Trials and Fibrillations with Dr John Mandrola

 
 

Trials and Fibrillations with Dr John Mandrola

  • ESC 2019 Will DAPA-HF Turn the Tide on Heart Failure? The term gamechanger is overused but may be appropriate for the DAPA-HF trial on the SGLT2 inhibitor dapagliflozin in patients with heart failure and reduced ejection fraction. Medical conservative John Mandrola, MD, was impressed.
  • ESC 2019 When Guideline Authors Dismiss Important Studies Why does a guideline document on chronic coronary disease exclude the landmark ORBITA trial? Perhaps it's an existential tension, suggests John Mandrola, MD.
  • ESC 2019 PARAGON-HF: Heart Failure With Preserved EF Proves a Tough Foe Given the few effective therapies for HFpEF, should a new expensive drug be adopted on the basis of a borderline clinical trial result? John Mandrola, MD, weighs in.
  • ESC 2019 Mandrola Previews ESC 2019 Read what John Mandrola, MD, is looking forward to in Paris. Despite some advance spoilers, there will be plenty to pique the interest of the average cardiologist.
  • In Defense of Digoxin -- No, It's Not a Killer Drug The much-maligned cardiac glycoside has been skewered by weak observational data, according to a clever analysis of the DIG trial.
  • Is Cardiology Overly Enamored of New Unproven Therapies? A review of many cases where study data reversed a common medical practice highlights the need to be slow to embrace unproven therapies and faster to de-adopt ineffective ones, says John Mandrola, MD.
  • Just Say No to the ICD in Patients With Kidney Disease Little evidence supports the use of ICDs in patients with kidney disease. A bold new study in patients on dialysis suggests that the devices should be avoided. John Mandrola, MD, weighs in.
  • HRS 2019 Should ICDs in Primary Prevention Go the Way of Aspirin? Do historic recommendations on ICD use for primary prevention in patients with ischemic heart failure still hold as background therapies and the patient population evolve, asks John Mandrola, MD.
  • HRS 2019 From Medical Skeptic to Researcher: The View From the Other Side Critiquing studies is all very well until you’re one of the co-authors. John Mandrola, MD feels the heady joy of having a late-breaking clinical trial at a major meeting and the temptation to ‘spin’.
  • HRS 2019 We Still Need a Sham-Controlled Trial for AF Ablation Catheter ablation for atrial fibrillation has yet to be put to the ultimate test of a sham-controlled trial. John Mandrola, MD, makes the case for doing one now.
  • ACC 2019 Taking the Pulse of the Apple Heart Study What did we really learn from the study using a smart watch and phone app to identify atrial fibrillation? New ways to conduct research, but not much to advance practice, argues John Mandrola, MD.
  • ACC 2019 A Sobering Breakthrough in AF Care Frequent alcohol drinkers with atrial fibrillation benefitted from abstinence in a novel randomized trial, which prompts the question: Should temperance be prescribed before meds and procedures?
  • ACC 2019 Boom: TAVR Low-Risk Trials Usher in a New Era in Cardiology The results are impressive for transcatheter aortic valve replacement in low-surgical-risk patients, but longer-term data on durability will be crucial, notes John Mandrola, MD.
  • ACC 2019 Quick Thoughts on the Wrap-IT Trial An antibiotic-impregnated envelope casing for cardiac implantable devices may lower the risk for infection, but is it enough to justify the costs?
  • ACC 2019 Mandrola Previews the 2019 ACC Meeting The Apple Heart Study will hog the spotlight, but trials on TAVR in low-risk aortic stenosis are more likely to affect practice, says digital-health skeptic John Mandrola, MD. Links
  • Broken PROMISE: CTA for Suspected CAD in Patients With Diabetes A flawed post hoc analysis was critiqued on social media, but why didn't peer review catch the weaknesses, asks John Mandrola, MD.
  • Ten Thoughts on the 2019 AF Treatment Guidelines John Mandrola, MD, agrees with a lot of the updates in the new atrial fibrillation guidelines but worries that color-coded tables of recommendations oversimplify the nuances of clinical decision making.
  • Mandrola's Top 10 Cardiology Stories of 2018 From blood pressure management in the community to a study on potentially biased referees -- John Mandrola reviews his picks for the year's big stories in cardiology and medicine.
  • Treating the Individual, Not the 'Average' Patient Using SPRINT trial data, researchers calculated a score to allow clinicians to measure how close their patient matches the study participants. John Mandrola, MD, sees a means to individualize therapy.
  • AHA 2018 Think You're Immune From Bias? Think Again John Mandrola, MD, is intrigued by two studies at AHA that track the cognitive and financial biases that may influence what physicians do in practice and how they write and read research papers.