May 09 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

🗓️ 9 May 2025

⏱️ 32 minutes

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Summary

The controversial KETO-CTA study, tough decisions in subclinical AF, and another potentially huge benefit for GLP-1 agonist drugs are discussed by John Mandrola, MD, 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 The KETO-CTA Study

JACC Advances Paper: https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686
Meta-analysis https://doi.org/10.1016/j.ajcnut.2024.01.009

II Subclinical AF – Anticoagulate or Not?

Anticoagulation in Subclinical AF May Offer Little Benefit

https://www.medscape.com/viewarticle/anticoagulation-subclinical-af-may-offer-little-benefit-2025a1000b31

Treat AFib ‘Diagnosed’ by Smartwatch

https://www.medscape.com/viewarticle/treat-afib-diagnosed-smartwatch-2025a1000avp

JAMA NO paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833437
NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062
ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234
McIntyre meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512
Singer et al https://pmc.ncbi.nlm.nih.gov/articles/PMC2777526/
Stroke paper https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.123.045843
American Journal of Medicine paper https://pubmed.ncbi.nlm.nih.gov/38331136/

III GLP1a for Treatment of Fatty Liver Disease

ESSENCE trial https://www.nejm.org/doi/10.1056/NEJMoa2413258

Features

CABG Still Superior to Stents Despite FAME 3 Endpoint Swap

https://www.medscape.com/viewarticle/cabg-still-superior-stents-despite-fame-3-endpoint-swap-2025a1000ao5

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.
0:05.4	This podcast is intended for health care professionals only. Any views expressed are the presenters
0:10.4	own and do not necessarily reflect the views of WebMD or Medscape. Hi, everyone. This is John Mandrola
0:16.9	from the heart.org medscape cardiology, and this is this week in cardiology for May 9th, 2025.
0:23.9	This week, the controversial keto-c-TTA study, tough decisions in subclinical AF, and a potentially huge new benefit for GLP1 agonist drugs.
0:35.9	First topic today is the keto CTA study.
0:40.0	The journal Jack Advances published a study looking at plaque progression in people eating a keto diet.
0:47.8	It stirred all sorts of controversy on social media and I will review it this week.
0:53.2	A few background comments first.
0:55.9	A obstacle to broad clinical implementation of carbohydrate-restricted diets and the keto diet
1:02.1	are lipid changes that occur in a minority of patients upon carbohydrate restriction.
1:08.9	What are these changes?
1:10.1	Bad lipid changes, as in large increases in
1:13.0	LDL cholesterol and associated APOB. Now, while there are many factors contributing to the
1:19.6	increase in LDL cholesterol in APOB in the keto diet, leanness seems important. Get this.
1:27.3	The author cite a meta-analysis of 41 studies that report that mean baseline BMI had a strong inverse association with LDL cholesterol change, whereas a saturated fat amount didn't seem to be significantly associated with LDL changes.
1:43.2	The meta-analysis found that for trials with a
1:45.7	mean baseline BMI of less than 25, LDL cholesterol increased by like 41 milligrams per decilator,
1:53.9	a lot. By contrast, for trials with a BMI of 25 to 35, LDL cholesterol didn't change. And for trials with the BMI greater than 35, LDL cholesterol actually decreased by 7
2:06.7	milligrams per deciliter on the carbohydrate-restricted diets.
2:11.2	I did not know that lipid changes with carbohydrate restriction was modified by BMI.
2:17.0	But these observations have given rise to this
	...

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