Disparities in health care disproportionally impact under-resourced and minority communities resulting in excess mortality and morbidity. Decreasing and eliminating these disparities will improve health statistics for all. The American College of Cardiology's (ACC) Health Equity Task Force is demonstrating its commitment to health equity through championing the improvement of patients' lived experiences, population health, and clinician well-being while reducing health care costs—the Quadruple Aim of Health Equity.  

In this interview, Drs. Richard Chazal and Paul Douglass discuss Achieving Equitable Cardiovascular Care for All: ACC Board of Trustees Health Equity Task Force Action Plan.  

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Medical therapy is critical in preventing the worst complications of peripheral artery disease (PAD), among them heart attack, stroke, bleeding risk, and leg disease, which could lead to acute limb ischemia and amputation. Blood thinning medications (antithrombotic therapy) have shown rapid evolution and broad benefits and novel approved strategies that improve outcomes are available. It is imperative that clinicians select appropriate patients for use and consider the complex situations for management. 

In this interview, Drs. Cindy Grines and Marc Bonaca discuss Antithrombotic Strategies for Patients with Peripheral Artery Disease: JACC Scientific Statement. 

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The goal of the ABYSS (Assessment of Beta-Blocker Interruption 1 Year After an Uncomplicated Myocardial Infarction on Safety and Symptomatic Cardiac Events Requiring Hospitalization) trial was to evaluate beta-blocker interruption compared with beta-blocker continuation after an uncomplicated myocardial infarction (MI). Although the efficacy of beta blockers on decreasing mortality has diminished in the reperfusion era in patients without heart failure, this class of well tolerated drugs  remain useful to decrease the rate of rehospitalization in patients who have suffered MI. 

 In this interview, Drs. Deepak Bhatt and Johanne Silvain discuss the results of ABYSS and beta blocker interruption in patients with prior MI. 

 References: 

1. Silvain J, Cayla G, Ferrari E, et al., for the ABYSS Investigators of the ACTION Study Group. Beta-Blocker Interruption or Continuation After Myocardial Infarction. N Engl J Med 2024;Aug 30:[Epub ahead of print]. 

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Patients can benefit from better healthcare access and outcomes by services that are enabled by artificial intelligence (AI). The current state of technology is evolving to now allow diagnosis of advanced conditions from simple diagnostic testing, broadening the scope of early diagnosis and treatment.  

What are the safe cards for the deployment of AI in real-world clinical care? In this interview, Drs. DJ Lakkireddy and Rohan Khera discuss Transforming Cardiovascular Care With Artificial Intelligence: From Discovery to Practice: JACC State-of-the-Art Review. 

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Can algorithms improve the management of patients with myocardial injury? Is there a tool to aid diagnosing patients faster and more accurately leading to appropriate treatment sooner to optimize results? This study highlights the challenges and opportunities associated with the integration of artificial intelligence (AI) into health care to improve outcomes. 

In this interview, Drs. Allen Taylor and Derek Chew discuss the findings of the RAPIDxAI trial: re-engineering the clinical approach to suspected cardiac chest pain assessment in the emergency department by expediting evidence to practice using AI. 

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The BedMed and BedMed-Frail trials assisted in providing clarity as to the daily timing of prescribed blood pressure medication. The two trials, one conducted in a general primary-care population and the other among nursing-home residents, determined no difference in major cardiovascular events or safety between blood pressure (BP) medication distribution in the evening or morning. 

 In this interview, Drs. Anthony DeMaria and Scott Garrison review the BedMed and BedMed-Frail trials findings which proved the emphasis to patients is taking BP medication when they are least likely to forget, irrelevant of time of day.  

References: 

1. Pigazzani F, Dyar KA, Morant SV, et al. Effect of timed dosing of usual antihypertensives according to patient chronotype on cardiovascular outcomes: the Chronotype sub-study cohort of the Treatment in Morning versus Evening (TIME) study. EClinicalMedicine 2024;72:102633.  

1. Mackenzie IS, Rogers A, Poulter NR, et al. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. Lancet 2022;400:1417-25.  

1. Hermida RC, Crespo JJ, Dominguez-Sardina M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J 2020;41:4565-76.  

1. Hermida RC, Ayala DE, Fernandez JR, et al. Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation. Chronobiol Int 2013;30:280-314.  

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The BedMed and BedMed-Frail trials assisted in providing clarity as to the daily timing of prescribed blood pressure medication. The two trials, one conducted in a general primary-care population and the other among nursing-home residents, determined no difference in major cardiovascular events or safety between blood pressure (BP) medication distribution in the evening or morning. 

In this interview, Drs. Anthony DeMaria and Scott Garrison review the BedMed and BedMed-Frail trials findings which proved the emphasis to patients is taking BP medication when they are least likely to forget, irrelevant of time of day.  

References: 

1. Pigazzani F, Dyar KA, Morant SV, et al. Effect of timed dosing of usual antihypertensives according to patient chronotype on cardiovascular outcomes: the Chronotype sub-study cohort of the Treatment in Morning versus Evening (TIME) study. EClinicalMedicine 2024;72:102633.  

1. Mackenzie IS, Rogers A, Poulter NR, et al. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. Lancet 2022;400:1417-25.  

1. Hermida RC, Crespo JJ, Dominguez-Sardina M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J 2020;41:4565-76.  

1. Hermida RC, Ayala DE, Fernandez JR, et al. Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation. Chronobiol Int 2013;30:280-314.  

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The goal of the TIGHT K trial was to evaluate if prescribing relaxed control of potassium levels and only giving supplements in the rare event that levels became pathologically low was equally as effective in preventing atrial fibrillation (AFib) after cardiac surgery as tightly controlling levels.  

In this interview, Drs. Steven Nissen and Benjamin O'Brien discuss the TIGHT K trial results which proved that practitioners can safely cease the widespread practice of maintaining high-normal potassium levels after isolated coronary artery bypass grafting surgery. Additional benefits include improved tpatient experience and reduced patient cost. 

References: 

1. O'Brien B, Campbell NG, Allen E, et al; TIGHT K Investigators. Potassium supplementation and prevention of atrial fibrillation after cardiac surgery: the TIGHT K randomized clinical trial. JAMA 2024;332:979-88. 

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The goal of the SENIOR RITA trial was to evaluate routine invasive therapy compared with conservative therapy among older patients with non–ST-elevation myocardial infarction. Additionally, the trial assessed whether optimal medical therapy or coronary angiography and stents are beneficial in older adults with heart attacks. 

In this interview, Drs. Nanette Kass Wenger and Vijay Kunadian discuss the SENIOR RITA trial results and the importance of individualizing routine invasive therapy in individuals ≥75 years of age. 

References: 

1. Kunadian V, Mossop H, Shields C, et al., for the British Heart Foundation SENIOR-RITA Trial Team and Investigators. Invasive Treatment Strategy for Older Patients With Myocardial Infarction. N Engl J Med 2024;Sep 1:[Epub ahead of print]. 

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Fasting is a routine part of preparing for a heart procedure. Research found through the SCOFF trial suggests that for certain procedures, removing the need to fast is safer and more comfortable for patients. 

 In this interview, Drs. Roxana Mehran and David Ferreira discuss new evidence from the SCOFF trial and the possibility of reconsidering fasting requirements in clinical guideline. 

 References: 

1. Ferreira D, Hardy J, Meere W, et al. Safety and care of no fasting prior to catheterization laboratory procedures: a non-inferiority randomized control trial protocol (SCOFF trial). Eur Heart J Open 2023;3:oead111. 

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The RESHAPE-HF2 (Randomized Investigation of the MitraClip Device in Heart Failure [HF]: Second Trial in Patients With Clinically Significant Functional Mitral Regurgitation [MR]) trial assessed the safety and efficacy of mitral transcatheter edge-to-edge repair (M-TEER) using MitraClip among symptomatic HF patients with secondary MR. The results of this trial indicate that M-TEER using the MitraClip on a background of maximally tolerated guideline-directed medical therapy (GDMT) was superior to GDMT alone in reducing HF hospitalization and mortality at 2 years in symptomatic HF patients with grade 3-4+ MR. 

 In this interview, Drs. Sidney Smith and Stefan Anker discuss the benefits of RESHAPE-HF2, including reduction in HF hospitalization (particularly among those with a history of HF hospitalization within the past year), significant quality-of-life improvements, and other patient-centered outcomes. 

 References: 

1. Anker SD, Friede T, von Bardeleben RS, et al., for the RESHAPE-HF2 Investigators. Transcatheter Valve Repair in Heart Failure With Moderate to Severe Mitral Regurgitation. N Engl J Med 2024;Aug 31:[Epub ahead of print]. 

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In this interview, Dhanunjaya Lakkireddy, MD, MBA, FACC, and Alison L. Bailey, MD FACC, discuss the Top Electrophysiology (EP) Takeaways from 2024. Dr. Lakkireddy discusses climate change, high school mandated education on cardiopulmonary resuscitation, important trials impacting atrial fibrillation including PROMPT-AF and ARREST-AF, and more.  

1. Sang C, Liu Q, Lai Y, et al. Pulmonary vein isolation with optimized linear ablation vs pulmonary vein isolation alone for persistent AF: the PROMPT-AF randomized clinical trial. JAMA 2024;Nov 18:[ePub ahead of print].  

1. Wood S. Lifestyle and Risk Factors Matter for AF Burden—Metformin May Not: TRIM-AF 

(tctMD website). 2024. Available at https://www.tctmd.com/news/lifestyle-and-risk-factors-matter-af-burden-metformin-may-not-trim-af. Accessed 12/17/24. 

1. Verma S, Butler J, Borlaug BA, et al.; on behalf of STEP-HFpEF and STEP-HFpEF DM Investigators. Atrial fibrillation and semaglutide effects in obesity-related heart failure with preserved ejection fraction: STEP-HFpEF program. J Am Coll Cardiol 2024;84:1603-14. 

1. Sapp JL, Tang AS, Parkash R, et al., for the VANISH2 Study Team. Catheter ablation or antiarrhythmic drugs for ventricular tachycardia. N Engl J Med 2024;Nov 16:[ePub ahead of print]. 

1. Katapadi A, Bawa D, Garg J, et al. Are high school cardiopulmonary resuscitation education mandates working? Insights from a high school survey on CPR knowledge, attitudes, and readiness. Heart Rhythm 2024;Sep 28:[ePub ahead of print]. 

1. Yang CH, Ng CJ, Huang HL, et al. Intraosseous and intravenous epinephrine administration routes in out-of-hospital cardiac arrest: survival and neurologic outcomes. J Am Heart Assoc 2024;13:e036739.  

1. Prioritizing Health | Weathering Change: The Importance of Talking to Patients About Environmental Risks to Heart Health (Cardiology Magazine). 2024. Available at https://www.acc.org/Latest-in-Cardiology/Articles/2024/04/01/00/42/Prioritizing-Health-Weathering-Change-The-Importance-of-Talking-to-Patients-About-Environmental-Risks-to-Heart-Health. Accessed 12/17/24. 

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In this interview, Andrew M. Kates, MD, FACC, and Alison L. Bailey, MD FACC, discuss the Top General CardiologyTakeaways from 2024. Dr. Kates discusses the 2024 Perioperative Guidelines, cardiac rehab, ACC's proposal for a new Board of Cardiovascular Medicine, and more.  

1. Bhave NM, Cibotti-Sun M, Moore MM. 2024 perioperative cardiovascular management for noncardiac surgery guideline-at-a-glance. J Am Coll Cardiol 2024;84:1970-75. 

1. Pack OR, Keys T, Priya A, et al. Is 70% achievable? Hospital-level variation in rates of cardiac rehabilitation use among medicare beneficiaries. JACC Adv 2024;3:101275. 

1. FDA Update: Acoramidis Approved to Reduce CV Death, Hospitalization in Patients With ATTR-CM (ACC.org). 2024. Available at https://www.acc.org/Latest-in-Cardiology/Articles/2024/11/26/15/02/fda-update-acoramidis-approved-to-reduce-cv-death-hospitalization-in-patients-with-attr-cm. Accessed 12/10/24. 

1. Gillmore JD, Judge DP, Cappelli F, et al., on behalf of the ATTRibute-CM Investigators. Efficacy and safety of acoramidis in transthyretin amyloid cardiomyopathy. N Engl J Med 2024;390:132-42.  

1. Board of Cardiovascular Medicine (ACC.org). 2024. https://cvboard.org/. Accessed 12/10/24. 

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In this interview, Clyde W. Yancy, MD, MACC, and Alison L. Bailey, MD FACC, discuss the Top Heart Failure Takeaways from 2024. Dr. Yancy discusses the FINEARTS-HF trial, the PREVENT calculator, the multisociety Heart Failure Guidelines, and more. 

1. Khan SS, Coresh J, Pencina MJ, et al. Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: a scientific statement from the American Heart Association. Circulation 2023;148:1982-2004. 

1. Zelniker TA, Braunwald E. Clinical benefit of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC State-of-the-Art Review. J Am Coll Cardiol 2020;75:435-47.  

1. Solomon SD, McMurray JJV, Vaduganathan M, et al; on behalf of the FINEARTS-HF Committees and Investigators. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med 2024;391:1475-85. 

1. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2022;79:e263–e421. 

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In this interview, Noel Bairey Merz, MD, FACC, and Alison L. Bailey, MD FACC, discuss the Top Preventive Cardiology Takeaways from 2024. Dr. Bairey Merz discusses the SELECT and SUMMIT trials, the impact of cardiac interventions on the carbon footprint, and more.  

1. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al; on behalf of the SELECT Trial Investigators. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023;389:2221-32. 

1. Packer M, Zile MR, Kramer CM, et al; on behalf of the SUMMIT Trial Study Group. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2024;Nov 16:[ePub ahead of print]. 

1. TOPSPIN  ̶̶  Treatment Optimization for Blood Pressure With Single-Pill Combinations in India. Presented by Dr. Dorairaj Prabhakaran at the American Heart Association Scientific Sessions, Chicago, IL, November 17, 2024.   

1. Sagheer U, Al-Kindi S, Abohashem S, et al. Environmental pollution and cardiovascular disease: part 1 of 2: air pollution. JACC Adv 2023;3:100805. 

1. Sagheer U, Al-Kindi S, Abohashem S, et al. Environmental pollution and cardiovascular disease: part 2 of 2: soil, water, and other forms of pollution. JACC Adv 2024;3:100815. 

1. Bawa D, Ahmed A, Darden D, et al. Impact of remote cardiac monitoring on greenhouse gas emissions: Global Cardiovascular Carbon Footprint Project. JACC Adv 2023;2:100286. 

1. Marfella R, Prattichizzo F, Sardu C, et al. Microplastics and nanoplastics in atheromas and cardiovascular Events. N Engl J Med 2024;390:900-10. 

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In this interview, Deepak L Bhatt, MD, MPH, MBA, FACC, and Alison L. Bailey, MD FACC, discuss the Top Interventional Takeaways from 2024. Dr. Bhatt discusses the CLEAR SYNERGY, DanGer Shock, EARLY TAVR trials and more. 

 Jolly SS, d'Entremont MA, Lee SF, et al., for the CLEAR Investigators. Colchicine in Acute Myocardial Infarction. N Engl J Med 2024;Nov 17:[Epub ahead of print]. 

1. Møller JE, Engstrøm T, Jensen LO, et al., on behalf of the DanGer Shock Investigators. Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. N Engl J Med 2024;390:1382-93. 

1. Généreux P, Schwartz A, Oldemeyer JB, et al., for the EARLY TAVR Trial Investigators. Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis. N Engl J Med 2024;Oct 28:[Epub ahead of print]. 

1. Erriquez A, Campo G, Guiducci V, et al. QFR for the Revascularization of Nonculprit Vessels in MI Patients: Insights From the FIRE Trial. JACC Cardiovasc Interv 2024;17:1425-36. 

1. Généreux P, Banovic M, Kang K-H, et al. Aortic valve replacement vs clinical surveillance in asymptomatic severe aortic stenosis: a systematic review and meta-analysis. J Am Coll Cardiol 2024;Nov 26:[ePub ahead of print]. 

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In this interview, Thomas H. Marwick, MD, PhD, FACC, and Alison L. Bailey, MD FACC, discuss the Top Takeaways from 2024 in Cardiovascular (CV) Imaging. Dr. Marwick discusses the SCOT-HEART trial, patient-echo reports augmented by AI, tricuspid valve regurgitation, and more. 

1. Dahl JS, Julakanti R, Ali M, Scott CS, Padang R, Pellikka PA. Cardiac damage in early aortic stenosis: is the valve to blame? JACC Cardiovasc Imaging 2024;17:1031-1040.  

1. Kolossvary M, Lin A, Kwiecinski J, et al. Coronary plaque radiomic phenotypes predict fatal or nonfatal myocardial infarction: analysis of the SCOT-HEART trial. JACC Cardiovasc Imaging 2024;Oct 30:[ePub ahead of print].  

1. Naser JA, Harada T, Tada A, et al. Prevalence, incidence, and outcomes of diastolic dysfunction in isolated tricuspid regurgitation: perhaps not really "isolated"? JACC Cardiovasc Imaging 2024;Jul 24:[ePub ahead of print].  

1. Spartera M, Stracquadanio A, Pessoa-Amorim G et al. Reduced left atrial rotational flow is independently associated with embolic brain infarcts. JACC Cardiovasc Imaging 2023;16:1149-59. 

1. Martin JA, Hill T, Saric M, et al. Evaluating patient-oriented echocardiogram reports augmented by artificial intelligence. JACC Cardiovasc Imaging 2024;17:1381-83. 

1. Sayed A, Al-Mallah M. Geographic proximity to cardiac positron emission tomography facilities across the United States. JACC Cardiovasc Imaging 2024;Aug 18:[ePub ahead of print].  

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Advanced lipid testing holds significant potential in cardiovascular care by enhancing risk prediction beyond standard lipid panels. For patients, this means more tailored treatment and better outcomes by addressing residual risk not captured by traditional LDL-C assessments​.  

 In this interview, Drs. Laxmi Mehta and Michael Shapiro discuss the role and importance of advanced lipid testing.  

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he SUMMIT trial compared the safety and efficacy of tirzepatide among patients with heart failure with preserved ejection fraction (HFpEF) and obesity. Results from the trial concluded that treatment of obesity reduces major heart failure events in addition to improving health status and exercise tolerance. 

In this interview, Drs. Alison Bailey and Milton Packer examine the power of tirzepatide expanding beyond weight loss and treating diabetes in addition to reducing heart failure events in patients with obesity-related HFpEF. 

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Nearly one-half of US counties have no practicing cardiologists. These counties with limited access to cardiovascular care tend to be more rural and socioeconomically disadvantaged, with a greater burden of cardiovascular disease, highlighting deep geographic disparity in access to cardiovascular care in the US. 

In this interview, Drs. Bailey and Kim discuss "Geographic Disparities in Access to Cardiologists in the United States." 

 Related References: 

1. Cross SH, Mehra MR, Bhatt DL, et al. Rural-urban differences in cardiovascular mortality in the US, 1999-2017. JAMA 2020;323:1852–54.  

1. Loccoh EC, Nguyen A, Kim G, Warraich HJ. Geospatial analysis of access to health care and internet services in the US. JAMA Netw Open 2022;5:e2243792. 

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Funded by the Congressionally Directed Medical Research Programs (CDMRP) of the Department of Defense, the WARRIOR (Women's IschemiA TRial to Reduce events In non-ObstRuctive CAD) Trial addresses the urgent need for evidence-based care in a growing population of patients—particularly women—experiencing ischemia without obstructive coronary artery disease (INOCA). 

This clinical strategy trial compares optimal medical therapy with usual care in women with angina but no significant coronary blockages. In this episode, Drs. Nanette Kass Wenger and Noel Bairey Merz discuss the trial's design, enrollment progress, follow-up strategies, and the primary and secondary outcomes that could reshape cardiovascular care for women. 

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Patients with peripheral artery disease (PAD) often experience significant walking difficulties, and there are limited therapies available to improve their mobility. Investigation made through the STRIDE (Effects of Semaglutide on Functional Capacity in Patients With Type 2 Diabetes and Peripheral Arterial Disease) trial focused on semaglutide, a drug known for promoting weight loss, reducing inflammation, and lowering the risk of heart attack or stroke, to determine if it could enhance the functional abilities of PAD patients. 

 In this interview, Drs. Alison Bailey and Marc Bonaca discuss how the STRIDE trial data supports the use of semaglutide for individuals with PAD and type 2 diabetes, highlighting its cardiometabolic, cardiovascular, and kidney benefits, as well as its ability to improve function, symptoms, and overall quality of life. 

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Pulmonary hypertension (PH) is most commonly linked to left heart disease (LHD). The 7th World Symposium on Pulmonary Hypertension PH-LHD task force reviewed newly reported randomized clinical trial results and explored novel strategies to enhance patient outcomes. Their findings uncovered key data essential for improving clinical care. 

In this interview, Drs. William Boden and Bradley Maron discuss the latest advancements in managing pulmonary hypertension caused by left heart disease. 

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Three complementary constructs  ̶  cardiovascular health, cardiovascular-kidney-metabolic (CKM) syndrome, and cardiovascular disease (CVD) risk assessment  ̶  exist to aid physicians in understanding where a patient is in the journey from health to disease and assist with clinical decision-making for preventive interventions across the life course.   

In this interview, Drs. Clyde Yancy and Donald Lloyd-Jones review the origins, objectives, and application of these cardiovascular constructs in practice.  

  SUGGESTED MATERIALS:   

1. Lloyd-Jones DM, Allen NB, Anderson CAM, et al; on behalf of the American Heart Association. Life's Essential 8: updating and enhancing the American Heart Association's construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation 2022;146:e18-e43.  

2. Ndumele CE, Rangaswami J, Chow SL, et al; on behalf of the American Heart Association. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation 2023;148:1606-35.  

3. Khan SS, Matsushita K, Sang Y, et al; for the Chronic Kidney Disease Prognosis Consortium and the American Heart Association Cardiovascular-Kidney-Metabolic Science Advisory Group. Development and validation of the American Heart Association's PREVENT equations. Circulation 2023;149:430-49.  

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The use of artificial intelligence (AI) assistance in echocardiography is proving beneficial in a multitude of ways: significantly reducing time per examination, increasing the average number of examinations per day, improving image quality, and decreasing mental fatigue in sonographers. Through AI-based echocardiography patients receive faster, high-quality diagnostics, which benefit both patient care and clinician workflow.  

  In this interview, Drs. Jeroen Bax and Nobuyuki Kagiyama examine the results of the AI-ECHO randomized crossover trial.  

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In this episode, Drs. Joseph Marine and Rajeev Pathak dive into the ARREST-AF trial and its implications for ablation outcomes in atrial fibrillation (AFib) patients. Listen as they explore the key findings of the trial, including the best approaches to risk factor management for AFib, and why catheter ablation remains a critical treatment option. Learn about the patient population in the ARREST-AF trial, along with the primary and secondary outcomes.  

 Drs. Marine and Pathak break down the key clinical takeaways and valuable insights on optimizing AFib management and improving outcomes through evidence-based strategies. 

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Hypertrophic cardiomyopathy (HCM) is generally an inherited global heart disease in which only a fraction of those with the condition are clinically diagnosed. The recently published HCM guidelines include major changes focusing on medical therapy, increased emphasis exercise testing, management of sudden death risk, and screening for atrial fibrillation. 

In this interview, Drs. Matthew Martinez and Himabindu Vidula reinforce the importance of these updates for general cardiologists, which aid in identifying HCM patients early and establishing appropriate management plans.  

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Transcatheter aortic valve replacement (TAVR) has emerged as the preferred treatment for aortic stenosis. However, there is a lack of long-term outcome data for low-risk patients. The 5-year results from the Evolut Low-Risk randomized trial address this gap, offering compelling evidence with no significant negative signals regarding TAVR's clinical outcomes and valve performance. 

In this episode, Drs. Richard A. Chazal and Michael J. Reardon delve into the 5-year results from the Evolut Low-Risk randomized trial, offering valuable insights about the future of TAVR and its impact on patient care. 

Related References: 

1. Popma JJ, Deeb GM, Yakubov SJ, et al; Evolut Low Risk Trial Investigators. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. N Engl J Med. 2019 May 2;380(18):1706-1715. doi: 10.1056/NEJMoa1816885. Epub 2019 Mar 16. PMID: 30883053. 

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Fluid restriction is often recommended for heart failure (HF) patients to prevent congestion, but its benefits and safety are unclear. The FRESH-UP study is the first to show that strict fluid restriction does not improve health status for chronic, symptomatic HF patients and may increase thirst distress without reducing mortality, hospitalization, acute kidney injury, or medication needs. 

In this interview, Roland RJ van Kimmenade, MD and Alison L. Bailey, MD, FACC discuss the impacts of the FRESH-UP study and how liberal fluid intake is safe for chronic HF patients, even enhancing their well-being. Providers are encouraged to reconsider universal fluid restrictions and adopt a more individualized approach. 

 RELATED REFERENCES: 

1. Herrmann JJ, Brunner-La Rocca HP, Baltussen LE, et al. Liberal Fluid Intake Versus Fluid Restriction in Chronic Heart Failure: A Randomized Clinical Trial. Nat Med 2025;Mar 30:[Epub ahead of print]. 

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and potentially fatal form of elevated blood pressure in the lungs. CTEPH treatment overall is a very complex clinical assessment and medical decision. Treatment options may include pulmonary thromboendarterectomy (PTE) surgery, balloon pulmonary angioplasty (BPA), or medical therapy.  

In this interview, Drs. Shashank Sinha and Anjali Vaidya discuss how to approach the treatment decision for CTEPH once a diagnosis has been made.  

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The 2024 American Heart Association/American College of Cardiology (AHA/ACC)/multisociety guideline for perioperative cardiovascular (CV) management for noncardiac surgery, released in September 2024, marks the fourth comprehensive revision of the perioperative guideline since its inception in 1996. This latest update reflects the most current, evidence-based recommendations, shaped by expert clinical insight, to guide the management of patients with CV conditions undergoing noncardiac surgery. 

 In this interview, Drs. Andrew Kates and Annemarie Thompson discuss the key updates from the 2014 guideline, highlighting significant changes and exploring its guidance on evaluating patients with CV disease before noncardiac surgery.  

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In this interview, Drs. Richard Chazal and Mikhail Kosiborod explore the rapidly evolving therapeutic landscape of obesity, with a particular focus on the cardiovascular benefits of emerging treatments. They delve into the impact of sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in enhancing cardiovascular outcomes and improving survival across diverse clinical settings. Their discussion highlights the latest advancements in these therapies, shedding light on their role in reshaping the management of cardiometabolic diseases.  

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Drafting messages, summarizing charts, managing appointments, and assessing eligibility are all tasks that large language models can streamline. However, integrating them safely and effectively—whether in small practices or large healthcare institutions—poses unique challenges. 

In this interview, Drs. Dipti Itchhaporia and Marly van Assen explore key strategies and safeguards designed to reduce errors and enhance reliability in high-stakes environments like healthcare. 

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A personalized approach to lowering cholesterol is crucial in preventing heart attacks, as the optimal level, speed, and duration of low-density lipoprotein (LDL) reduction can vary from person to person. Both physicians and patients must carefully assess and monitor these factors to achieve the best cardiovascular outcomes. 

In this interview, Drs. Douglas Weaver and Kausik Ray delve into the importance of individualized cholesterol management. They discuss the latest research, the benefits of aggressive LDL reduction, and how tailoring treatment plans can help optimize heart health while minimizing risks. 

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Notifying patients and their clinicians about incidental coronary calcium findings can encourage shared decision-making on preventive therapies and significantly boost statin use among high-risk individuals. Each year, tens of millions of chest computed tomography (CT) scans are performed, yet valuable data on coronary calcium often remain unused — an untapped opportunity to enhance cardiovascular prevention. 

In this interview, Drs. Glenn Hirsch and Alexander Sandhu discuss how screening previously acquired non-gated chest CTs can help improve statin prescription rates and optimize preventive care. 

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Adverse pregnancy outcomes (APOs), affecting up to 20% of pregnancies, serve as early indicators of a woman's future cardiovascular risk and should be treated as critical markers in preventive care. Pregnancy offers a unique opportunity—a "window"—to identify and address cardiovascular vulnerabilities, making routine screening for heart health essential at every clinical encounter. Long-term monitoring beyond the postpartum period is vital, as cardiovascular risks persist and evolve over time. Improving women's heart health requires a collaborative, lifelong approach across specialties, integrating cardiology with obstetrics and primary care. This comprehensive strategy ensures that prevention remains central during and after reproduction. 

In this interview, Drs. Alison L. Bailey, MD, FACC and Ijeoma Isiadinso, MD, FACC discuss "The Role of Prevention During & After Reproduction". 

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Cohort studies have provided robust data on cardiovascular risk factors, forming the basis for predictive models like the Pooled Cohort Equations and PREVENT. Clinical trials confirm that treating these risk factors effectively reduces cardiovascular events. Over the past 50 years, age-adjusted mortality from acute myocardial infarction has dropped by 89%, reflecting major progress. To advance further, we must consider integrating imaging to identify those at highest risk, using risk factors to guide treatment decisions. This dual approach could enhance precision and improve outcomes in cardiovascular prevention. 

 In this interview, Drs. Alison L. Bailey and David J. Maron discuss "The Role of Imaging in Cardiovascular Prevention". 

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Rapid emergency medical services transport to a percutaneous coronary intervention (PCI)-capable hospital is critical for timely intervention and management of life-threatening arrhythmias in ST-elevation myocardial infarction patients. Upon emergency room arrival, immediate transfer to the cath lab is essential to restore perfusion and improve both short- and long-term cardiovascular outcomes, as recommended by clinical guidelines. Interventional cardiologists must also be adept at managing culprit lesions in multivessel disease (MVD) and addressing complications like the no-reflow phenomenon during PCI. 

 In this interview, Drs. Dipti Itchhaporia and Nabil Farag discuss "What's the Best Time to Revascularize the Non-culprit Lesions in MVD." 

 Suggested Materials: 

1. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes [published correction appears in Eur Heart J. 2024 Apr 1;45(13):1145. doi: 10.1093/eurheartj/ehad870.]. Eur Heart J. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191 

1. Mehta SR, Wood DA, Meeks B, et al. Design and rationale of the COMPLETE trial: A randomized, comparative effectiveness study of complete versus culprit-only percutaneous coronary intervention to treat multivessel coronary artery disease in patients presenting with ST-segment elevation myocardial infarction. Am Heart J. 2019;215:157-166. doi:10.1016/j.ahj.2019.06.006 

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Cardiogenic shock remains a critical, time-sensitive emergency with a high mortality rate. However, recent advances—particularly multidisciplinary, team-based strategies—have shown promise in improving patient outcomes.  With the release of the 2025 ACC Concise Clinical Guidance on Cardiogenic Shock, clinicians now have access to a streamlined, evidence-informed roadmap for early recognition, rapid stabilization, and escalation of care.  

 In this episode, Drs. Glenn A. Hirsch and Shashank S. Sinha explore the latest strategies in cardiogenic shock management in 2025, emphasizing the how the new guidance integrates clinical decision-making tools and highlighting the role of shock teams and regional partnerships in optimizing care delivery. 

 SUGGESTED MATERIALS:   

1. Sinha SS, Geller BJ, Katz JN, et al; American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; and Council on Kidney in Cardiovascular Disease. Evolution of Critical Care Cardiology: An Update on Structure, Care Delivery, Training, and Research Paradigms: A Scientific Statement From the American Heart Association. Circulation. 2025 Feb 13. doi: 10.1161/CIR.0000000000001300. Epub ahead of print. PMID: 39945062.  

1. Hall EJ, Agarwal S, Cullum CM, Sinha SS, Ely EW, Farr MA. Survivorship After Cardiogenic Shock. Circulation. 2025 Jan 21;151(3):257-271. doi: 10.1161/CIRCULATIONAHA.124.068203. Epub 2025 Jan 21. PMID: 39836757.  

1. Ton VK, Li S, John K, et al. Serial Shock Severity Assessment Within 72 Hours After Diagnosis: A Cardiogenic Shock Working Group Report. J Am Coll Cardiol. 2024 Aug 1:S0735-1097(24)07740-4. doi: 10.1016/j.jacc.2024.04.069. Epub ahead of print. PMID: 39217545.  

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Heart failure arises when the heart is unable to pump or fill with blood effectively. In the cardiac catheterization lab, we have the unique ability to directly measure the physiological abnormalities underlying this condition, making it the gold standard for diagnosing heart failure. While not every patient requires heart catheterization, it is often essential for those with heart failure with preserved ejection fraction (HFpEF). This is because noninvasive tests, which are commonly used, frequently fall short—providing false reassurance and leading to missed diagnoses. As a result, HFpEF remains underrecognized. And ultimately, a condition that goes unrecognized cannot be properly treated. 

In this interview, Drs. Matthew Martinez and Barry Borlaug discuss "Hemodynamic Assessment for Diagnosis and Treatment Selection in HFpEF." 

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The SOUL trial demonstrated that in patients with type 2 diabetes (T2DM) and established atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), or both, treatment with oral semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE) compared to placebo—without an increase in serious adverse events. These findings position oral semaglutide as a compelling option with cardiovascular benefits consistent with those seen in injectable GLP-1 receptor agonists. 

 In this episode, Drs. Deepak L. Bhatt and Darren K. McGuire explore how the SOUL trial further strengthens the favorable risk-benefit profile of oral semaglutide for patients with T2DM and coexisting ASCVD and/or CKD, highlighting its potential to reshape cardiovascular risk management in this high-risk population. 

 SUGGESTED MATERIALS 

1. McGuire DK, Marx N, Mulvagh SL, et al.; SOUL Study Group. Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. N Engl J Med. 2025 Mar 29. doi: 10.1056/NEJMoa2501006. Epub ahead of print. 

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The SMART-CHOICE 3 trial demonstrated that clopidogrel monotherapy is more effective than aspirin monotherapy in reducing the risk of major adverse cardiac and cerebrovascular events in high-risk patients who completed standard dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). Despite concerns that more potent antiplatelet agents may increase bleeding risk, the study found that clopidogrel significantly reduced ischemic events—including myocardial infarction and all-cause death—without increasing bleeding risk, making it a highly favorable option for long-term maintenance therapy. 

 In this episode, Drs. Allen J. Taylor and Joo-Yong Hahn discuss the clinical implications of these findings and offer insights into selecting the optimal single antiplatelet regimen after PCI. 

  SUGGESTED MATERIALS 

1. Choi H, Park H, Lee JY, et al. Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial. Lancet. 2025;405(10486):1252-63. doi: 10.1016/S0140-6736(25)00449-0. 

1. Koo BK, Kang J, Park KW, et al.; HOST-EXAM investigators. Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial. Lancet. 2021;397(10293):2487-2496. doi: 10.1016/S0140-6736(21)01063-1. 

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The DapaTAVI trial, conducted across 39 centers in Spain, is the first study to evaluate the use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, specifically dapagliflozin, in patients with heart failure undergoing transcatheter aortic valve implantation (TAVI). The trial found that patients who received dapagliflozin (10 mg daily) within 14 days of hospital discharge after TAVI experienced a 28% relative risk reduction in the composite outcome of all-cause mortality or worsening heart failure at one year, compared to those receiving standard care  

 In this episode, Drs. Allen J. Taylor and Sergio Raposeiras Roubin discuss the safety and clinical benefits of initiating dapagliflozin—or other SGLT-2 inhibitors—in patients undergoing TAVI who are at risk for heart failure, emphasizing its potential to improve outcomes in this high-risk population. 

  SUGGESTED MATERIALS 

1. Raposeiras-Roubin S, Amat-Santos IJ, Rossello X, et al.; the DapaTAVI Investigators. Dapagliflozin in patients undergoing transcatheter aortic-valve implantation. N Engl J Med 2025;392:1396-14. Doi: 10.1056/NEJMoa2500366 

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The PRAGUE-25 study evaluated the effectiveness of two treatment strategies in patients with both atrial fibrillation (AF) and obesity: catheter ablation versus lifestyle modification (including weight loss and increased physical activity) combined with antiarrhythmic drug therapy. While motivated patients who adhered to lifestyle changes experienced a reduction in AF episodes, the study found that catheter ablation was significantly more effective in achieving and maintaining sinus rhythm. 

In this episode, Drs. Joseph Marine and Pavel Osmancik discuss the trial's findings, highlighting that catheter ablation outperformed lifestyle modification and medication in restoring and sustaining normal heart rhythm. 

SUGGESTED MATERIALS 

1. Osmancik P, Havránek Š, Bulková V, et al. Catheter ablation versus antiarrhythmic drugs with risk factor modification for treatment of atrial fibrillation: a protocol of a randomised controlled trial (PRAGUE-25 trial). BMJ Open. 2022 Jun 15;12(6):e056522. doi: 10.1136/bmjopen-2021-056522. 

1. Pathak RK, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Wong CX, Twomey D, Elliott AD, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol. 2015 May 26;65(20):2159-69. doi: 10.1016/j.jacc.2015.03.002.  

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A Global Cardiovascular Risk Consortium study of nearly 2 million people worldwide found that avoiding five modifiable risk factors—hypertension, hyperlipidemia, abnormal weight, diabetes, and smoking—by age 50 added over a decade of life expectancy for both sexes. Midlife control of systolic blood pressure and smoking yielded the greatest global gains. 

In this interview, Drs. Roger S. Blumenthal and Christina Magnussen discuss how this landmark study moves beyond a predominantly North American and European focus, translating abstract risk factors into tangible years of healthy life for patients. 

SUGGESTED MATERIALS 

1. The Global Cardiovascular Risk Consortium. Global effect of cardiovascular risk factors on lifetime estimates. NEJM. Published online March 30, 2025. Doi: 10.1056/NEJMoa2415879 

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The ZENITH trial evaluated sotatercept, an activin signaling inhibitor, in patients with advanced pulmonary arterial hypertension (PAH) at high risk of death. Sotatercept met its primary endpoint—time to first morbidity or mortality event—prompting an independent data monitoring committee to recommend early trial termination and offer the drug to all participants. 

In this interview, Drs. Allen J. Taylor and Marc Humbert discuss how ZENITH highlights sotatercept's clinical benefit even in the sickest PAH patients, offering renewed hope for a disease long seen as unrelenting. 

 SUGGESTED MATERIALS 

1. Humbert M, McLaughlin VV, Badesch DB, et al., for the ZENITH Trial Investigators. Sotatercept in Patients With Pulmonary Arterial Hypertension at High Risk for Death. N Engl J Med 2025;Mar 31:[Epub ahead of print]. 

2. Hoeper MM, Badesch DB, Ghofrani HA, et al.; STELLAR Trial Investigators. Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension. N Engl J Med 2023;388:1478-90.  

3. Humbert M, McLaughlin V, Gibbs JSR, et al.; PULSAR Trial Investigators. Sotatercept for the treatment of pulmonary arterial hypertension. N Engl J Med 2021;384:1204-15. 

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The "Cardiac Arrest During Long-Distance Running Races: 2010–2023" study analyzed the incidence and outcomes of sudden cardiac arrests (SCAs) occurring during marathons and half-marathons in the United States. Known as the RACER2 study, it serves as a follow-up to the original RACER1 study, which covered the years 2000–2009. 

 In this episode, Drs. Jonathan H. Kim and Aaron L. Baggish discussed the study findings, emphasizing the importance of continued vigilance and preparedness to further reduce the risk of fatal outcomes during endurance events. 

 SUGGESTED MATERIALS  

 1. Kim JH, Rim AJ, Miller JT, et al. Cardiac Arrest During Long-Distance Running Races. JAMA. Published online March 30, 2025. doi:10.1001/jama.2025.3026. 

2. Kim JH, Malhotra R, Chiampas G, d'Hemecourt P, Troyanos C, Cianca J, Smith RN, Wang TJ, Roberts WO, Thompson PD, Baggish AL; Race Associated Cardiac Arrest Event Registry (RACER) Study Group. Cardiac arrest during long-distance running races. N Engl J Med. 2012;366:130-40.  

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The menopause transition marks a pivotal period of cardiometabolic change that significantly elevates cardiovascular (CV) risk in women. Despite its clinical importance, this phase remains underrecognized in CV risk assessment, contributing to a profound knowledge gap. Enhancing clinician education and fostering multidisciplinary collaboration are essential to delivering individualized care that addresses both symptom burden and long-term CV outcomes. By prioritizing this life stage, we can improve prevention strategies and reduce the overall burden of cardiovascular disease in women. 

In this interview, Drs. Alison L. Bailey and Lily Dastmalchi discuss "Improving Cardiovascular Clinical Competencies for Menopausal Transition". 

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The 2025 ACC/AHA Acute Coronary Syndrome guideline is the first major update since 2013, incorporating a decade of new evidence and clinical insights. The writing committee stayed on track and on time, reaching consensus on key recommendations, including checklist-based Class I and II interventions before discharge. They thoughtfully addressed legacy practices and controversial studies to ensure clarity and relevance. While some emerging data didn't meet the threshold for formal inclusion, areas like discharge antiplatelet therapy, coronary imaging, and mechanical support devices were flagged as important for clinicians to monitor. The result is a practical, evidence-based tool to guide bedside decision-making. 

In this interview, Drs. Roxana Mehran and Sunil V. Rao take listeners "Behind the 2025 Acute Coronary Syndrome Guidelines." 

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The 2025 ACC/AHA Acute Coronary Syndrome (ACS) Guideline clarifies diagnostic distinctions using electrocardiogram changes, troponin levels, and imaging tools such as coronary CT angiography and echocardiography in the emergency setting. Updates in lipid-lowering strategies and antiplatelet therapy reflect a more personalized approach to risk reduction and long-term care. These recommendations aim to streamline acute decision-making and improve outcomes across the ACS spectrum. 

In this interview, Drs. Sidney C. Smith Jr. and Michelle L. O'Donoghue discuss "Top Takeaways From the 2025 ACC/AHA Acute Coronary Syndrome Guideline." 

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