This Week in Cardiology

The moderate aortic stenosis TAVR trial, blinded withdrawal in the DECISION digoxin trial, CTO-PCI vs no CTO-PCI 10-year results, and the P4 trial are the topics John Mandrola, MD, discusses in 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 PROGRESS Trial
PROGRESS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607326
PROGRESS Trial Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2613400
Genereux Classification https://academic.oup.com/eurheartj/article/38/45/3351/4002776
II Withdrawing Digoxin in the DECISION trial
DECISION Trial Substudy https://academic.oup.com/eurheartj/article/47/38/5545/8674856
DECISION Trial - Main Trial https://www.nature.com/articles/s41591-026-04406-6
Efficacy and Safety of Digitalis Glycosides in HF: Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2848972
RADIANCE trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101
PROVED trial https://www.jacc.org/doi/10.1016/0735-1097(93)90403-N
III DECISION CTO Trial at 10 Years
DECISION-CTO Trial 10-Year Outcomes 10.1016/j.jacc.2026.10.068
DECISION-CTO Main paper https://doi.org/10.1161/CIRCULATIONAHA.118.031313
EURO-CTO trial https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusions
COMET-CTO trial https://pmc.ncbi.nlm.nih.gov/articles/PMC9868942/
EXPLORE Trial https://www.ahajournals.org/doi/10.1161/JAHA.123.033556
ORBITA-CTO trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.027
IV The P4 Trial
Coronary CT Angiography Cuts Procedural Time Relative to IVUS-Guided PCI https://www.medscape.com/viewarticle/coronary-ct-angiography-cuts-procedural-time-relative-ivus-2026a1001684
P4 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2610771
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

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The ASPIRED syncope RCT, two studies in coronary artery calcium scoring, and the LEAP-Block trial of CSP vs RV pacing are the topics John Mandrola, MD, discusses in 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 Syncope
ASPIRED Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2605812
REMOSYNCED Trial https://clinicaltrials.gov/study/NCT05066347
II TWO CAC Studies
Atherosclerosis in Young Adults and Risk of Mortality Over 30 Years https://jamanetwork.com/journals/jamacardiology/fullarticle/2855732
Predictive Utility of CAC Score Added to PREVENT Score https://jamanetwork.com/journals/jama/fullarticle/2853347
III Conduction System Pacing vs Standard RV Pacing for AV block
LEAP-Block Trial https://jamanetwork.com/journals/jama/fullarticle/2855975
Meta-analysis: CSP vs RV Pacing in Preserved or Mildly Reduced EF https://doi.org/10.1016/j.cjca.2026.04.009
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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
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Listener feedback on the nonobstructive HCM trials, AI-enhanced visits, timing of non-culprit PCI in STEMI, new tricuspid valve intervention, and EP at a crossroads are the topics John Mandrola, MD, discusses in 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
Koelemen meta-analysis https://www.medrxiv.org/content/10.64898/2026.09.08.26362195v1.full.pdf
Improving SCD Risk Stratification in HCM https://pmc.ncbi.nlm.nih.gov/articles/PMC11026183/
II More on Nonobstructive HCM
Communication on Post-Hoc Analysis of ODYSSEY (mavacamten)
Mavacamten in Nonobstructive HCM 10.1016/j.jacc.2025.12.092
III Complete vs Staged PCI in STEMI With Multivessel Disease
Immediate vs Staged CR in Multivessel Disease and STEMI: Meta-Analysis https://doi.org/10.1016/j.jcin.2026.07.033
Timing of Nonculprit PCI for STEMI and Multivessel Disease: Editorial https://doi.org/10.1016/j.jcin.2026.08.009
COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
FLOWER MI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2104650
FRAME AMI Trial https://doi.org/10.1093/eurheartj/ehac763
iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918
COCUA Trial https://doi.org/10.1016/j.ahj.2023.01.020
MULTISTARS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307823
OPTION STEMI Trial 10.1016/S0140-6736(25)01529-6 External Link
CULPRIT SHOCK Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1710261
BioVasc Trial Substudy https://eurointervention.pcronline.com/article/immediate-versus-staged-complete-revascularisation-in-patients-presenting-with-stemi-and-multivessel-disease
Main BioVasc Trial 10.1016/S0140-6736(23)00351-3 External Link
FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
IV A Call to Action for Electrophysiologists
Twenty Years at the Crossroads 10.1016/j.jacep.2026.09.023
EP at a Crossroads - Josephson 2007 https://doi.org/10.1016/j.hrthm.2006.12.045
EP at a Crossroads: A Revisit - Josephson 2016 https://doi.org/10.1016/j.hrthm.2016.07.024
V FDA Approves Another Tricuspid Valve Repair System
Press release https://www.edwards.com/newsroom/news/2026-10-21-fda-approval-of-edwards-lifesciences--pascal-preci
TRIC I HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2606934
CLASP II TR Trial https://pubmed.ncbi.nlm.nih.gov/42855029/
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

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Some promising studies in amyloidosis, aficamten in nonobstructive HCM, costs of the microaxial flow pump in cardiogenic shock, and more on the VESALIUS trial of evolocumab are the topics John Mandrola, MD, discusses in 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 Light Chain Amyloidosis – A Potentially Helpful Drug
Anselamimab Does Not Reduce Light-Chain Amyloidosis Deaths
https://www.medscape.com/viewarticle/anselamimab-does-not-reduce-light-chain-amyloidosis-deaths-2026a1000z79
II Aficamten in Nonobstructive HCM: The ACACIA trial
III Microaxial Flow Pump Cost Analysis of Danger Shock
IV More on Evolocumab at ESC: Vesalius Trial Substudies
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
https://www.medscape.com/viewarticle/1003092

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Listener feedback on POET II, sham control trials in atrial fibrillation, ICDs in HCM, and agenda laundering are the topics John Mandrola, MD, discusses in 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
POET II Response-Tailored or Standard-Duration ABX for Infectious Endocarditis
POET I Trial https://www.nejm.org/doi/10.1056/NEJMoa1808312
POET II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607887
II PVI-SHAM-AF trial Back in the News
GAP-AF Trial https://www.ahajournals.org/doi/10.1161/circep.115.003337
PVI-SHAM-AF Trial 10.1016/S0140-6736(26)01558-8 External Link
Why Sham Studies Are a Sham in 2026 10.1016/j.hrthm.2026.09.056 External Link
The Indispensable Role of Sham Controls in Evaluating Interventional Therapies 10.1016/j.hrthm.2026.10.001 External Link
III ICDs in HCM
I CDs for the Prevention of SCD in High-Risk Patients with HCM https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.078597
ICDs in HCM: Editorial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079687
IV Agenda Laundering
How Commercial “Agenda Laundering” Shapes Critical Care https://www.bmj.com/content/395/bmj-2026-100963
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

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