Eagle's Eye View: Your Weekly CV Update From ACC.org

In this week's View, Dr. Eagle looks at the feasibility of mechanical leaflet splitting in high-risk patients undergoing valve-in-valve TAVR. He follows this with an examination of lower ambient temperature and it association with greater SCA risk at marathon races, then offers a commentary on two studies that provide new insights on the durability of pulmonary vein isolation (PVI) with pulsed field ablation (PA) vs radiofrequency ablation IRF) in patients with persistent atrial fibrillation (AFib). Finally, Dr. Eagle discusses the SHaRe Registry and its use in predicting major adverse cardiovascular events MACE for patients with mild hypertrophic cardiomyopathy (HCM).
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In this week's View, Dr. Eagle looks at withdrawing guideline-directed medical therapy (GDMT) for patients with atrial fibrillation (AF). He follows this with commentary on two important recently released ACC scientific statements: one on anti-platelet therapy for atherosclerotic cardiovascular disease (ASCVD), and the other examining the use of direct oral anticoagulants (DOACs) for primary and secondary prevention of thrombotic events. Finally, Dr. Eagle summarizes a recent longitudinal study on sugar-sweetened beverages and fruit juice and their potential relationship to the development of hypertension later in a young person's life.  

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In this week's View, Dr. Eagle looks at how genotype independently predicts heart failure outcomes in patients with hypertrophic cardiomyopathy (HCM). He then examines the ten-year follow-up of the PARTNER 2A trial and compares the transcatheter aortic valve replacement (TAVR) outcomes to results from the Partner 2 SAPIEN XT and SAPIEN 3 studies. He follows this with a report on how clopidogrel may offer a long-term edge over aspirin after percutaneous coronary intervention (PCI). Finally, Dr. Eagle summarizes HELIUS cohort findings demonstrating that LDL-C, Lp(a), and hsCRP provide complementary, independent insights for identifying long-term atherosclerotic cardiovascular disease (ASCVD) risk across diverse ethnic populations. 

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In this week's View, Dr. Eagle reviews 21-year follow-up data from the Diabetes Prevention Program (DPP), showing that lifestyle intervention—but not metformin—reduces multimorbidity risk in prediabetes. He also highlights low rates of hypertension and hyperlipidemia treatment among U.S. adults with cardiovascular-kidney-metabolic (CKM) syndrome, and summarizes evidence that resistance training, particularly when combined with aerobic exercise, is associated with a lower risk of cardiovascular (CV) disease, especially myocardial infarction, in women. Finally, he discusses the CAMERA-MRI II study in patients with atrial fibrillation and left ventricular systolic dysfunction (LVSD), where catheter ablation significantly improved left ventricular ejection fraction (LVEF) regardless of late gadolinium enhancement status. 

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In this week's View, Dr. Eagle highlights a study showing race and sex disparities in M-TEER outcomes, with Black patients presenting with more advanced disease, lower success, and higher heart failure readmissions than White patients, and women having lower success rates than men. He reviews the SOGALDI-PEF trial, where patients with low plasma renin levels experienced greater blood pressure reduction with spironolactone/dapagliflozin compared to dapagliflozin alone. Next, he discusses the FAVOR III trial, which found that QFR-guided percutaneous coronary intervention improved five-year outcomes versus angiography guidance, with most benefits occurring in the first two years. Lastly, Dr. Eagle examines two renal disease studies addressing optimal chronic kidney disease (CKD) GFR thresholds and the benefits of finerenone in CKD patients.