Dr. Sarah Schaidle discusses factor XI inhibitors and the OCEANIC-AF trial with CardioScripts co-host Dr. Nathan Wayne.

0:00-0:59: Introduction

0:56-4:26: OCEANIC-AF trial overview

4:27-7:08: Overview of Factor XI (FXI) inhibition

7:09-08:29: New drug targets for FXI inhibition

08:30-11:17: OCEANIC-AF trial discussion

14:01-17:03 : Other areas of interest for FXI inhibitors 

17:04-19:23: Ongoing phase 3 trials

19:25-20:10: Final thoughts

20:18-20:46: Closing

References:

OCEANIC-AF

Piccini, Jonathan P., et al. “Asundexian versus apixaban in patients with atrial fibrillation.” New England Journal of Medicine 392.1 (2025): 23-32.

PACIFIC-AF

Piccini, Jonathan P., et al. “Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study.” The Lancet 399.10333 (2022): 1383-1390.

FOXTROT

Weitz, Jeffrey I., et al. “Effect of osocimab in preventing venous thromboembolism among patients undergoing knee arthroplasty: the FOXTROT randomized clinical trial.” Jama 323.2 (2020): 130-139.

AXIOMATIC

Sharma, Mukul, et al. “Safety and efficacy of factor XIa inhibition with milvexian for secondary stroke prevention (AXIOMATIC-SSP): a phase 2, international, randomised, double-blind, placebo-controlled, dose-finding trial.” The Lancet Neurology 23.1 (2024): 46-59.

PACIFIC-AMI

Rao, Sunil V., et al. “A multicenter, phase 2, randomized, placebo-controlled, double-blind, parallel-group, dose-finding trial of the oral factor XIa inhibitor asundexian to prevent adverse cardiovascular outcomes after acute myocardial infarction.” Circulation 146.16 (2022): 1196-1206.

This episode is a rebroadcast of the ACCP Cardiology PRN webinar where Drs. Vicki Groo and Ian Hollis reviewed several different presentations from the ACC and ISHLT meetings. 

This episode is a rebroadcast of the ACCP Cardiology PRN webinar where Drs. Kristen De Almeida and Augustus (Rob) Hough reviewed the DANGER-SHOCK and ULTIMATE-DAPT trials released at the ACC 24 meeting. 

The views expressed in this presentation reflect those of the presenter, and not necessarily those of the Department of Veterans Affairs or Public Health Service.

0:00-1:32: Introduction

1:33-7:14: The DANGER-SHOCK Trial

7:15-12:21: The ULTIMATE-DAPT Trial

12:22-16:27: Questions

16:28-16:59: Closing

References:

DANGER-SHOCK

Møller JE, Engstrøm T, Jensen LO, et al. Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. N Engl J Med. 2024;390(15):1382-1393. doi:10.1056/NEJMoa2312572

ULTIMATE-DAPT

Ge Z, Kan J, Gao X, et al. Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial [published correction appears in Lancet. 2024 May 11;403(10439):1854. doi: 10.1016/S0140-6736(24)00929-2]. Lancet. 2024;403(10439):1866-1878. doi:10.1016/S0140-6736(24)00473-2

This episode is a rebroadcast  of the ACCP Cardiology PRN webinar where Drs. Tracy Macaulay and Bill Larsen reviewed the REDUCE-AMI and EMPACT-MI trials released at the ACC 24 meeting. 

0:00-2:19: Introduction

2:05-9:24: The REDUCE-AMI Trial

9:25-14:19: The EMPACT-MI Trial

14:20-17:58: Questions

17:59-18:36: Closing thoughts

References:

REDUCE-AMI

Yndigegn T, Lindahl B, Mars K, et al. Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction. N Engl J Med. 2024;390(15):1372-1381. doi:10.1056/NEJMoa2401479

EMPACT-MI

Butler J, Jones WS, Udell JA, et al. Empagliflozin after Acute Myocardial Infarction. N Engl J Med. 2024;390(16):1455-1466. doi:10.1056/NEJMoa2314051

Dr. Tomasz Jurga discusses the CLEAR Outcomes trial and current cholesterol management considerations with co-host, Dr. Liz Wang. 

0:00-2:19: Introduction

2:20-7:13: TIME trial overview

7:14-11:18: What is bempedoic acid?

11:19-16:45: What is the current landscape of cholesterol management?

16:46-20:54: Previous CLEAR trials: Tranquility, Serenity, Harmony, Wisdom

20:55-28:55: CLEAR Outcomes overall thoughts

28:56-32:38: Where does bempedoic acid fit into therapy?

32:39-36:27: Approach to statin intolerance

36:28-40:09: Overall approach to reduce ASCVD

40:10-42:58: Closing thoughts

References:

CLEAR Outcomes

Nissen SE, Lincoff AM, Brennan D, et al. Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients. N Engl J Med. 2023;388(15):1353-1364. doi:10.1056/NEJMoa2215024

CLEAR Tranquility

Ballantyne CM, Banach M, Mancini GBJ, et al. Efficacy and safety of bempedoic acid added to ezetimibe in statin-intolerant patients with hypercholesterolemia: A randomized, placebo-controlled study. Atherosclerosis. 2018;277:195-203. doi:10.1016/j.atherosclerosis.2018.06.002

CLEAR Harmony

Ray KK, Bays HE, Catapano AL, et al. Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol. N Engl J Med. 2019;380(11):1022-1032. doi:10.1056/NEJMoa1803917

CLEAR Serenity

Laufs U, Banach M, Mancini GBJ, et al. Efficacy and Safety of Bempedoic Acid in Patients With Hypercholesterolemia and Statin Intolerance. J Am Heart Assoc. 2019;8(7):e011662. doi:10.1161/JAHA.118.011662

CLEAR Wisdom

Goldberg AC, Leiter LA, Stroes ESG, et al. Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial. JAMA. 2019;322(18):1780-1788. doi:10.1001/jama.2019.16585

Pooled meta-analysis of four CLEAR trials:

Banach M, Duell PB, Gotto AM Jr, et al. Association of Bempedoic Acid Administration With Atherogenic Lipid Levels in Phase 3 Randomized Clinical Trials of Patients With Hypercholesterolemia. JAMA Cardiol. 2020;5(10):1124-1135. doi:10.1001/jamacardio.2020.2314

Subanalysis of CLEAR outcomes primary prevention participants:

Nissen SE, Menon V, Nicholls SJ, et al. Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients. JAMA. 2023;330(2):131-140. doi:10.1001/jama.2023.9696

Dr. Ricky Turgeon discusses the TIME Trial with co-host, Dr. Liz Wang.

0:00-1:09: Introduction

1:10-7:16: TIME trial overview

7:17-9:10: When to take blood pressure medications?

9:11-14:37: Previous trials

14:38-19:08: Thoughts on the TIME trial and key takeaways

19:09-19:34: Closing

References:

TIME Trial

Cardiovascular Outcomes in Adults With Hypertension With Evening Versus Morning Dosing of Usual Antihypertensives in the UK (TIME Study): A Prospective, Randomized, Open-Label, Blinded-Endpoint Clinical Trial. Lancet 2022;Oct 11:[Epub ahead of print].

MAPEC

Hermida RC, Ayala DE, Mojón A, Fernández JR. Influence of circadian time of hypertension treatment on cardiovascular risk: results of the MAPEC study. Chronobiol Int. 2010;27(8):1629-1651. doi:10.3109/07420528.2010.510230

Hygia Chronotherapy Trial

Hermida RC, Crespo JJ, Domínguez-Sardiña M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J. 2020;41(48):4565-4576. doi:10.1093/eurheartj/ehz754

Lowering Nighttime Blood Pressure With Bedtime Dosing of Antihypertensive Medications: Controversies in Hypertension – Con Side of the Argument

Turgeon RD, Althouse AD, Cohen JB, et al. Lowering Nighttime Blood Pressure With Bedtime Dosing of Antihypertensive Medications: Controversies in Hypertension – Con Side of the Argument. Hypertension. 2021;78(3):871-878. doi:10.1161/HYPERTENSIONAHA.121.16501

Dr. Steve Antoine discusses the STRONG-HF trial with co-host, Dr. Liz Wang.

0:00-2:37: Introduction

2:38-7:54: STRONG-HF trial overview

7:55-11:44: Overall thoughts

11:45-13:45: Baseline therapies

13:46-19:59: Discussion of titration and follow up in the trial

20:00-21:22: Ejection fraction considerations

21:23-23:22: Final thoughts

23:23-23:58: Closing

References:

STRONG-HF

Mebazaa A, Davison B, Chioncel O, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022;400(10367):1938-1952. doi:10.1016/S0140-6736(22)02076-1

TOPCAT

Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392. doi:10.1056/NEJMoa1313731

In this special episode the CardioScripts crew join Pharmacy to Dose podcast creator and host, Nick Peters, to discuss his Top 3 Trials in cardiology. Listen to the full episode on the Pharmacy to Dose podcast (https://pharmacytodose.com/) where you can also find a full list of references! 

Dr. Sara Ward discusses the SECURE trial with co-host, Dr. Tracy Macaulay

0:00-1:08: Introduction

1:09-3:40: SECURE trial overview

3:41-7:55: History of polypill and overall trial considerations

7:56-11:36: Polypill formulation and titration

11:37-14:04: Antiplatelet therapy in SECURE discussion

14:05-18:06: Polypill use in the US

18:07-19:29: Final thoughts

19:30-20:00: Closing

References: 

SECURE Castellano JM, Pocock SJ, Bhatt DL, et al. Polypill Strategy in Secondary Cardiovascular Prevention. N Engl J Med. 2022;387(11):967-977. doi:10.1056/NEJMoa2208275

Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and riskfactors, 1990–2019: update from the GBD 2019 Study. J Am Coll Cardiol 2020; 76: 2982–3021.

Bansilal S, Castellano JM, Garrido E, et al. Assessing the impact of medication adherence onlong-term cardiovascular outcomes. J Am Coll Cardiol 2016;68:789-801.

KolandaiveluK, Leiden BB, O’Gara PT, Bhatt DL. Non-adherence to cardiovascular medications.Eur Heart J 2014; 35:3267-76.

Ferket BS, Hunink MG, Khanji M, et al. Cost-effectiveness of the polypill versus risk assessment forprevention of cardiovascular disease. Heart 2017;103:483-491.

Munoz D, Uzoije P, Reynolds C, et al. Polypill for cardiovascular disease prevention in an underservedpopulation. New Eng J Med 2019;381:1114-23.

Macaulay T, Sheridan E, Ward S. Reconsidering the Polypill for management of cardiovascularrisk factors in underserved patietsion. Curr Cardiol Rep 2021; 23:19.

Yusuf S, Joseph P, Dans A, et al. Polypill with or without aspirin in persons withoutcardiovascular disease. N Engl J Med 2021; 384: 216–28.

Roshandel G, Khoshnia M, Poustchi H, et al. Effectiveness of polypill for primary and secondaryprevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial. Lancet2019; 394:672–83.

Yusuf S, Lonn E, Pais P, et al. Blood-pressure and cholesterol lowering in persons withoutcardiovascular disease. N Engl J Med 2016; 374: 2032–43.

Castellano JM, Sanz G, Peñalvo JL, et al. A polypill strategy to improve adherence: results fromthe FOCUS project. J Am Coll Cardiol 2014;64:2071-82.

Joseph P, Roshandel G, Gao P, et al. Fixed-dose combination therapies with and without aspirin forprimary prevention of cardiovascular disease: an individual participant data meta-analysis.Lancet2021;398:1133-46.

Dr. Noelle Leung discusses the CHAP trial with co-host, Dr. Tracy Macaulay.

0:00-0:55: Introduction

0:56-4:32: CHAP trial overview

4:33-17:40: Overall thoughts and discussion 

17:41-19:55: Collaboration in patient care

19:56-23:38: Use of aspirin 

23:39-24:37: Final thoughts

24:38-25:12: Closing

References:

CHAP

Tita AT, Szychowski JM, Boggess K, et al. Treatment for Mild Chronic Hypertension during Pregnancy. N Engl J Med. 2022;386(19):1781-1792. doi:10.1056/NEJMoa2201295