JACC Deep Dive

Dr. Harlan Krumholz reviews the STEP trial, which studied over 8,500 older adults in China to compare intensive versus standard blood pressure control. The trial found that lowering systolic blood pressure to 110–130 mm Hg significantly reduced major cardiovascular events by 26% without added safety risks, confirming benefits previously shown in the SPRINT trial. A six-year follow-up revealed a la...

In this episode of JACC Deep Dive, Editor-in-Chief Dr. Harlan Krumholz explores groundbreaking findings from the CLEAR-IE registry—the largest study to date on percutaneous mechanical aspiration (PMA) for right-sided infective endocarditis. He discusses the procedure's feasibility, outcomes, and its role alongside surgery, offering insights into how PMA may reshape treatment options for high-risk...

In this JACC Deep Dive, Dr. Harlan Krumholz highlights a study by Ikemura et al. that used data from the ISCHEMIA trial to model how angina symptoms evolve over three years in patients with stable coronary disease treated either invasively or conservatively. The study identified six distinct symptom trajectories, showing that while most patients improved over time, those undergoing revascularizati...

In this JACC Deep Dive, Dr. Harlan Krumholz discusses a pre-specified analysis from the SUMMIT trial, which evaluated the effects of tirzepatide in patients with heart failure with preserved ejection fraction (HFpEF) and obesity, both with and without type 2 diabetes. The study found that tirzepatide significantly improved symptoms, function, and reduced heart failure events, with similar benefits...

In this Deep Dive, Editor-in-Chief Dr. Harlan Krumholz explores a pragmatic, randomized crossover trial testing whether in-home HEPA filtration can reduce blood pressure in adults living near high-traffic roadways. The findings offer early insights into how targeted environmental interventions may influence cardiovascular risk—especially among individuals with elevated baseline systolic blood pres...

In this episode of JACC Deep Dive, Dr. Harlan Krumholz explores new insights from a post hoc analysis of the MASTER DAPT trial, highlighting the real-world burden of ischemic and bleeding events in high bleeding risk patients after PCI. By examining recurrent—not just first—events, the study sheds light on how abbreviated dual antiplatelet therapy (DAPT) impacts total clinical outcomes. Key findin...

In this episode of JACC Deep Dive, KACC Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC,  explores a post hoc analysis of the HELIOS-B trial, which examined whether echocardiographic parameters can track treatment response in transthyretin amyloid cardiomyopathy (ATTR-CM) patients treated with vutrisiran. The study found that changes in cardiac function correlated with clinical outcomes, suggesti...

JACC focuses in again on Lipids in our June 3 issue, bringing critical insights into emerging targeted therapies. In the June 3 Deep Dive, editor-in-chief Harlan M. Krumholz, MD, SM, FACC, reviews the INTERASPIRE study by Ray et al, reviewing implications, key findings, and a thoughtful summary and analysis of the reviewer findings.

Go behind the scenes with JACC as editor-in-chief Harlan M. Krumholz, MD, SM, FACC, talks about what 's caught his attention in the latest JACC issue on amyloid. In this paper by Sheikh et al, the authors did a pre-specified exploratory analysis from the HELIOS-B trial, evaluating vutrisiran in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). The study showed that vutrisiran helped pr...

Join JACC Editor in Chief Harlan Krumholz, MD, SM, as he speaks about this ACC.25 presentation published in JACC. This fascinating study by Rohan Khera et al independently analyzed patient-level data from the SURMOUNT trials of tirzepatide for obesity. The study revealed striking individual variability in weight loss and metabolic response, even to a highly effective therapy—an insight powerfully...

This JACC Deep Dive in our May 13 issue highlights new findings from the SUMMIT CKD study, showing that terzepatide improves symptoms, function, and weight in patients with HFpEF and obesity—regardless of kidney function. The analysis also underscores the importance of using both creatinine and cystatin C to better assess kidney health. Reviewers praised the study's methodological rigor and dual f...

In this JACC Deep Dive episode, Dr. Harlan Krumholz reviews the ADVANTAGE-AF trial, which evaluated pulse field ablation (PFA) as a treatment for persistent atrial fibrillation. The study demonstrated that PFA is a safe and effective approach, with strong symptomatic outcomes and a low complication rate, though questions remain about long-term durability and the need for more rigorous follow-up. P...

In a Deep Dive in our May 13 issue, Editor-in-Chief Harlan Krumholz, MD, SM, FACC, discusses a study led by Barry Borlaug that investigates whether excess weight or metabolic dysfunction has a greater impact on heart failure with preserved ejection fraction (HFpEF). The findings showed that obesity—more than insulin resistance—was strongly associated with worse hemodynamic and functional outcomes....

In this JACC Deep Dive episode, Editor-in-Chief Dr. Harlan Krumholz discusses a major study on sudden cardiac arrest in young competitive athletes, highlighting survival rates, causes, and racial disparities. The study shows that survival improves dramatically with immediate AED use and has increased over time, emphasizing the need for widespread emergency preparedness and health equity efforts.....

In this in-depth analysis of the Altshock-2 trial (Study on Early Intra-aortic Balloon Pump Placement in Acute Decompensated Heart Failure Complicated by Cardiogenic Shock), Harlan M Krumholz, MD, FACC, goes deep into the study and its two related editorials. Listen here for this unique behind-the-scenes look at the review process, plus a thoughtful summary of the study and the two related editori...

In this JACC Deep Dive, Editor-in-Chief Harlan M. Krumholz, MD, SM, discusses a large real-world study by Min et al. examining heart failure with improved ejection fraction (HFimpEF) in over 24,000 patients. The study found that while EF improvement is common (30%), true remission is rare and relapse occurs in about 25% of cases—highlighting the need for continued guideline-directed medical therap...

JACC's July 29 issue explores why the ACURATE neo2 valve failed in its IDE trial, with a post-hoc analysis pointing to under-expansion in heavily calcified anatomies as a potential culprit. Though the valve is off the market, the findings raise critical questions about procedural success, device design, and future innovation in TAVR. Listen to our Deep Dive narrated by JACC Editor-in-Chief Harlan...

In this JACC Deep Dive, JACC Editor in Chief Harlan M. Krumholz, MD, SM, explores a study led by Dr. Pradeep Natarajan that evaluates how well the new AHA PREVENT risk equations predict cardiovascular events across four major U.S. health systems. The study found wide variation in performance—PREVENT was well-calibrated at Penn Medicine but significantly underestimated risk at Mass General Brigham...

In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC reviews a study by Covani, et al that uses OCT imaging in over 1,500 ACS patients to show how increasing cardiovascular risk factor burden—like smoking, diabetes, and hypertension—is strongly associated with vulnerable plaque features such as thin caps, inflammation, and rupture. The findings were most pronounced in STEMI patients and reinfo...

In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC, discusses a new study in the July 8 issue of JACC, authored by Saket Girotra MD, SM, et al. In the study, which links national registry and Medicare data, the authors found striking hospital-level variation in cardiac arrest rates and outcomes—and identified better nurse staffing as a key factor in both preventing arrests and improving surv...