process. Drug development often starts before a drug molecule is even conceived by identifying potential drug targets. Chronic inflammation is important for a variety of diseases, including obesity and atherosclerosis. Dr. Shahid's work focuses on a specific gene, Immediate Early Response 3 Gene (IER3 or IEX-1), and its role in modulating the inflammatory response in these disease states. The research process frequently leads to unexpected discoveries and new lines of inquiry. With Dr. Shahid, his work in obesity and inflammation actually led to a new understanding of the IER3's role in the interplay between macrophages, inflammation, and energy expenditure. References Shahid M, Javed AA, Chandra D, et al. IER3 deficiency induces browning of white adipose tissue and resists diet-induced obesity. Sci Rep. 2016;6:24135. Published 2016 Apr 11. doi:10.1038/srep24135 Shahid M, Hermes EL, Chandra D, et al. J Am Heart Assoc. 2018;7:e009261. DOI: 10.1161/JAHA.118.009261. Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-2207. doi:10.1056/NEJMoa0807646 Tardif JC, Kouz S, Waters DD, et al. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. N Engl J Med. 2019;381(26):2497-2505. doi:10.1056/NEJMoa1912388

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 Social Determinants of Health and 30-Day Readmission After Acute Myocardial Infarction in the REGARDS Study

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Utilization of Cardiovascular Procedures, Consultation Services, and Cardioprotective Medications Among Type 2 Myocardial Infarction Patients

Send us a textFor patients w/ myocardial infarction & anemia, at what hemoglobin should you transfuse? Tune into Rounds Table where Dr. Mike Fralick interviews Dr. Jeffrey Carson to discuss his individual patient data meta-analysis published in NEJM Evidence. Do you ever feel like you can't get ahead of charting? Freed AI has an AI driven scribe for you! You can try Freed for free right now by going to getfreed.ai. Listeners can use the INTERN50 code for $50 off their first month!Support the show

N Engl J Med 2001;344:1879-1887Background: Acute coronary syndrome is broadly categorized into unstable angina, non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). In unstable angina, there is no rise in cardiac biomarkers, although some challenge this clinical entity in the current era of high sensitivity troponins. In NSTEMI, there is elevation of cardiac biomarkers but no ST segment elevation on the electrocardiogram. In STEMI, there is an ST segment elevation on the electrocardiogram as well as a rise in cardiac biomarkers.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.In patients with STEMI, percutaneous coronary intervention (PCI) significantly improves outcomes. However, its role in acute coronary syndrome without ST-segment elevation is less clear for several reasons. Patients with NSTEMI tend to be older and have more comorbidities, increasing procedural risks. This also means that they have competing risks for mortality, potentially reducing the benefit of PCI. Another key challenge is that NSTEMI patients frequently have multivessel disease, making it more difficult to identify the culprit lesion; since there is usually only partial occlusion of the culprit coronary artery. In contrast, there is usually complete occlusion of a coronary artery in STEMI and ST-segment elevation on the electrocardiogram helps localize the infarcted area, making it relatively easy to identify the culprit artery.The findings from previous randomized trials of revascularization in unstable angina and NSTEMI, have been inconsistent. The TACTICS–Thrombolysis in Myocardial Infarction 18 trial sought to compare early invasive vs conservative strategy in patients with unstable angina or NSTEMI.Patients: Eligible patients had angina within 24 hours that was: >20 minutes in duration, accelerating angina, or recurrent episodes at rest or with minimal effort. Patients also had to have one of the following: ST-segment depression of at least 0.05 mV, transient ( 2.5 mg/dL.Baseline characteristics: The trial randomized 2,220 patients – 1,114 randomized to early invasive strategy and 1,106 randomized to conservative strategy.The average age of patients was 62 years and 66% were men. Approximately 28% had diabetes and 39% had prior myocardial infarction.Troponin T levels were elevated (>0.01 ng/ml) in 54% of the patients.Procedures: Patients were randomly assigned in a 1:1 ratio to undergo early invasive vs conservative strategy.Patients received aspirin 325 mg daily, intravenous unfractionated heparin (5000U bolus, followed by an infusion at 1000U/ hour for 48 hours), and intravenous tirofiban (0.4 μg/kg/minute for 30 minutes followed by an infusion of 0.1 μg/kg/minute for 48 hours or until revascularization with tirofiban administered for at least 12 hours after PCI).Patients in the early invasive arm underwent coronary angiogram between 4 and 48 hours after randomization and underwent PCI as appropriate. Patients in the conservative arm were treated medically. If stable, they underwent an exercise-tolerance test before discharged (83% of these tests were with nuclear perfusion or echocardiography imaging). Patients in the conservative arm underwent coronary angiography with PCI if they had angina at rest associated with ischemic EKG changes or elevation in cardiac biomarkers, had clinical instability or had ischemia on their stress test.Endpoints: The primary outcome was a composite of death from any cause, nonfatal myocardial infarction, and rehospitalization for an acute coronary syndrome, at six months.The estimated sample size to provide 80% power was 1,720 patients. This assumed that 22% of the patients in the conservative arm would experience the primary outcome and that the early invasive strategy would result in 25% relative risk reduction in the primary outcome. The sample size was later increased to 2,220 patients.Results: In the early invasive strategy, 97% of the patients underwent coronary angiogram after a medium of 22 hours after randomization, and 60% underwent PCI or CABG. In the conservative arm, 51% underwent coronary angiogram and 36% underwent revascularization during the index hospitalization.The primary composite endpoint was lower with the early invasive strategy (15.9% vs 19.4%, odds ratio: 0.78, 95% CI: 0.62 - 0.97; p= 0.025). The Kaplan-Meier curves started to separate at approximately one week. This benefit was driven by lower myocardial infarction and lower rehospitalization for an acute coronary syndrome with the early invasive strategy; (4.8% vs 6.9%) and (11.0% vs 13.7%), respectively. There was no difference in all-cause death (3.3% vs 3.5%).There were 3 important subgroup interactions. First is based on ST changes where patients with ST changes at presentation had all the benefit with an early invasive strategy (16.4% vs 26.3% [for patients with ST changes] and 15.6% vs 15.3% [for patients without ST changes]). Second is based on Troponin T levels where patients with troponin T> 0.1 ng/mL had significantly more benefit with an early invasive strategy (16.4% vs 24.5% and 15.1% vs 16.6%). The third is based on TIMI score where patients with higher TIMI score had more benefit with an early invasive approach. For a high TIMI score of 5-7, the event rate was 19.5% with early invasive vs 30.6% with conservative approach. Patients with TIMI score of 0-2 had no benefit with an early invasive strategy (12.8% with early invasive vs 11.8% with conservative strategy).Note to readers: TIMI score is a risk stratification tool used to predict 14-day adverse outcomes in patients with unstable angina or NSTEMI. The score ranges from 0 to 7 with higher scores indicating worse prognosis.Conclusion: In patients with unstable angina or NSTEMI, an early invasive strategy reduced the composite endpoint of death from any cause, nonfatal myocardial infarction, and rehospitalization for an acute coronary syndrome at six months with a number needed to treat of approximately 29 patients.The subgroup analysis of this trial is particularly important and biologically plausible, as the presence of ST changes and level of cardiac biomarkers elevation indicate more significant myocardial ischemia or necrosis. Patients without ST changes comprised 62% of the study participants, while those with negative cardiac biomarkers made up 59%, and the study results should not be generalized to these subgroups.Another key consideration is the lack of detailed criteria for what was deemed ‘appropriate' revascularization. Only 60% of patients in the early invasive strategy group underwent revascularization, underscoring that not all patients with unstable angina or NSTEMI benefit from coronary angiography and that further risk stratification is necessary.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

Welcome back Rounds Table Listeners!We are back this week with a special podcast episode! Dr. Mike Fralick sits down with Dr. Jeffrey Carson, Distinguished Professor of Medicine at the Rutgers Robert Wood Johnson Medical School and Provost at Rutgers University, to chat about his recent publication - Restrictive versus Liberal Transfusion in Myocardial Infarction — A Patient-Level Meta-Analysis. Here we go!Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Brief Mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Pregnancy-Associated Myocardial Infarction in Alberta: A Population-Based Study

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Psychological Distress in Adults With Myocardial Infarction: Implications for Health Care Utilization and Expenditure

¿El huevo realmente aumenta el riesgo de infarto?

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study by Dr. Anna Barton and her team on myocardial fibroblast activation following acute myocardial infarction. Using advanced imaging techniques, the research uncovers how fibroblast activity plays a critical role in heart remodeling, revealing that fibrosis is dynamic and may offer new therapeutic opportunities for preventing heart failure and improving long-term recovery after heart attacks.

The CLEAR SYNERGY (OASIS 9) Trial: A 2x2 Factorial Randomized Controlled Trial of Colchicine versus placebo and Spironolactone versus placebo in Patients with Myocardial Infarction.

It's that time of year, the weather is cold and major snowstorms are occurring, and while beautiful to watch, they can turn deadly. Driving becomes hazardous. Frostbite is a very real risk. Skiing and snowboarding accidents can ruin a family vacation, and worse, cause a fatality. But our primary discussion this week is about the dangers of shoveling snow with a history of heart disease or prior heart attack. Learn what the Valsalva Maneuver is and how it can affect you.In this Episode:03:04 - Recipe: Texas Trash Pie03:55 - Celebrities Who Died Without a Will06:46 - Have a Will, and Make Sure It Can Be Found08:21 - How to Stay Safe in the Snow12:09 - Shoveling Snow: Valsalva Maneuver and Who is At Risk for Heart Attack24:24 - Film Review and Discussion: His Three Daughters39:24 - OutroSupport the showGet show notes and resources at our website: every1dies.org. Facebook | Instagram | YouTube | mail@every1dies.org

Drs Harrington and Gibson review their picks for the top cardiology trials of 2024 and look ahead to 2025, particularly what health topics may be prioritized by the new administration. This podcast is intended for healthcare professionals only. To read a transcript or to comment https://www.medscape.com/author/bob-harrington Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction (REDUCE AMI) https://www.nejm.org/doi/abs/10.1056/NEJMoa2401479 Intensive Blood-Pressure Control in Patients with Type 2 Diabetes (BPROAD) https://doi.org/10.1056/nejmoa2412006 Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis EARLY TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2405880 Asundexian versus Apixaban in Patients with Atrial Fibrillation (OCEANIC-AF) https://doi.org/10.1056/NEJMoa2407105 In the Wake of OCEANIC-AF, Is Equipoise Regarding Factor XI Inhibition Still Afloat? https://www.jacc.org/doi/10.1016/j.jacc.2024.10.105 Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial https://doi.org/10.1016/S0140-6736(24)00413-6 Preventive Coronary Stents: Not There Yet https://www.medscape.com/viewarticle/preventive-coronary-stents-not-there-yet-2024a10006yr Speech by Commissioner Robert M. Califf to the House of Medicine June 16, 2023 https://www.fda.gov/news-events/speeches-fda-officials/speech-commissioner-robert-m-califf-house-medicine-06162023 Evolution of Single-Lead ECG for STEMI Detection Using a Deep Learning Approach https://doi.org/10.1016/j.ijcard.2021.11.039 From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction https://doi.org/10.1016/j.jacadv.2024.101314 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

DRAMI: Randomized Comparison of Puncture Success Rate Between Distal Radial Access and Transradial Access in Patients With ST-Elevation Myocardial Infarction

CLEAR SYNERGY (OASIS 9): A 2x2 Factorial Randomized Controlled Trial of Colchicine Versus Placebo and Spironolactone Versus Placebo in Patients with Myocardial Infarction

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Revascularization During Cardiac Arrest While Receiving Extracorporeal Life Support in Patients With Acute Myocardial Infarction.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Revascularization During Cardiac Arrest While Receiving Extracorporeal Life Support in Patients With Acute Myocardial Infarction.

N Engl J Med 1993;328:673-679Background: Previous trials established that thrombolysis improves mortality in patients with acute myocardial infarction, as seen in the GISSI-1 and ISIS-2 trials. However, thrombolysis has limitations, including an increased risk of bleeding and the inability to achieve arterial patency in approximately 20% of the cases. As a result, there was a growing interest in the use of percutaneous transluminal coronary angioplasty (PTCA).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 Primary Angioplasty in Myocardial Infarction Study Group sought to test the hypothesis that PTCA compared to thrombolysis, improves outcomes and reduces bleeding in patients with acute myocardial infarction.Patients: Eligible patients presented within 12 hours of ischemic chest pain and had ST elevation of at least 1 mm in two or more contiguous electrocardiographic leads. Patients were excluded if they had dementia, LBBB, cardiogenic shock or elevated bleeding risk.Baseline characteristics: The study enrolled 395 patients – 195 assigned to the PTCA arm and 200 assigned to the thrombolysis arm. The average age of patients was 60 years with 73% being men. Approximately 14% had prior myocardial infarction, 43% had hypertension, 12% had diabetes and 2% had congestive heart failure. The average ejection fraction 52%.The infarct was anterior in 34% of the patients, inferior in 59% and lateral in 8%.Procedures: All patients were given 325 mg of aspirin plus 10,000-unit bolus of intravenous heparin. After that, patients were randomly assigned to thrombolytic therapy or PTCA. The thrombolytic agent used was tissue plasminogen activator (t-PA) at a dose of 100 mg (or 1.25 mg/kg of body weight for patients weighing less than 65 kg) over three hours. Patients randomly assigned to PTCA underwent immediate diagnostic catheterization.Angiographic criteria for exclusion from PTCA included left main stenosis of more than 70%, infarct-related vessel was patent, three-vessel disease, morphologic features of the lesion known to indicate high risk, small infarct-related vessels or stenosis 70 years or admission heart rate > 100 bpm. PTCA reduced in-hospital mortality in the “not low risk” group (2.0% vs 10.4%; p= 0.01) but not in the low risk group (3.1% vs 2.2%; p= 0.69).Conclusion: In patients with ST-elevation myocardial infarction, PTCA compared to t-PA reduced death and reinfarction at the hospital and at 6 months with a number needed to treat of approximately 14 and 12, respectively.This was one of the trials that established the foundation for the use of PTCA in patients with acute myocardial infarction. While the treatment effect was large, there are important considerations to keep in mind. First, the sample size was small. In comparison, GISSI-1 had almost 12,000 patients and ISIS-2 had over 17,000. The results of small trials are not always replicated in larger pragmatic trials. Second, the use of aspirin + heparin + t-PA likely increased bleeding in the t-PA arm as heparin plus thrombolysis compared to thrombolysis without heparin increased bleeding without improving outcomes, as seen in the GISSI-2 and ISIS-3 trials. Third, two thirds of the patients had inferior or lateral infarcts and these subgroups did not benefit from thrombolysis in the GISSI-1 trial. Finally, standalone angioplasty is infrequently performed nowadays and patients often receive a stent which has improved vessel patency.In the current era, patients with ST-elevation myocardial infarction receive early revascularization with stent placement, which improved outcomes in these patients. We discussed the limitations above to help readers and learners appraise clinical trials, as these limitations were important at the time of this trial's publication.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

In this episode, Dr. Valentin Fuster discusses a comprehensive network meta-analysis published in JACC, which evaluates the optimal strategy for complete revascularization in patients with STEMI and multi-vessel disease. The study concludes that both immediate and staged complete revascularization improve patient outcomes over partial revascularization, with no significant advantage between angiographic and functional guidance, suggesting that angiographic guidance alone may be sufficient in clinical practice.

In this special episode of Diabetes Core Update, our host, Dr. Neil Skolnik, discusses with two expert guests the recommendations for respiratory vaccinations in people with diabetes, the rise in vaccine hesitancy and some of the possible reasons for this hesitancy, and several ways to address vaccine hesitancy in the office. This special edition is sponsored by Sanofi.  Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington–Jefferson Health John J. Russell, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair, Department of Family Medicine, Abington–Jefferson Health Aaron Sutton, LCSW, BCD, CAADC, Behavioral Health Faculty at the Family Medicine Residency Program at Abington–Jefferson Health; Chief Wellness Officer for Graduate Medical Education at Abington–Jefferson Health Select references mentioned in the podcast: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024–25 Influenza Season. MMWR Recomm Rep 2024;73:1–25. DOI: 10.15585/mmwr.rr7305a1 Recombinant or Standard-Dose Influenza Vaccine in Adults Under 65 Years of Age. N Engl J Med 2023;389:2245–2255. DOI: 10.1056/NEJMoa2302099 Influenza Vaccine as a Coronary Intervention for Prevention of Myocardial Infarction. Heart 2016;102:1953–1956. DOI: 10.1136/heartjnl-2016-309983

Commentary by Dr. Veronique Roger.

Dr. Centor discusses transfusion thresholds in persons with myocardial infarction with Drs. Jeffrey Carson and Maria Brooks.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on azithromycin exposure in a 10-Day window of myocardial infarction and short- and long-term outcomes.

Karen Joynt Maddox is an associate professor of medicine at Washington University School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S.A. Shashikumar, A.M. Ryan, and K.E. Joynt Maddox. Medicare's New Mandatory Bundled-Payment Program — Are We Ready for TEAM? N Engl J Med 2024;391:2065-2067.

SENIOR RITA – Older Patients with Non-ST Segment Elevation Myocardial Infarction Randomized Interventional Treatment Trial

In this podcast, Dr. Valentin Fuster discusses a study revealing that women with hypertensive disorders during pregnancy face a higher risk of early coronary artery disease and myocardial infarction. The findings emphasize the need for proactive cardiovascular monitoring and tailored prevention strategies, as these women are more susceptible to both obstructive and non-obstructive heart conditions later in life.

Live Nursing Review with Regina MSN, RN! Every Monday & Wednesday we are live. LIKE, FOLLOW, & SUB @ReMarNurse for more.     ► NCLEX V2 - https://study.remarnurse.com/vit/ ► Black Friday Event - ReMarNurse.com/blackfriday ► Get Quick Facts Next Gen - https://bit.ly/QF-NGN ► Subscribe Now - http://bit.ly/ReMar-Subscription ► GET THE PODCAST: https://remarnurse.podbean.com/ ► WATCH LESSONS: http://bit.ly/ReMarNCLEXLectures/ ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/   Quick Facts for NCLEX Next Gen Study Guide here - https://bit.ly/QF-NGN Study with Professor Regina MSN, RN every Monday as you prepare for NCLEX Next Gen.   ReMar Review features weekly NCLEX review questions and lectures from Regina M. Callion MSN, RN. ReMar is the #1 content-based NCLEX review and has helped thousands of repeat testers pass NCLEX with a 99.2% student success rate! ReMar focuses on 100% core nursing content and as a result, has the best review to help nursing students to pass boards - fast!

In this episode, Dr. Valentin Fuster reviews an exploratory analysis from the 80s2 trial, which examined CSL 112's impact on ischemic events after acute myocardial infarction. While CSL 112 didn't significantly reduce cardiovascular death or stroke in the short term, the study found promising long-term benefits, suggesting that enhancing cholesterol efflux could be a valuable approach for reducing recurrent ischemic events in high-risk patients.

Did you miss AHA 2024? Listen here to brief discussions of the latest research. Eric Rubin is the Editor-in-Chief of the Journal. Jane Leopold is a Deputy Editor of the Journal. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E.J. Rubin, J. Leopold, and S. Morrissey. NEJM at AHA — Routine Spironolactone in Acute Myocardial Infarction. N Engl J Med. DOI: 10.1056/NEJMe2414472.

MINOCA: Myocardial Infarction with Non-Obstructive Coronary Arteries   Guest: Claire E. Raphael, M.B.B.S., Ph.D. Host: Sharonne Hayes, M.D.   MINOCA is a myocardial infarction with no obstructive coronary artery disease.  This podcast will discuss the underlying causes of MINOCA, how to and who to investigate and discuss contemporary management strategies.   Topics Discussed: What is MINOCA? What testing should I consider in patients with MINOCA How are these patients treated?   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.

Despite advances in the management of acute myocardial infarction (MI), up to 38% of patients will experience signs of heart failure (HF) and many have a reduced left ventricular ejection fraction (LVEF). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have well-documented cardiovascular benefits. However, data are limited regarding their use after an acute MI. Guest Authors: Amy Hu, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP, CDCES Music by Good Talk

In this episode, Dr. Valentin Fuster discusses a pivotal study on revascularization strategies in older patients with myocardial infarction, comparing complete versus culprit-only approaches. The findings suggest that physiology-guided complete revascularization significantly reduces adverse outcomes in both STEMI and non-STEMI patients, emphasizing its potential benefits across a diverse patient population.

Welcome back Rounds Table Listeners!We are back today with a special Rapid Fire Podcast!This week, Drs. Mike Fralick and Justin Boyle discuss top papers from the 2024 European of Society of Cardiology Congress. Here we go!Edoxaban Antithrombotic Therapy for Atrial Fibrillation and Stable Coronary Artery Disease (0:00 – 9:25).Beta-Blocker Interruption or Continuation after Myocardial Infarction (9:25 – 13:52).Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (13:52 – 21:20).Continuation vs. Discontinuation of Renin-Angiotensin System Inhibitors Before Major Non-Cardiac Surgery (21:20 – 28:51).Of note, for prescribers in Ontario, there is now a limited use code for finerenone for patients that have both T2DM and CKD. Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this week's episode of Parallax, host Dr Ankur Kalra engages in a thought-provoking discussion with Dr Stephen Smith, a pioneer in electrocardiography and myocardial infarction diagnosis. They delve into the groundbreaking OMI/NOMI paradigm (Occlusion MI vs Non-Occlusion MI), challenging the traditional STEMI vs non-STEMI terminology that has long been the cornerstone of acute coronary syndrome management. Dr Smith presents compelling evidence highlighting the limitations of ST-elevation as a marker for acute coronary occlusion, discussing his recently published review paper: "From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction". The conversation explores the proposed shift to the OMI/NOMI terminology and the specific ECG criteria for diagnosing occlusion MI. Dr Smith discusses the challenges in disseminating this new paradigm and teaching these refined ECG interpretation skills to clinicians. Dr Kalra and Dr Smith explore exciting developments in AI-assisted OMI detection and ongoing studies aimed at validating the OMI/NOMI approach. How can clinicians effectively implement the OMI/NOMI criteria into daily practice? What challenges exist in teaching these new ECG interpretation skills, and how can they be overcome? What advice does Dr Smith have for our listeners? Full source library for this episode can be found on radcliffecardiology.com.

In this episode, Dr. David J. Schneider research identifies platelet FCγRIIA (PFCG) as a key biomarker for cardiovascular risk post-myocardial infarction. In an 800-patient study, higher PFCG levels were linked to increased risks of myocardial infarction, stroke, and death, indicating its potential for guiding personalized antiplatelet therapy, pending further validation.

Although they are among the most widely prescribed medications and most popular over-the-counter remedies, acid blocking drugs may not be the best way to deal with heartburn or GERD.References:Overutilization of proton pump inhibitors: a review of cost-effectiveness and riskBody weight, lifestyle, dietary habits and gastroesophageal reflux disease.Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach.Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population | PLOS ONEAcupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis - PubMed (nih.gov)Nutrition Diva is hosted by Monica Reinagel, MS, LDN.  Transcripts are available at Simplecast.  Check out our special Spotify playlist of episodes focused on Gut Health here! Have a nutrition question? Send an email to nutrition@quickanddirtytips.com or leave a voicemail at 443-961-6206.Follow Nutrition Diva on Facebook and subscribe to the newsletter for more diet and nutrition tips. Find Monica's blog and other programs at Nutrition Over Easy. Nutrition Diva is a part of the Quick and Dirty Tips podcast network. LINKS:Transcripts: https://nutrition-diva.simplecast.com/episodes/Facebook: https://www.facebook.com/QDTNutrition/Newsletter: https://www.quickanddirtytips.com/nutrition-diva-newsletterNutrition Over Easy: https://nutritionovereasy.comQuick and Dirty Tips: https://quickanddirtytipscom

It's been a long time, but we are back!Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box.Today we talk about important, practice changing studies in internal medicine from the last several months. What's the best anticoagulant in patients with cirrhosis and atrial fibrillation? Why do doctors use so much unfractionated heparin for acute PE? Should we still be using beta blockers in patients with acute MI? Does finerenone improve outcomes in HFpEF? Is continuous infusion of antibiotics better than intermittent? And will the cefepime vs piperacillin-tazobactam battle ever end?Apixaban, Rivaroxaban and Warfarin in Cirrhosis for AFAnticoagulation Trends for Acute PEBeta Blockers for Acute MI with Normal EF Finerenone for HFpEF FINEARTS-HFContinuous vs Intermittent Infusion of Beta-Lactams BLING IIIProlonged vs Intermittent Infusions of Beta-Lactams Meta-analysisPiperacillin-Tazobactam vs Cefepime for SepsisRecurrent SBP in Patients on Secondary Prophylaxis

In the September 24, 2024 issue of JACC, Dr. Ben Lee Nay and colleagues reveal that short-term exposures to lower temperatures and cold spells significantly increase the risk of myocardial infarction hospitalizations in Sweden. This nationwide study, utilizing advanced machine learning techniques, underscores the pressing need to address both extreme cold and heat in climate change mitigation efforts to better protect cardiovascular health.

Learn about a study in NEJM which found no significant benefits from discontinuing beta-blocker therapy in MI patients, gut microbiota's potential influence on hematologic cancers and, data from ESC Congress 2024 suggesting that catching up on sleep during weekends may reduce heart disease risk by up to 20%.

Editor-in-Chief Eric Rubin and Deputy Editor Jane Leopold discuss research that was presented at the 2024 European Society of Cardiology annual meeting. Visit NEJM.org to read the latest research.

A patient arrives at the ER, complaining of chest pain that dramatically worsens when she lies down. What could this clue reveal about her condition? In this episode, host Sarah Lorenzini recounts her experience caring for her first pericarditis patient and the subtle yet critical signs that distinguish it from more common cardiac emergencies.Sarah dives into the tricky nature of chest pain, sharing how the PQRST pain assessment and an EKG played a critical role in uncovering the patient's condition. She also outlines the diagnostic criteria that help differentiate pericarditis from more serious conditions like myocardial infarction, emphasizing the symptoms that can make diagnosis challenging.Listen to the episode for insights on recognizing the easily mistaken signs of pericarditis, diagnosing the condition, and providing effective treatment!Topics discussed in this episode:Patient case study of a young woman with chest painAssessment and diagnosis of pericarditisPathophysiology of pericarditisInfectious vs. noninfectious causes of pericarditisThe diagnostic criteria for pericarditisEKG characteristics in pericarditis vs. myocardial infarctionKey takeaways on the diagnosis and treatment of pericarditisLearn more by reading this Brady et al article about ECG morphology in pericarditis:https://pubmed.ncbi.nlm.nih.gov/11581081/Mentioned in this episode:Rapid Response and Rescue Intro CourseCONNECT

Health and income, high BP in the hospital, and more on subclinical AF and when to use anticoagulants are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic   I. Health and Income  A Cash Giveaway to Improve Health https://www.medscape.com/viewarticle/cash-giveaway-improve-health-2024a1000dhf?form=fpf JAMA RCT https://jamanetwork.com/journals/jama/fullarticle/2821454 NBER RCT https://www.nber.org/papers/w32711 Have We Missed the Hidden Cause of Medical Overuse? https://www.medscape.com/viewarticle/908309 Mar 17, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/989775 Other References  Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status https://jamanetwork.com/journals/jamacardiology/article-abstract/2793120 Rand Link https://www.rand.org/pubs/reports/R3055.html The Oregon Health Insurance Experiment https://www.healthaffairs.org/do/10.1377/hpb20150716.236899/full/ Effect of Health Insurance in India: A Randomized Controlled Trial https://www.nber.org/papers/w29576 Full Coverage for Preventive Medications after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmsa1107913 Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial InfarctionThe ARTEMIS Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2720024 II. Elevated BP in the hospital JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821364 III. Short-duration Subclinical AF Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA https://www.medscape.com/viewarticle/998379 ARTESiA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 ARTESiA CHADSVASC Subgroup  https://www.jacc.org/doi/10.1016/j.jacc.2024.05.002 NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 EHJ NOAH subanalysis https://doi.org/10.1093/eurheartj/ehae225 Stroke: Prolonged Heart Rhythm Monitoring After Stroke https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.045843 EHRA Analysis https://esc365.escardio.org/EHRA-Congress/sessions/10668   You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington   Questions or feedback, please contact news@medscape.net