Three more digoxin trials, yet another GLP-1 drug on the horizon, vagal nerve stimulation, trial inside baseball, and more on lipid guidelines 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 More About Low-dose Digoxin in HF — The DECISION Trial(s)

• DECISION Trial https://www.nature.com/articles/s41591-026-04406-6
• Digitalis Glycosides in HF — JAMA Meta-Analysis https://jamanetwork.com/journals/jama/fullarticle/2848972
• DIGIT-HF Trial https://www.nejm.org/doi/10.1056/NEJMoa2415471
• RADIANCE Trial (1993) https://www.nejm.org/doi/full/10.1056/NEJM199307013290101
• DECISION Withdrawal Study https://doi.org/10.1093/eurheartj/ehag385
• Digoxin Discontinuation vs Continuation in Chronic HF https://doi.org/10.1016/j.amjcard.2007.02.099

II Yet another GLP-1 Drug Announced this Week

Lillly News Release on Retatrutide https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-powerful-weight-loss

III A Big Story in HF Science – Vagal Nerve Stimulation in HFrEF

• ANTHEM HFrEF trial https://doi.org/10.1016/j.jacc.2026.03.040
• Editorials

An Unfinished ANTHEM https://doi.org/10.1016/j.jacc.2026.04.033

When Trials Stop Prematurely https://doi.org/10.1016/j.jacc.2026.03.039

IV Lipid Guideline News

Lipid Guidelines: Four Major Concerns

https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim

• Editorial: Time to Move Beyond the Statin Nocebo Effect https://www.jacc.org/doi/10.1016/j.jacc.2026.04.002
• Correspondence: SAMSON N-of-1 Trial of Statin, Placebo, or No Treatment https://www.nejm.org/doi/full/10.1056/NEJMc2031173

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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

Questions or feedback, please contact news@medscape.net

Another positive digoxin trial, another classic coronary physiology study from Imperial College London (ORBITA-FIRE), news in hypertrophic cardiomyopathy, and TAVR done in the wrong patients 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 Digoxin in Rheumatic Heart Disease

• Dig-RHD Trial https://jamanetwork.com/journals/jama/fullarticle/2848973
• Safety and Efficacy of Digoxin: Meta-Analysis https://www.bmj.com/content/351/bmj.h4451.long
• DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471
• DIG Trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801
• RADIANCE Trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101

II The Physiologic Threshold for Angina

• ORBITA-FIRE Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.078738

III Prediction in Hypertrophic Cardiomyopathy

• Predictors of Long-Term Outcomes in HCM https://jamanetwork.com/journals/jama/fullarticle/2848800#250998713

IV TAVR Trends in Young Patients

• Temporal Trends in AVR for Aortic Stenosis in Patients < 65 https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016826
• Wall Street Journal article https://www.wsj.com/health/healthcare/heart-valve-tavr-surgery-aorta-1e0eda70

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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

Questions or feedback, please contact news@medscape.net

Listener feedback from the DanGer Shock investigators, complete vs staged revascularization, polygenic risk scores, and quality improvement failure in an RCT 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

• DanGer Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572
• CHIP-BCIS 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2515704

II Immediate Complete vs Staged Revascularization in STEMI

• Meta-analysis: Timing of Complete Revasc in Patients with STEMI and Multivessel Disease https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016601
• COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
  FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
• iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918

III Polygenic Risk Scores for Prediction

• Polygenic Risk Report in US-Based Hospitals for 8 CV Conditions https://www.jacc.org/doi/10.1016/j.jacc.2026.03.035

IV Practice Improvement Policies Undergo the Proper Test – Randomization

• Quality Improvement on Hospitalizations and Health Outcomes for People with CHD https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012904

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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

Questions or feedback, please contact news@medscape.net