PACUPod: Cardiology

This PACUPod episode reviews Wu et al.'s randomized trial in JAMA Network Open evaluating early cardiac rehabilitation initiated during the CICU for patients with acute decompensated heart failure. In this single-center study of 120 high-risk CICU patients, participants were randomized to an early, progressive, personalized cardiac rehab program during CICU stay (AHF-CR) or to usual care without s...

In this episode, hosts Britany and Seth unpack the prospective Murcia AF Project III (MAFP-III) cohort study, which investigates remnant cholesterol (RC) and LDL-C discordance as predictors of thromboembolic events in patients with atrial fibrillation on oral anticoagulation. They explain how RC reflects triglyceride-rich lipoproteins (VLDL/IDL), how RC is calculated from standard lipid panels (to...

Myocardial bridge (MB) is a common congenital coronary anomaly where a coronary artery tunnels through the myocardium, causing systolic compression. This PACUPod overview examines whether single antiplatelet therapy (APT), such as aspirin, provides ischemic protection for MB patients without other indications, and how the RIALTO registry informs clinical practice. The ambispective study analyzed 2...

This PACUPod episode reviews a secondary analysis of the SUMMIT trial investigating how baseline adiposity (BMI and central adiposity via waist-height ratio) and weight loss influence tirzepatide's benefits in obesity-related HFpEF. The discussion covers study design, primary outcome (time to cardiovascular death or worsening heart failure), and secondary outcomes (KCCQ-CSS, six-minute walk distan...

PACULit examines the SOGALDI-PEF trial, the first randomized crossover study comparing dapagliflozin alone versus dapagliflozin plus spironolactone in heart failure with preserved or mildly reduced ejection fraction (HFpEF/HFmrEF). The episode discusses the rationale for combining an SGLT2 inhibitor with a mineralocorticoid receptor antagonist, the primary NT-proBNP endpoint as a surrogate for car...

This PACUPod episode summarizes Barry et al.'s population-based cohort study on the impact of post-CABG P2Y12 inhibitors (primarily clopidogrel) on major adverse cardiovascular events. Using data from British Columbia (2002–2020) involving over 15,000 adults undergoing isolated CABG, exposure was defined as filling a P2Y12 inhibitor prescription within 30 days after surgery, compared with aspirin...

A concise overview of a prospective controlled cohort study assessing whether adding low-dose colchicine (0.5 mg daily) to stable vitamin K antagonist (VKA) therapy in adults with chronic coronary disease affects anticoagulation control. Primary outcome: INR changes; secondary outcomes: VKA dose adjustments and time in therapeutic range (TTR). Findings: initiation, continuation, or withdrawal of l...

This PACULit episode reviews the PRAGUE-25 randomized multicenter noninferiority trial comparing catheter ablation with lifestyle modification plus guideline-directed antiarrhythmic drugs in adults with obesity (BMI 30–40) and paroxysmal or persistent atrial fibrillation. The ablation strategy focused on pulmonary vein isolation, while the lifestyle arm emphasized weight loss and physical activity...

This PACULit update summarizes a single-center, prospective observational study (ChangZhou Registry) evaluating whether initiating dapagliflozin during hospitalization for acute myocardial infarction reduces malignant ventricular arrhythmias in elderly patients and affects all-cause mortality over about seven months. In 2,607 patients aged 60 and older with confirmed AMI, those treated with dapagl...

This PACULit episode reviews a large observational cohort study by Aebi et al. using UK CPRD data (2000–2021) to compare new monotherapy users of amlodipine, ramipril, and bendroflūmethylthiazide (bendroflumethiazide) and to assess risk of acute outpatient infections (respiratory, genitourinary, gastrointestinal, sepsis) and SARS-CoV-2 infection during 2020–2021. The primary comparisons were amlo...

A concise episode summarizing a post hoc analysis of the STEP trial that investigates how baseline cardiovascular risk modifies the balance of benefits and harms of intensive blood pressure control in older hypertensive adults. We cover study design, key findings (overall reduction in cardiovascular events with intensive targets, modest non-significant rise in adverse events), risk-stratified resu...

In this PACUPod episode, we review a pragmatic, cluster-randomized trial evaluating AI-assisted interpretation of standard 12-lead ECGs to identify atrial fibrillation and prompt guideline-directed oral anticoagulant therapy in hospitalized patients managed by non-cardiologists across two Taiwanese hospitals. The AI sends alerts with actionable recommendations to consider AF diagnosis and initiate...

This PACULit episode reviews a phase 3, randomized, open-label multicenter trial evaluating edoxaban started within three months after surgical bioprosthetic valve replacement (aortic and/or mitral) compared with warfarin. The primary outcome was stroke or systemic embolism; edoxaban showed 0.5% vs 1.5% in warfarin with a risk difference of −1.03% (95% CI −4.34% to 1.95%), indicating comparable ef...

In this PACUPod episode, the study by Augustine et al. on pharmacist-led transitions of care (TOC) after hospitalization for acute myocardial infarction (AMI) is examined. The real-world, single-center pre-post design compares outcomes before and after implementing a TOC service focused on medication reconciliation, patient education, and discharge optimization. The primary outcome was 90-day card...