Dr. Baliga's 'Podkasts for Curious Docs'
The new Lancet Series on ultra-processed foods offers a striking insight: as UPFs rise globally, traditional whole-food diets decline—bringing nutrient imbalance, overeating, toxic exposures, and hyper-palatable formulations that quietly reshape health trajectories. 🍔➡️⚠️ Across more than 100 prospective studies and multiple trials, higher UPF intake consistently links to obesity, type 2 diabetes, cardiovascular disease, kidney disease, depression, and higher all-cause mortality. 📉🩺 The message is clear: reducing UPF consumption isn’t a wellness...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
Home-delivered DASH-patterned groceries paired with dietitian counseling meaningfully lowered blood pressure and LDL cholesterol among Black adults living in food deserts 🥗📉—as demonstrated in the GoFresh randomized trial (JAMA). An accompanying editorial highlights why future “food-as-medicine” programs must prioritize underconsumed, health-promoting foods and align with modern evidence favoring higher-fat DASH/Mediterranean patterns 🌱🫒. A powerful reminder: the right groceries can be therapeutic.
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
🩺 New insights in hemodialysis care. A major New England Journal of Medicine study reports that daily supplementation with long-chain omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) led to a 43% reduction in serious cardiovascular events among adults receiving maintenance hemodialysis. 🐟💙 In a population where traditional cardioprotective therapies often fall short, these findings open a fresh path for investigation — and perhaps, future practice. 📉🔬 A confirmatory trial will be essential, but the signal is compelling. 🌅
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
🚀 A milestone moment in lipid therapeutics! The new JAMA trial on the oral PCSK9 inhibitor Enlicitide reports a ~60% reduction in LDL-C, with parallel decreases in ApoB and Lp(a)—all on top of maximally tolerated statin therapy. For individuals with heterozygous familial hypercholesterolemia (HeFH)—where reaching LDL targets remains a persistent challenge—this represents a major advance. An oral agent matching the potency of injectable PCSK9 inhibitors could reshape adherence, access, and long-term ASCVD prevention. 🌉💊 Safety was comparable to placebo, and effects...
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☕ DECAF Trial insight! A new JAMA study shows that daily caffeinated coffee may lower recurrence of atrial fibrillation compared with abstinence. Patients drinking ~1 cup/day had 47% recurrence vs 64% with abstinence (HR 0.61, p=0.01) 📉💓 No major safety concerns—challenging long-held beliefs that coffee is proarrhythmic. 💡Takeaway: For many patients with AF, enjoying their morning brew may be both safe and possibly beneficial. #AtrialFibrillation #Cardiology #JAMA #ClinicalTrials #HeartHealth ☕💓📊
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🚨 New insights from The Lancet 🚨 A major individual-patient-data meta-analysis (6 RCTs, 8,836 patients) shows that complete revascularisation in acute myocardial infarction significantly reduces cardiovascular death, all-cause mortality, and recurrent MI. 💓📉 Benefits were consistent across age, sex, STEMI/NSTEMI, and lesion characteristics — strengthening the case for a more comprehensive approach beyond the culprit lesion alone. 🔬🩺 A powerful reminder: treating the whole heart saves more lives. ❤️✨
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
🧬 New NEJM data on Olezarsen! In patients with severe hypertriglyceridemia, monthly RNA-targeted therapy delivered major triglyceride reductions (−62% to −72%) and a significant drop in acute pancreatitis risk (rate ratio 0.15). ✨ Improvements extended to ApoC-III, remnant cholesterol, and non-HDL cholesterol, with consistent benefits across both CORE-TIMI trials. 💡 A promising step forward in precision lipid therapy and pancreatitis prevention.
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📘 New Evidence from NEJM In a large meta-analysis of 17,801 patients with preserved LVEF after MI, beta-blockers did not reduce death, recurrent MI, or heart failure. Event rates were low, and outcomes were similar with or without therapy. 🫀📊 This clarifies practice for a growing post-MI population with LVEF ≥50%—precision matters more than tradition. 🎯 Full study: New England Journal of Medicine (2025). #Cardiology 💙 #ClinicalEvidence #MI #HeartHealth
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📢 ADAPT AF-DES Trial — A Safer Path Forward! In patients with atrial fibrillation beyond 1 year after drug-eluting stent implantation, NOAC monotherapy delivered striking benefits over combination therapy. ✅ Lower net adverse clinical events ✅ Marked reduction in major/CRNM bleeding ✅ Similar ischemic protection A beautifully simple strategy with meaningful impact. Published in NEJM (2025). 💊🛡️📉💓
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🌊 OCEAN Trial offers fresh insight into antithrombotic therapy after successful AF ablation. In 1284 patients followed for 3 years, event rates were remarkably low 🌟. Rivaroxaban did not show superiority over aspirin for preventing stroke, systemic embolism, or covert embolic events, while bleeding risk was higher with anticoagulation. 🧠 96% had no new infarcts on MRI at follow-up. Published in NEJM (2025) — a valuable contribution to nuanced AF post-ablation care.
info_outlineCoronary CT angiography-guided management of patients
with stable chest pain: 10-year outcomes from the SCOT-
HEART randomised controlled trial in Scotland
Michelle C Williams, Ryan Wereski, Christopher Tuck, Philip D Adamson, Anoop S V Shah, Edwin J R van Beek, Giles Roditi, Colin Berry,Nicholas Boon, Marcus Flather, Steff Lewis, John Norrie, Adam D Timmis, Nicholas L Mills, Marc R Dweck, David E Newby, on behalf of theSCOT-HEART Investigators*
Summary
Background The Scottish Computed Tomography of the Heart (SCOT-HEART) trial demonstrated that management
guided by coronary CT angiography (CCTA) improved the diagnosis, management, and outcome of patients with
stable chest pain. We aimed to assess whether CCTA-guided care results in sustained long-term improvements in
management and outcomes.
Methods SCOT-HEART was an open-label, multicentre, parallel group trial for which patients were recruited from
12 outpatient cardiology chest pain clinics across Scotland. Eligible patients were aged 18–75 years with symptoms of
suspected stable angina due to coronary heart disease. Patients were randomly assigned (1:1) to standard of care plus
CCTA or standard of care alone. In this prespecified 10-year analysis, prescribing data, coronary procedural
interventions, and clinical outcomes were obtained through record linkage from national registries. The primary
outcome was coronary heart disease death or non-fatal myocardial infarction on an intention-to-treat basis. This trial
is registered at ClinicalTrials.gov (NCT01149590) and is complete.
Findings Between Nov 18, 2010, and Sept 24, 2014, 4146 patients were recruited (mean age 57 years [SD 10], 2325 [56·1%] male, 1821 [43·9%] female), with 2073 randomly assigned to standard care and CCTA and 2073 to standard care
alone. After a median of 10·0 years (IQR 9·3–11·0), coronary heart disease death or non-fatal myocardial infarction
was less frequent in the CCTA group compared with the standard care group (137 [6·6%] vs 171 [8·2%]; hazard ratio
[HR] 0·79 [95% CI 0·63–0·99], p=0·044). Rates of all-cause, cardiovascular, and coronary heart disease death, and
non-fatal stroke, were similar between the groups (p>0·05 for all), but non-fatal myocardial infarctions (90 [4·3%] vs
124 [6·0%]; HR 0·72 [0·55–0·94], p=0·017) and major adverse cardiovascular events (172 [8·3%] vs 214 [10·3%];
HR 0·80 [0·65–0·97], p=0·026) were less frequent in the CCTA group. Rates of coronary revascularisation procedures
were similar (315 [15·2%] vs 318 [15·3%]; HR 1·00 [0·86–1·17], p=0·99) but preventive therapy prescribing remained
more frequent in the CCTA group (831 [55·9%] of 1486 vs 728 [49·0%] of 1485 patients with available data; odds ratio
1·17 [95% CI 1·01–1·36], p=0·034).
Interpretation After 10 years, CCTA-guided management of patients with stable chest pain was associated with a
sustained reduction in coronary heart disease death or non-fatal myocardial infarction. Identification of coronary
atherosclerosis by CCTA improves long-term cardiovascular disease prevention in patients with stable chest pain.