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This Week in Cardiology

Sep 05 2025 This Week in Cardiology

This Week in Cardiology

Medscape Podcasts

Science, Medicine, Health & Fitness

4.9 • 963 Ratings

🗓️ 5 September 2025

⏱️ 38 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

The big beta-blocker story from ESC, dual pathway therapy with aspirin and OAC, stopping OAC after successful AF ablation, and DANCAVAS II trial are the topics John Mandrola, MD, discusses on 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

This Week in Cardiology Podcast – August 29 https://www.medscape.com/viewarticle/1002877

II The Big Beta-blocker Story from ESC

Beta-Blockers Post-MI: A Clear Clinical Message https://www.medscape.com/viewarticle/beta-blockers-post-mi-clear-clinical-message-2025a1000mz0

  • REBOOT https://www.nejm.org/doi/full/10.1056/NEJMoa2504735
  • BETAMI-DANBLOCK https://www.nejm.org/doi/abs/10.1056/NEJMoa2505985
  • REDUCE AMI https://www.nejm.org/doi/10.1056/NEJMoa2401479
  • CAPITAL RCT https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199347
  • Post Hoc Analysis From REBOOT Trial https://eurointervention.pcronline.com/article/effect-of-beta-blocker-withholding-or-withdrawal-after-myocardial-infarction-without-reduced-ejection-fraction-on-ischaemic-events-a-post-hoc-analysis-from-the-reboot-trial
  • Beta-Blockers After MI With Mildly Reduced Ejection Fraction https://doi.org/10.1016/S0140-6736(25)01592-2
  • CAPRICORN 10.1016/S0140-6736(00)04560-8 External Link
  • BHAT https://jamanetwork.com/journals/jama/fullarticle/370103
  • ISIS 1 https://pubmed.ncbi.nlm.nih.gov/2873379/

III Aspirin and OAC Combination Clearly Dangerous

Aspirin Plus Oral Anticoagulants Raises Mortality, Bleeding https://www.medscape.com/viewarticle/aspirin-plus-oral-anticoagulants-raises-mortality-bleeding-2025a1000nam

  • AQUATIC https://www.nejm.org/doi/full/10.1056/NEJMoa2507532
  • AFIRE https://www.nejm.org/doi/full/10.1056/NEJMoa1904143
  • EPIC CAD https://www.nejm.org/doi/10.1056/NEJMoa2407362
  • OAC-ALONE  https://pubmed.ncbi.nlm.nih.gov/30586700/

IV Stop or Continue OAC after Successful AF Ablation

  • ALONE-AF https://jamanetwork.com/journals/jama/fullarticle/2838294
  • OCEAN trial protocol https://doi.org/10.1016/j.ahj.2017.12.007

V DANCAVAS II Trial

  • DANCAVAS II https://doi.org/10.1093/eurheartj/ehaf704
  • DANCAVAS I https://www.nejm.org/doi/full/10.1056/NEJMoa2208681

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

Transcript

Click on a timestamp to play from that location

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.

0:15.2

Hi, everyone.

0:16.6

This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology

0:22.4

for September 5th, 2025.

0:25.6

This week, some brief listener feedback, the big beta blocker story from ESC, dual pathway

0:32.4

therapy with aspirin and anticoagulation, stopping anticoagulation after successful ablation, and Dan Kavas,

0:40.3

too. As there were so many big trials from ESC, this podcast is a little longer than normal,

0:46.8

and I'll get back to my normal 20 to 25 minutes soon. First listener feedback. I received two

0:53.4

emails regarding my coverage of the recent

0:55.8

Western Danish study of patients with KAC-Zero, coronary calcium zero, and high LDL. Recall that

1:02.7

that study looked at relative risks of events in patients with coronary artery calcium of zero

1:07.6

and varying levels of the LDL.

1:16.9

Compared to those with normal LDL cholesterol, the comparator arm, people with higher levels of LDL had higher rates of disease and there was a gradient of risk, higher among younger people,

1:22.9

and the take-home message was that KAC zero was not so reassuring for patients with higher levels of

1:29.8

LDL cholesterol. Now, the first objection I received came from an American cardiologist who made two

1:35.4

points, and one was that while the relative risk were increased, the absolute risk was minimal.

1:41.2

He wrote, quote, the long-term prognosis for this patient is excellent, and there is no

1:45.6

indication to change management, i.e. add a statin. And then he added this zinger, which really hit me.

1:51.6

He wrote, quote, almost as bad as missing the details in the statistics, your title,

1:56.7

Kek Zero takes a gut punch as a sensationalist and misleading lead.

...

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