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ISCHEMIA trial, DAPA-HF, and valsartan recall: AHA Special

32m · MDedge Cardiocast · 26 Nov 09:00

In this special meeting edition of the Cardiocast, MDedge Cardiology editor Catherine Hackett is joined by MDedge reporters Mitchel L. Zoler, Bruce Jancin, and Richard Mark Kirkner. 

The MDedge cardiology team reviews three big stories from the 2019 annual scientific sessions of the American Heart Association in Philadelphia. 

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ISCHEMIA trial hailed as practice changing

The results of the ISCHEMIA trial were emphatically declared practice changing by interventional cardiologists and noninterventionalists alike at the AHA meeting. 

Bruce Jancin discusses the story.

DAPA-HF: Dapagliflozin's HFrRF efficacy confirmed in nondiabetes

The results in nondiabetics from the practice-changing DAPA-HF trial gives clinicians strong evidence that the diabetes drug dapagliflozin is equally effective at reducing cardiovascular death and acute exacerbations in heart failure patients regardless of diabetes status. 

Mitchel L. Zoler discusses this report. 

Weakness exposed in valsartan recall

ED visits for hypertension in the month after the 2018 recall spiked 55%. The 2018 recall of generic forms of the antihypertensive drug valsartan exposed weaknesses in the recall systems for generics in both the U.S. and Canada that caused many patients who were on the drug to fall through the cracks. 

Richard Mark Kirkner goes deeper into this story. 

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The episode ISCHEMIA trial, DAPA-HF, and valsartan recall: AHA Special from the podcast MDedge Cardiocast has a duration of 32:06. It was first published 26 Nov 09:00. The cover art and the content belong to their respective owners.

More episodes from MDedge Cardiocast

Top stories from the American Heart Association scientific sessions

ISCHEMIA trial hailed as practice changing
The largest-ever RCT of initial invasive versus conservative management of stable ischemic heart disease makes waves.

DAPA-HF: Dapagliflozin’s HFrEF efficacy confirmed in nondiabetics
Further analyses from the DAPA-HF trial showed dapagliflozin cut death and heart failure events in HFrEF patients with no diabetes.

Colchicine cut post-MI CVD events
Colchicine fulfilled the promise first seem in CANTOS that anti-inflammatory treatment can reduce cardiovascular disease events.

Getting high heightens stroke, arrhythmia risks
Cannabis use or abuse among the young was associated with adverse cardiovascular consequences in two studies.

Editor's note: This is the final episode of the MDedge Cardiocast. On behalf of Dr. Jim Dwyer and all of us at MDedge, thank you for supporting Cardiocast.

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Vascepa gains event-reduction nod; diabetes ups ischemic risks

Vascepa approved for cardiovascular risk reduction
The FDA’s decision on cutting events in high-risk patients was based primarily on the REDUCE-IT trial.

ENGAGE AF-TIMI: Insulin linked to greater risk for stroke, CV death, bleeding
Novel oral anticoagulants may be preferred over warfarin in patients with diabetes and AFib.

HHS drug importation proposals aim to address high costs
Trump administration drops key health care proposal on day of impeachment vote.

End ‘therapeutic nihilism’ in care of older diabetic patients, says expert
‘It’s not hyperglycemia that’s killing people; it’s heart disease and renal disease.’

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Post-STEMI events less likely in women; bariatric surgery may lower stroke risk

Women have fewer cardiovascular events after non–ST-segment elevation ACS
But they also remain undertreated with guideline-directed therapies.

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FDA panel rejects vernakalant bid for AFib cardioversion indication
Eleven years after the first attempt of the antiarrhythmic agent, the FDA panel voted resoundingly against approval.

Bariatric surgery tied to fewer cerebrovascular events
The incidence of cerebrovascular events was 65% lower in obese people who underwent bariatric surgery compared with those without surgery

Intensive BP control cut dementia but increased brain atrophy and hurt cognition
The small but significant ill effects worried some researchers at the Clinical Trials on Alzheimer's Disease conference.

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New trick for old drug; Vascepa cost effective for CV reduction

Icosapent ethyl cost effective in REDUCE-IT analysis
Treatment with the fish-derived drug Vascepa for CV event reduction is more effective and less costly than placebo.

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DAPA-HF: Dapagliflozin benefits regardless of age, HF severity
The SGLT2 inhibitor had similar efficacy in the elderly and across the spectrum of baseline symptom status.

Colchicine cut post-MI CVD events
Colchicine fulfilled the promise first seem in CANTOS that anti-inflammatory treatment can reduce cardiovascular disease events.

Cardiac arrests peak with pollution in Japan
The incidence of out-of-hospital cardiac arrests in Japan increased on days when counts of particulate matter spiked from the day before.

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Card Talk: TAVR and glass ceilings

This week’s Cardiocast is devoted entirely to Card Talk with cardiologist brothers Jim and Jerry Dwyer. They welcome two structural interventionalists at the Structural Heart and Valve Center at Emory Healthcare, Kendra J. Grubb, MD, and Isida Byku, MD. Both followed a unique track, training in both cardiac surgery and interventional cardiology and practicing in the fast-moving field of structural heart disease.

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From the “picture that went around the world” of an all-female transcatheter aortic valve replacement team at Emory to advances in structural heart disease treatment, this interview includes expanding TAVR beyond the aortic valve and interventional heart failure treatment using “hooks and anchors and pulleys” to reshape the heart.

Dr. Grubb is assistant professor in surgery and medicine at Emory University in Atlanta and surgical director of the Structural Heart and Valve Center at Emory Healthcare. On Twitter @KendraGrubb. She is an adviser, consultant, and/or speaker for Boston Scientific, Edwards, and Medtronic. She is also a principal investigator in Medtronic’s Optimize PRO trial and Ancora’s CorCinch PMVI studies.

Dr. Isida Byku is an assistant professor at Emory University. On Twitter @IsidaByku. She has no disclosures. 

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