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Published by American College of Cardiology
The weekly cardiovascular update from Kim Eagle, MD, MACC for ACC.org covering the hottest cardiovascular topics, from new clinical guidelines to practice-changing research and innovative quality initiatives and tools.
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In this week's View, Dr. Eagle looks at s ome of the important trials p resented at this year ' s European Society of Cardiology (ESC) Congress. First, he evaluates the SINGLE-AF trial on DOAC t herapy v ersus no anticoagulation in atrial fibrillation ( AFib ) with patients with intermediate stroke ris k . Dr. Eagle then examines REBOOT- PARADOX and its study of the potential value of t ranscatheter a ortic v alve r eplacement ( TAVR ) in symptomatic patients with low-flow , low-gradient aortic stenosis . Next , Dr. Eagle covers ViVA , a randomized trial that looked at vericiguat for the treatment of coronary vaso spasm, followe d by a summary of the REA C T t rial that investigated the use of imaging to d etect silent atherosclerosis in early adulthood. Finally, Dr. Eagle explores NOTION-4, which looks at short-term direct oral anticoagulant (DOAC) t herapy and subclinical leaflet thickening after TAVR . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle evaluates how s acubitril/ v alsartan promote s cardiac remodeling, but not functional capacity, in nonobstructive hypertrophic cardiomyopathy . Next, he examines the prognostic value of stress perfusion cardiac magnetic resonance in patients with suspected coronary artery disease . Finally, Dr. Eagle explores a study on mitral transcatheter edge-to-edge repair (M-TEER) and its effectiveness for treatment of patients with ventricular functional mitral regurgitation (MR) and very severe left ventricular (LV) dysfunction . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle evaluates how s acubitril/ v alsartan promote s cardiac remodeling, but not functional capacity, in nonobstructive hypertrophic cardiomyopathy . Next, he examines the prognostic value of stress perfusion cardiac magnetic resonance in patients with suspected coronary artery disease . Finally, Dr. Eagle explores a study on mitral transcatheter edge-to-edge repair (M-TEER) and its effectiveness for treatment of patients with ventricular functional mitral regurgitation (MR) and very severe left ventricular (LV) dysfunction . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks a t the relationship between lower cardiorespiratory fitness (CRF) and higher coronary artery calcium scores (CAC) and later-life dementia . He follow s this with a look at a new State of the Art Review related to guidance on treating athletes with arrhythmia . He then offer s a perspective on the use of vutrisiran in the treatment of amyloid burden . Finally , Dr. Eagle explores the TARTAN-HF study on NT- proBNP screening and its ability to identify undiagnosed heart failure (HF) among patients with diabetes . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks a t the wide variation in antithrombotic regimens after valve-in-valve t ranscatheter aortic valve replacement (TAVR) . Next, he examines PARTNER- 3, a 7-year study on TAVR v ersu s surg ical aortic valve replacement ( S A VR ) outcomes in low-risk p atients. He then offer s a perspective on the effect of sex difference and delayed diagnosis in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) from amyloidosis . Finally, Dr. Eagle explores the prospective SAMCRO t rial which evaluates lifestyle intervention in addition to medical therapy in patients with invasively confirmed angina with no obstructive coronary artery disease (ANOCA). Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks a t a post-hoc analysis of the API-CAT trial that showed recurrent venous thromboembolism (VTE) is un co mmon but associate d with poor short-term survival of patients with cancer-as s ociate d thrombosis. He follow s with a look at a n observational cohort study on how influenza vaccination i s associate d with lower risks of incident atrial fibrillation (AFib) , then reviews evidence from the DAPT-MVD trial demonstrating that extended DAPT lowers the risk of cardiovascular events after p ercutaneous c oronary i ntervention ( PCI ) in multivessel c oronary a rtery d isease . Finally, Dr. Eagle explores ACC's updated e xpert c onsensus d ecision p athway addressin g the management of h eart f ailure p reserved e jection f raction ( HFpEF ) . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at age, body mass index ( BMI ) , and cardiovascular outcomes after t ranscatheter aortic valve replacement ( TAVR ) . He follow s this with a n examination of a new consensus statement about enhanced radiation protection in c ath labs , then offer s a perspective on particulate matter in the environment and increased coronary heart disease risk . Finally , Dr. Eagle provides an analysis of the SUMMIT Trial , showing the benefit of tirzepatide for h eart failure with preserved ejection fraction (HFpEF) both in women and men . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at the feasibility of mechanical leaflet splitting in high-risk patients undergoing valve-in-valve TAVR . He follows this with an examination of lower ambient temperature and it association with greater SCA risk at marathon races, then offers a commentary on two studies that provide new insights on the durability of pulmonary vein isolation (PVI) with pulsed field ablation (PA) vs radiofrequency ablation IRF) in patients with persistent atrial fibrillation (AFib). Finally, Dr. Eagle discusses the SHaRe Registry and its use in predicting major adverse cardiovascular events MACE for patients with mild hypertrophic cardiomyopathy (HCM). Subscribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at withdrawing guideline-directed medical therapy (GDMT) for patients with atrial fibrillation (AF) . He follow s this with commentary on two important recently released ACC scientific statements : one on anti- platelet therapy for atherosclerotic cardiovascular disease (ASCVD) , and the other examining the use of d irect oral anticoagulants (DOACs) for p rimary and secondary prevention of thrombotic events . Finally , Dr. Eagle summarize s a recent longitudinal study on sugar- sweetened beverages and fruit juice and their potential relationship to the development of hypertension later in a young person's life . Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at how genotype independently predicts heart failure outcomes in patients with hypertrophic cardiomyopathy (HCM) . He then examines the ten-year follow-up of the PARTNER 2A trial and compare s the t ranscatheter aortic valve replacement ( TAVR ) outcomes to results from the Partner 2 SAPIEN XT and SAPIEN 3 studies . He follow s this with a report on how clopidogrel may offer a long-term edge over aspirin after p ercutaneous coronary intervention (PCI) . Finally, Dr. Eagle summarizes HELIUS cohort findings demonstrating that LDL-C, Lp (a), and hsCRP provide complementary, independent insights for identifying long-term atherosclerotic cardiovascular disease (ASCVD) risk across diverse ethnic populations. Su b scribe to Eagle's Eye View
In this week's View , Dr. Eagle reviews 21-year follow-up data from the Diabetes Prevention Program (DPP), showing that lifestyle intervention—but not metformin—reduces multimorbidity risk in prediabetes. He also highlights low rates of hypertension and hyperlipidemia treatment among U.S. adults with cardiovascular-kidney-metabolic (CKM) syndrome, and summarizes evidence that resistance training, particularly when combined with aerobic exercise, is associated with a lower risk of cardiovascular (CV) disease, especially myocardial infarction, in women. Finally, he discusses the CAMERA-MRI II study in patients with atrial fibrillation and left ventricular systolic dysfunction (LVSD), where catheter ablation significantly improved left ventricular ejection fraction (LVEF) regardless of late gadolinium enhancement status. Su b scribe to Eagle's Eye View
In this week's View , Dr. Eagle highlights a study showing race and sex disparities in M-TEER outcomes, with Black patients presenting with more advanced disease, lower success, and higher heart failure readmissions than White patients, and women having lower success rates than men . He reviews the SOGALDI-PEF trial, where patients with low plasma renin levels experienced greater blood pressure reduction with spironolactone/dapagliflozin compared to dapagliflozin alone. Next, he discusses the FAVOR III trial, which found that QFR-guided p ercutaneous coronary intervention improved five-year outcomes versus angiography guidance, with most benefits occurring in the first two years. Lastly, Dr. Eagle examines two renal disease studies addressing optimal chronic kidney disease ( CKD ) GFR thresholds and the benefits of finerenone in CKD patients.
In this week's View , Dr. Eagle highlights several noteworthy developments shaping cardiovascular and renal care. He first examines the FLOW analysis, underscoring the benefits of semaglutide for patients with chronic kidney disease, with particular attention to its impact on both renal and cardiovascular outcomes. He then reviews a phase I study exploring an innovative therapeutic approach involving a single intravenous infusion—Verve-2—which targets PCSK9 expression in the liver and may represent a promising future strategy for treating familial hyperlipidemia. Finally, Dr. Eagle discusses recent findings on antihypertensive drug combinations, emphasizing those regimens that provide optimal efficacy while minimizing adverse effects that often lead to early treatment discontinuation.
In this week's View, Dr. Eagle looks at recent research found in ACC's new expert d ecision p athway for postpartum cardiovascular care . He then offers insights from the ACC Chest Pain - MI Registry examining 'low risk' chest pain and its evaluation in the emergency departments . Next, a discussion of how negative patient outcomes were associated with late pericardial effusion post - left atrial appendage occlusion (LAAO) device implantation . Finally , Dr. Eagle summarize s the ALLEVIATE-HF trial that explored heart failure (HF) risk detection with an insertable cardiac monitor paired with a centrally coordinated nurse-led diuretic intervention. Su b scribe to Eagle's Eye View
In this week's View, Dr. Eagle examines recent research into maintaining weight loss with t i rzepatide . He then offers insights into the new dyslipidemia guidelines, including addressing reproductive and hormone risk factors in cardiovascular risk assessment. Next, Dr. Eagle look s at the use of sacubitril / valsartan to improve exercise tolerance in patients with heart failure with reduced ejection fraction (HFpEF) and functional mitral regurgitation (MR) . Finally , Dr. Eagle summarize s a new study on the use of digitoxin and digoxin in patients with heart failure . Su b scribe to Eagle's Eye View
In this week's View , Dr. Eagle reviews evidence supporting the use of cardiac magnetic resonance (CMR) and NT- proBNP in hypertrophic cardiomyopathy (HCM) risk assessment. He then examines the EXCALIBUR study, which aims to better characterize arrhythmic burden in patients with cardiac amyloidosis. Next, he discusses research identifying obesity as a significant risk factor for heart failure, highlighting key findings and clinical implications. Finally, he summarizes new evidence on the use of ivabradine and propranolol in treating postural orthostatic tachycardia syndrome (POTS). Su b scribe to Eagle's Eye View
In this week's View , Dr. Eagle examines the role of rhythm control in improving moderate-to-severe and severe secondary tricuspid valve regurgitation. He then explores evidence showing that blood pressure reduction can deliver comparable cardiovascular benefits for patients with chronic kidney disease (CKD). Another study reviewed in this episode assesses the outcomes of continuing versus switching direct oral anticoagulant (DOAC) therapy in patients with atrial fibrillation (AFib) who experience breakthrough stroke. Finally, Dr. Eagle summarizes the AVANTE-GUARD trial, which evaluates pulsed field ablation as a first-line treatment for patients with persistent AFib. Subscribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at the NOBLE trial evaluating whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) i s best for patients with unprotected left main coronary artery disease (CAD) . He then explores a report highlighting nanosecond pulsed field abl atio n ( nsPFA ) and its safety and efficacy at one year for paroxysmal atrial fibrillation . Finally, Dr. Eagle presents a summary of the TRIDENT trial, which compares a triple ‑ pill antihypertensive strategy with conventional therapy and finds a positive impact on hypertension management and stroke risk following intracerebral hemorrhage. Subscribe to Eagle's Eye View
In this week's View, Dr. Eagle looks at endovascular therapy for post-thrombotic syndrom e a n d how it reduces severity and improves quality of life . He then explores c urrent e vidence and s trategies to a ddress s ex h ormone- a ssociated t hrombotic and cardiovascular r isk . Next, Dr. Eagle examines the OCEANIC-STROKE trial which studied a sundexian and its potential to lower r ecurrent s troke r isk in p atients w ith n oncardioembolic s troke or transient ischemic attack . Finally , Dr. Eagle asks the question, i s h igh c ardiorespiratory f itness a ssociated w ith l onger l ifespan and l ower m ultimorbidity? Subscribe to Eagle's Eye View
In this week's View , Dr. Eagle examines early surgery for asymptomatic patients with severe aortic stenosis. He then reviews evidence linking blood pressure trajectories and rapid control to significantly improved outcomes. Finally, he compares percutaneous coronary intervention with medical therapy for chronic total occlusion in patients with chronic coronary disease. Subscribe to Eagle's Eye View
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