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Weekly summary and focused insights of the high-impact cardiovascular research published in the JACC from Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, shaping cardiovascular care today.
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In this episode, Editor-in-Chief Harlan Krumholz explores the evolving landscape of cardiovascular medicine, beginning with a call for responsible stewardship of artificial intelligence. Highlights include a major registry study on percutaneous aspiration for right-sided endocarditis, the predictive power of polygenic risk scores in heart failure, and the diverse causes of myocardial infarction in younger adults—especially women. The episode also covers a randomized trial on Intensive versus conventional intraoperative blood pressure management on cardiovascular events after major abdominal surgery, a state-of-the-art review on stressor-associated atrial fibrillation, and insights into long-term antithrombotic therapy after PCI. Each segment underscores the need for precision, equity, and innovation in clinical practice.
In this episode, Dr. Harlan Krumholz introduces the September 16, 2025 issue of JACC, which features studies that challenge conventional clinical thinking, including a detailed ECMO physiology study showing that higher ECMO flow does not uniformly raise pulmonary capillary wedge pressure, suggesting the need for individualized management. A novel analysis of the ISCHEMIA trial revealed distinct angina symptom trajectories, emphasizing that recovery is not binary and supporting a more personalized approach to treatment and monitoring. A landmark target trial emulation found that statins significantly reduce cardiovascular risk in patients with type 1 diabetes—filling a key evidence gap. Additional highlights include a call to redefine early cardiogenic shock, a nuanced review of moderate secondary mitral regurgitation, and an editorial reaffirming JACC's commitment to independent, transparent science in alignment with new "Gold Standard Science" principles.
In this episode, Dr. Harlan Krumholz reviews the September 9, 2025 issue of JACC, covering key studies on artificial intelligence in cardiovascular research, the effects of tirzepatide in heart failure with preserved ejection fraction (HFpEF), and how social, racial, and genetic factors influence heart failure risk. He discusses the growing burden of heart failure in the elderly, the need to disaggregate data in Asian American and Pacific Islander populations, and the role of rare genetic variants in atrial fibrillation outcomes. The episode also features perspectives on clinical trial design, complex case reports, and emphasizes the need for AI submissions to meet high standards of clinical relevance, feasibility, and long-term impact.
In the September 2, 2025 JACC This Week, Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC highlights the issue. Listen here for a summary of our latest content, including new research on cognitive dysfunction in adults with congenital heart disease, a review of calcific aortic valve stenosis, and insights into cardiologists’ own lifestyle habits. We also have an article on the limitations of binary thresholds in cardiovascular risk assessment, as well as several articles reprinted from across the JACC journals.
In this week’s issue, Dr. Harlan Krumholz highlights new science with direct clinical implications: a randomized trial showing conduction system pacing outperforms RV pacing in AV block, a pragmatic study suggesting HEPA filtration may modestly lower blood pressure, and long-term data from FLAVOR comparing FFR and IVUS-guided PCI. Also featured are a state-of-the-art review on heart failure therapy implementation, a brief report refining NT-proBNP thresholds for pre–heart failure, and an updated JACC Report Card revealing persistent cardiovascular mortality disparities among Black Americans. The issue closes with reflections on equity, anatomy, and two complex case reports.
In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz explores device safety, abbreviated DAPT, drug-coated balloons, and a novel surgical polymer valve. Plus: expert insights on cardiovascular innovation, obesity management, fellowship signaling, and more.
In this mini focus issue of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz explores the evolving landscape of cardiac amyloidosis care. From structural and biomarker findings in the HELIOS-B substudy to broader discussions on access, treatment sequencing, and multidisciplinary care, this episode highlights new momentum in ATTR-CM management. Also covered: a sham-controlled trial on compression therapy for vasovagal syncope and pooled trial data on DOAC use in frail older adults with atrial fibrillation. Fast-moving insights, practical takeaways, and a clear message—amyloidosis is no longer rare and mysterious, but a condition we can monitor, modify, and manage.
Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD, welcome Yuichi Saito, MD, of Chiba University Hospital, to discuss recent trends in out-of-hospital cardiac arrest (OHCA) among Japan’s oldest populations. Using data from the All-Japan Utstein Registry, Dr. Saito and the Japanese Circulation Society Resuscitation Science Study (JCS-ReSS) Group highlight that OHCA cases in nonagenarians are steadily increasing. Despite prehospital resuscitation efforts, outcomes—particularly neurologically favorable survival—remain poor in this age group. The study underscores the urgent need for a national conversation on resuscitation strategies in a super-aging society.
Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, Kentaro Ejiri, MD, and Satoshi Shoji, MD, welcome Dr. Kunihiro Matsushita of Johns Hopkins University to discuss findings from the ARIC study on cumulative cardiovascular risk and healthy arterial aging. Dr. Matsushita highlights that maintaining favorable levels of cholesterol, blood pressure, and avoiding smoking from mid- to late-life is strongly associated with the absence of coronary artery calcium (CAC) at older age—a marker of healthy arterial aging. The study emphasizes the long-term impact of sustained risk factor control and its implications for preventive cardiology and public health.
In this JACC Deep Dive, Editor-in-Chief Harlan M. Krumholz, MD, SM, discusses a large real-world study by Min et al. examining heart failure with improved ejection fraction (HFimpEF) in over 24,000 patients. The study found that while EF improvement is common (30%), true remission is rare and relapse occurs in about 25% of cases—highlighting the need for continued guideline-directed medical therapy (GDMT) even after apparent recovery. Listen to the podcast, find out what reviewers and editors liked about the paper, and get more insight into our dedicated focus issue on heart failure.
In this focus issue on Heart Failure in Practice, JACC Editor-in-Chief Dr. Harlan Krumholz examines how contemporary research continues to refine and at times challenge our understanding of heart failure management. This week’s episode features a first-of-its-kind trial on dual therapy with SGLT2 inhibitors and MRAs, new real-world data on heart failure with improved EF, and sobering insights into what happens when foundational therapies are withdrawn. Also explored: sex-specific risks in genetic cardiomyopathies, the limitations of standard stroke prediction tools, and the case for modernizing ICD eligibility criteria. As always, the episode concludes with a synthesized summary of key takeaways for clinicians.
Cardiac electrophysiology is rapidly evolving, blending procedural expertise with innovations in pharmacotherapy, device design, and lifestyle medicine. This week's Editor's Page spotlights key studies from JACC that challenge long-standing practices—from lifestyle strategies for atrial fibrillation to the role of defibrillation testing and device comparisons. We also explore disparities in cardiac arrest outcomes and complex real-world cases that push clinical boundaries. Tune in for a dynamic look at the future of arrhythmia care.
Interventional cardiology is rapidly evolving, with advances in imaging, devices, and techniques driving both innovation and rising expectations for safety and patient-centered outcomes. This week's editor's page highlights cutting-edge research and expert commentary on topics such as plaque vulnerability, stent performance, imaging-guided interventions, and long-term outcomes, reflecting both progress and ongoing challenges in the field. By bringing together this wealth of new science, the issue aims to inform clinical practice, encourage thoughtful decision-making, and inspire continued innovation in cardiovascular care.
In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC, discusses a new study in the July 8 issue of JACC, authored by Saket Girotra MD, SM, et al. In the study, which links national registry and Medicare data, the authors found striking hospital-level variation in cardiac arrest rates and outcomes—and identified better nurse staffing as a key factor in both preventing arrests and improving survival. Behind the scenes, the manuscript underwent multiple rounds of revision, with close collaboration between editors and authors to strengthen the analysis, add new visualizations, and clarify key takeaways. The study underscores the need to invest in systems and staffing that detect clinical deterioration before it becomes irreversible.
In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC reviews a study by Covani, et al that uses OCT imaging in over 1,500 ACS patients to show how increasing cardiovascular risk factor burden—like smoking, diabetes, and hypertension—is strongly associated with vulnerable plaque features such as thin caps, inflammation, and rupture. The findings were most pronounced in STEMI patients and reinforce the biological impact of cumulative risk. Reviewers found the core results intuitive but pushed for deeper mechanistic insights, leading to a stronger final paper with improved clarity, additional analyses, and a more nuanced understanding of how traditional risk factors shape plaque instability.
Validation of AHA PREVENT in healthcare populations| JACC Deep Dive In this JACC Deep Dive, JACC Editor in Chief Harlan M. Krumholz, MD, SM, explores a study led by Dr. Pradeep Natarajan that evaluates how well the new AHA PREVENT risk equations predict cardiovascular events across four major U.S. health systems. The study found wide variation in performance—PREVENT was well-calibrated at Penn Medicine but significantly underestimated risk at Mass General Brigham and Vanderbilt, particularly among women and minority groups. Reviewers praised the importance and rigor of the work but raised key questions about model calibration, fairness in outcome comparisons, and whether truly "plug-and-play" risk tools are realistic across diverse healthcare environments.
JACC's July 29 issue explores why the ACURATE neo2 valve failed in its IDE trial, with a post-hoc analysis pointing to under-expansion in heavily calcified anatomies as a potential culprit. Though the valve is off the market, the findings raise critical questions about procedural success, device design, and future innovation in TAVR. Listen to our Deep Dive narrated by JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, as he goes into the science behind the peer review.
In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz introduces the journal’s new design and highlights key studies from the July 29, 2025 issue. Topics include the under-expansion analysis of the ACURATE NEO2 valve, the impact of tirzepatide in obesity-related HFpEF, the effects of private equity ownership on heart failure care, and evolving strategies for managing multivalve disease.
In this special prevention-focused issue of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz spotlights new research that underscores the urgent global need to prevent cardiovascular disease. From the projected impact of single-pill combination therapies (polypills) and validation of new risk equations across major U.S. health systems, to the sobering rise of modifiable risk factors in both high- and low-income countries, this episode dives deep into the data and the implications.
In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz summarizes key studies from the July 15 issue, focused on cardiovascular interventions. Topics include new insights on plaque vulnerability in acute coronary syndromes, virtual flow reserve after PCI, long-term data on FFR-guided revascularization, and stent thrombosis risk. This issue delivers high-impact, practice-relevant research for interventionalists, imaging specialists, and general cardiologists alike.
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sir your ENGLISH is so....especially for our english as second lang users... thats too difficult to understand.