Nov 21 2025 This Week in Cardiology
This Week in Cardiology
Medscape Podcasts
4.9 • 963 Ratings
🗓️ 21 November 2025
⏱️ 29 minutes
🧾️ Download transcript
Summary
Listener feedback, huge news in the world of carotid disease with the CREST-2 publication, prasugrel beats ticagrelor again, and a big coffee trial 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 Listener Feedback
- Complete Revascularization for Acute MI Meta-analysis https://doi.org/10.1016/S0140-6736(25)02170-1
II A Sea Change in the Treatment of Carotid Artery Disease — CREST-2 Published
- ECST-2 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00107-3/fulltext
- SPACE-2 https://pubmed.ncbi.nlm.nih.gov/36115360/
- CREST-2 Trial www.nejm.org/doi/full/10.1056/NEJMoa2508800
- CREST Protocol paper https://pmc.ncbi.nlm.nih.gov/articles/PMC5987521/
III Prasugrel Beats Ticagrelor in High-Risk Patients With Diabetes After PCI https://www.medscape.com/viewarticle/prasugrel-beats-ticagrelor-high-risk-patients-diabetes-after-2025a1000wbt
- PLATO trial https://www.nejm.org/doi/full/10.1056/NEJMoa0904327
- Ticagrelor or prasugrel vs clopidogrel in PCI https://eurointervention.pcronline.com/article/ticagrelor-or-prasugrel-versus-clopidogrel-in-patients-undergoing-percutaneous-coronary-intervention-for-chronic-coronary-syndromes
- ISAR-REACT 5 trial https://www.nejm.org/doi/full/10.1056/NEJMoa1908973
IV Another Coffee and AF study
Can Coffee Cut the Risk for Atrial Fibrillation?
https://www.medscape.com/viewarticle/can-coffee-cut-risk-atrial-fibrillation-2025a1000w11
A Coffee a Day to Keep the AFib Away? The DECAF Trial Discussed https://www.medscape.com/viewarticle/coffee-day-keep-afib-away-decaf-trial-discussed-2025a1000v5z
- DECAF trial https://jamanetwork.com/journals/jama/fullarticle/2841253
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Questions or feedback, please contact news@medscape.net
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. |
| 0:15.0 | Hi, everyone. |
| 0:16.5 | This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in |
| 0:22.0 | cardiology for November 21st, 2025. This week will do a little bit more listener feedback. |
| 0:30.1 | There's huge, huge news in the world of carotid vascular disease with publication of the |
| 0:36.2 | Crest 2 trial this morning. |
| 0:39.4 | Prosagel and Ticagular are at it again and a big coffee trial. |
| 0:45.3 | Now the first order of business today is that next weekend is Thanksgiving, so this week |
| 0:50.2 | and cardiology takes a week off, and I'll be back on December 5th. |
| 0:55.8 | All right, listener feedback. I continue to receive pushback on my view of the complete |
| 1:02.0 | versus culprit-only debate during STEMI. I contend that the most recent, highly, non-significant |
| 1:09.7 | full revast trial likely represents the truth, namely that the most recent, highly, non-significant, full revast trial likely represents the truth, |
| 1:12.7 | namely that the other coronary disease that's not involved in the occlusion represents stable |
| 1:18.9 | disease and that PCI of stable disease does not reduce future serious outcomes over medical therapy. |
| 1:25.3 | My argument is that if PCI of the non-culpate lesion improved outcomes, |
| 1:32.1 | then that would go against decades of evidence that PCI of stable CAD does not improve outcomes |
| 1:37.9 | over medical therapy. Now, of course, I bolster my argument by citing the fact that the complete |
| 1:43.1 | trial was positive only |
| 1:45.2 | because of non-fatal MI reduction. |
| 1:48.0 | This was not enough to improve CV death. |
... |
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