Apr 18 2025 This Week in Cardiology

This Week in Cardiology

Medscape Podcasts

Cardiology, Science, Medicalpractice, Electrophysiologist, Medscape, Internalmedicine, Medicaldecisionmaking, Expertcommentary, Eartrhythmdisorder, Health, Perspective, Medicine, Healthnews, Medicalexpert, Endoflifecare, Clinicaltrials, Health & Fitness

4.9 • 876 Ratings

🗓️ 18 April 2025

⏱️ 24 minutes

🔗️ Recording | iTunes | RSS

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Summary

The FAME 3 trial 5-year results, TAVR at 5 years, pacers after TAVR, and mavacamten not a wonder drug 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 FAME 3 at Five Years

Stents as Good as Surgery for Triple-Vessel Disease https://www.medscape.com/viewarticle/noninvasive-stents-good-surgery-triple-vessel-disease-2025a10007l4

Main trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2112299
Circulation 3-years https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065770
5-year results Lancet 10.1016/S0140-6736(25)00505-7 https://linkinghub.elsevier.com/retrieve/pii/S0140673625005057

II TAVR in Low-Risk Patients at 5 years

5-Year TAVR, Surgery Outcomes Similar in Low-Risk Patients

https://www.medscape.com/viewarticle/5-year-tavr-surgery-outcomes-similar-low-risk-patients-2025a10007zl

EVOLUT Low-Risk 5 years https://www.jacc.org/doi/10.1016/j.jacc.2025.03.004
EVOLUT Editorial – We're Halfway There
https://www.jacc.org/doi/10.1016/j.jacc.2025.03.428
PARTNER 3 Low-Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2307447
NOTION at 5 years https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036606

III The Matter of Pacemakers After TAVI

JACC IV Study Badertscher https://www.jacc.org/doi/10.1016/j.jcin.2025.03.028
Assessing the quality of reporting of harms in randomized controlled trials published in high impact cardiovascular journals

IV Mavacamten Looks to Have Specific Indications

EXPLORER HCM 10.1016/S0140-6736(20)31792-X External Link
VALOR HCM https://jamanetwork.com/journals/jamacardiology/fullarticle/2809050
BMS Press Release https://news.bms.com/news/details/2025/Bristol-Myers-Squibb-Provides-Update-on-Phase-3-ODYSSEY-HCM-Trial/

FINAL THOUGHTS

PRAGUE 25 https://bmjopen.bmj.com/content/12/6/e056522

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 [email protected]

Transcript

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0:00.0	You're listening to This Week in Cardiology from the heart.org, Medscape Cardiology.
0:05.7	This podcast is intended for health care professionals only.
0:08.8	Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape.
0:14.7	Hi, everyone.
0:16.1	This is John Mandrola from the heart.org medscape cardiology.
0:20.5	And this is this week in cardiology for
0:22.3	April 18th 2025. This week we'll do a Fame 3 redux, Taver at five years, pacer's after Taver,
0:32.8	and Mavacompton doesn't look like a wonder drug. So the first topic is the Fame 3 trial at five years.
0:41.1	The authors of Fame 3 presented results at five years at the ACC meeting. Now recall that
0:47.2	Fame 3 first published in the New England Journal of Medicine in 2021 compared FFR guided PCI
0:53.6	to cabbage in patients with three-vessel coronary disease.
0:57.7	Now, the one-year results were quite clear.
1:00.8	Cabbage dominated.
1:02.3	A primary endpoint of death, MI, stroke, or repeat revascularization occurred in 10.6% of patients
1:09.5	in the PCI arm versus 6.9% in a cabbage arm, that hazard
1:14.1	ratio of 1.5 or 50% worse with PCI had 95% comparizils that went from 1.1 to 2.2.
1:23.7	Since the non-inferiority margin was 1.65 or 65% worse, PCI did not even reach non-inferiority.
1:32.5	Of note, all components of the primary endpoint favored cabbage. The incidence of death by a carol infarction or stroke was 7.3% in the PCI arm versus 5.2% in the cabbage group. That hazard ratio was 1.4, but the conference
1:48.7	intervals was 0.9 to 2.1. Now, before I tell you the five-year results, I should set the stage
1:55.9	regarding the PCI versus cabbage for multivessel disease situation.
2:03.2	It's all bad for PCI.
2:05.9	There are three trials before Fame 3.
	...

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