Ted Kyle explaining MariTide’s poor Wall Street reaction, despite its strong results.

The Cardiac Wire Show made its RSNA debut this week, capturing key insights into the latest cardiovascular imaging breakthroughs in interviews with… 

• Optum’s Omer Schalit Cohen discussing their vision for enterprise imaging, and the key role that cardiovascular imaging innovations play in that strategy.

• Sectra’s Megan Olmscheid and Björn Limber discussing the enterprise imaging leader’s big expansion into cardiology.

Pharmaceuticals

MariTide’s Weight Loss Milestone

The red hot weight loss segment just got even hotter, as the Phase 2 trial of Amgen’s maridebart cafraglutide (MariTide) yielded exceptional body mass reductions among people with obesity and T2D, propelling the pharma giant closer to FDA approval.

• Like Eli Lilly’s tirzepatide, MariTide is a GLP-1/GIP-agonist, setting it apart from Novo Nordisk’s popular GLP-1 semaglutide.
• MariTide’s previous Phase 1 trial demonstrated an average 14.5% weight reduction through 12 weeks, and patients maintained that weight loss for 70 days after stopping treatment.

Building on this earlier success, Amgen’s new Phase 2 trial lasted 52 weeks and enrolled patients living with obesity or both obesity and T2D.

• MariTide demonstrated up to ~20% average weight loss in the obesity group after 52 weeks.
• In the obesity + T2D group, MariTide led to ~17% average weight loss and lowered average hemoglobin A1C by up to 2.2%.

The study notably showed that MiraTide might be able to continue to drive weight loss beyond 52 weeks, potentially giving it a weight loss plateau advantage versus competing GLP-1s.

MariTide also meaningfully improved several cardiometabolic parameters without significant increases in free fatty acids.

• These improvements included blood pressure, triglycerides, and high-sensitivity C-reactive protein across various doses.

The most common adverse events were gastrointestinal related, including mild nausea, vomiting, and constipation. 

• Discontinuation due to any adverse effect was ~11%, and less than 8% were for GI-related events. 

The second part of the Phase 2 study will investigate MariTide beyond 52 weeks to evaluate further weight loss, weight maintenance through lower dosing, and weight loss durability after discontinuation. 

• More than 90% of eligible patients chose to continue to participate in Part 2 of the study.

Despite these results, investors seemed unimpressed, sending Amgen’s shares down 10%, because its performance didn’t surpass Lilly’s tirzepatide.

• That said, matching tirzepatide’s performance is nothing to scoff at, while MariTide still beat Lilly’s frontrunner on dosing frequency (once a month vs bi-weekly), and it could have a longer weight loss trajectory.

The Takeaway

Amgen might not be the first to the weightloss party, but MariTide’s strong Phase 2 results and unique advantages could help it stand out in the long run. 

Echo Automation’s Big Impact

Improving clinician efficiency and quality is the goal for most AI solutions, but we rarely see AI achieve both. See how Juntendo University’s Dr. Nobuyuki Kagiyama achieved both of those goals, while reducing sonographer fatigue in the process.

Cardiology AI: From Research to Clinical Practice

Explore how AI algorithms are reshaping cardiology with insights from Tempus’ recent webinar, featuring Dr. David Ouyang of UCLA and Cedars-Sinai, alongside Tempus’ Dr. John Pfeifer and Dr. Brandon Fornwalt. This expert panel dives into how AI can bridge diagnostic gaps, enhance patient outcomes, and streamline workflows for conditions like AFib and pulmonary hypertension. Read the full recap to glimpse the future of AI-driven cardiology.

PRECISE Trial Rewrites the Patient Pathway

HeartFlow’s landmark PRECISE trial found that their precision approach for evaluating people with stable chest pain avoided unnecessary testing and improved care without putting patients at risk of a missed heart disease diagnosis.

The Wire

• CVD & T2D: Highlighting the importance of early preventative care in prediabetic patients, a JACC study found that patients with T2D experienced two-times more CVD events during the 30 years leading up to their diagnosis. The study compared 127k individuals with T2D to 381k people without the condition, finding that 11.2% of the T2D group and 4.7% of the non-diabetic group experienced CV events during the 30-year period before T2D diagnosis.

• Pacemakers Placed, without Cardiologists: Intensifying concerns over which providers can perform which procedures, a new report revealed that Canisius-Wilhelmina Hospital in the Netherlands placed pacemakers with no cardiologists present as “the first surgeon.” The decision to perform these procedures without involving cardiologists was based on an investigation by the Dutch Society of Cardiology that determined the hospital’s cardiologists were “more concerned about their own businesses” than their patients, leading to extremely long wait times and the diversion of emergencies to other hospitals.

• Emory Implants First BrioVAD: As part of the INNOVATE trial, an Emory University Hospital team successfully implanted the U.S.’ first BrioVAD, a magnetically levitated ventricular assist device. BrioHealth Solutions’ BrioVAD System uses a hemocompatible blood pump to lower side effects and includes a magnetically levitated rotor and two lightweight patient-worn components. BrioHealth hopes the new BrioVAD may be used as life-long destination therapy, as an alternative to a heart transplant.

• Real World Sapien 3 Data: Edwards Lifesciences announced one-year analysis from +9k TAVR patients, demonstrating that 84.4% of those who received its Sapien Ultra 3 RESILIA valve experienced low mortality, low rates of reintervention, larger effective orifice areas, and no paravalvular leak. Patients who received the Sapien Ultra 3 RESILIA valves also experienced a meaningful 31-point increase in KCCQ2 scores, with 93% discharged from the hospital after one day.

• HeartFlow Plaque AI Matches IVUS: A retrospective subanalysis found that HeartFlow’s CCTA AI-based plaque quantification solution, AI-QCPA, performed similarly to intravascular ultrasound. Across 33 patients and 67 blood vessels, HeartFlow AI-QCPA agreed closely with IVUS measurements for vessel (ρ = 0.94) and lumen volumes (ρ = 0.97), with high agreement for total plaque volume (ρ = 0.92), noncalcified plaque (ρ = 0.91), and calcified plaque (ρ = 0.87).

• Cutting AFib After CABG: In a trial of 430 patients, partial cardiac denervation prevented postoperative atrial fibrillation (POAF) after CABG. The technique, which involves cutting the ligament of Marshall and resecting fat along the Waterston groove, reduced POAF from 31.6% to 18.1% during the 6-day post-op period compared to patients who received CABG alone. Notably, the denervation group had no increase in complications and lower post-op medical costs.

• Rapiblyk’s FDA Approval: Expanding on its success in Europe, AOP Health secured FDA approval for its AFib drug, Rapiblyk (landiolol), for use in hospital critical care settings. The approval stems from RCTs that demonstrated Rapiblyk decreased heart rate by >20% within ~10 minutes in 40-90% of patients, versus 0-11% of patients who received placebo. Rapiblyk achieved this decrease without substantially lowering blood pressure, which could bode well for its U.S. adoption.

• Sniffing New Options for Diuresis: Bumetanide nasal spray (BNS) is showing promise as a non-oral diuretic option for heart failure patients. In a 66-patient trial, BNS delivered similar bioavailability to oral bumetanide but was absorbed more quickly (median Tmax: 1 vs. 1.5 hours). BNS’ diuretic effects (mainly natriuresis and urine volume) were comparable across oral, nasal, and IV routes, while it had fewer adverse events compared to oral bemtanide (8.8% vs. 17.9%).

• Riverain’s CAC Clearance: Imaging AI leader Riverain Technologies just entered the coronary artery calcium scoring segment, following the FDA 510(k) clearance of its ClearRead CT CAC solution. ClearRead CT CAC analyzes ungated non-contrast chest CTs to detect, quantify, and report an Agatston score, and becomes part of Riverain’s ClearRead CT software suite, which previously focused on lung nodule detection. That combo could make adopting CAC screening more straightforward for the many Riverain users who already use ClearRead CT for lung cancer screening.

• Evolut Impresses at London Valves: The Medtronic Evolut team shared more good news at London Valves. Analysis of 620 patients who received Evolut PRO valves showed improvements in paravalvular leak severity over time, as patients with non/trace PVL jumped from 60.8% at 30 days post-TAVR to 79.8% after three years. Meanwhile, the Optimize PRO study showed that using the “cusp overlap” TAVR deployment technique led to low rates of all-cause mortality or stroke (5.1%) and permanent pacemaker implantation (6.4% ) at 30 days.

• Predicting ICD Mortality: A JACC study detailed a new RF-SLAM algorithm that can accurately predict mortality and HF hospitalization in patients with ICDs. Using the algorithm, researchers predicted death at three months and one year with 91% and 80% accuracy, while time-varying physiologic ICD data (e.g. daily physical activity) had substantial importance in predicting outcomes.

Experience the Future of Learning: Medtronic Academy 2.0 is Here!

Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

The All in One Cardiac Imaging Solution

Ready for an all-in-one solution that supports all of your MR and CT needs? See how Circle Cardiovascular Imaging’s cvi42 can streamline your core reading and reporting workflows within a single, customizable platform.

A Universal View of Your Patient

Think you’re getting the most out of your viewer? See how GE HealthCare’s Centricity Cardio Enterprise Universal Viewer allows you to quickly review exams, access and compare prior studies, and perform measurements in this 60-second video.

The Resource Wire

• Transforming Ischemia Detection: CCTA AI is poised to transform ischemia detection, leading to far greater diagnostic efficiencies and far fewer unnecessary invasive procedures. See how ischemia’s AI transformation is unfolding in this Cardiac Wire Show interview with Cleerly’s chief medical officer James Earls, MD.

• Innovating AFib Care: The first manifestation of AFib is often stroke, but many hospitals aren’t set up to coordinate these patients’ post-stroke care. See how UCSD is leveraging Viz.ai’s Viz Connect solution to simplify neuro and EP collaboration in this HRX 2024 interview.

• Connecting the ECG Monitoring Ecosystem: There’s so much that goes into building the solutions that providers use each week, and that’s definitely true for ECG monitoring. In this Cardiac Wire Show interview with Flipside Media’s president Brad Ummer, we get an insider’s view of what it takes to develop an ECG monitoring solution, including Flipside’s partnership with Monebo Technologies.

• PIA Medical Processes It All: Need an analysis like calcium scoring, strain or even FFR? PIA Medical began as a Core Lab and can handle creative cardiac research and clinical trials along with the full breadth of clinical analyses available today.

• How to Plan Your Cloud Migration: Ready to move your enterprise imaging to the cloud? Explore the different pathways to the cloud, and the advantages available through a cloud-native platform in this Optum white paper.

• Discover Innovation in Intervention: Explore how the AGENT™ Drug-Coated Balloon from Boston Scientific is advancing U.S.-based treatment options for patients with coronary artery disease. Rx Only. (Sponsored by Boston Scientific)

• Explore the Potential of Cardio AI: Explore the potential of AI-powered cardiology solutions in this on-demand TeraRecon webinar, detailing how its Cardio Suite solutions help expedite disease diagnosis, care coordination, and provide the data to support cardiac treatment decisions.

• Merge and Duly Health Streamline Cardiology Reporting: Over the last 10 years, Dr. Sujith Kalathiveetil of Duly Health and Care has seen a significant evolution in cardiovascular imaging and experienced a similar evolution with Merge’s cardiology solutions. See how Merge Cardio has helped make cardiology reporting more consistent, accurate, and easier to obtain for Dr. Kalathiveetil and his colleagues.

The Industry Wire

1. UnitedHealthcare CEO Brian Thompson killed in New York shooting.
2. Only 14% of adults age 65+ meet federal guidelines for physical activity.
3. Intermountain Health names new Chief Digital and Information Officer.
4. Biggest hospital cyberattacks of 2024.
5. How a billionaire’s ‘baby project’ ensnared dozens of women.
6. VillageMD co-founder Tim Barry steps down as CEO. 
7. AI’s best route to improving the U.S. economy is by improving healthcare.
8. Atrium Health apologizes to patient portal users: 5 notes.
9. Your friends shape your microbiome – and so do their friends.
10. Aetna employee sentenced to 5 years for fraud scheme.