Rob Rogers MD on the prevalence of calcium scoring in cardiology.

Cardiology Pharmaceuticals

Wegovy Rapidly Lowers MACE Risk

Getting us closer to understanding GLP-1s’ heart benefits, a post hoc analysis of the SELECT trial suggests that Novo Nordisk’s Wegovy (semaglutide) significantly reduces a patient’s MACE risk in just three months of treatment. 

• Semaglutide’s CV event reduction indication already comes from the SELECT trial which supported its FDA approval and payor reimbursement
• Prior to its cardiovascular approval in March 2024, semaglutide was already approved for diabetes (Ozempic) and weight loss (Wegovy).
• However, it’s unknown if semaglutide leads to these results due to weight loss or a real cardiac benefit.

Researchers analyzed the SELECT trial data by looking at CV events in the first three to six months following semaglutide treatment for obesity, and found that the drug significantly lowered a patient’s MACE and CV mortality risk – even before major weight loss occurred.

• Patients on Wegovy had a 37% lower risk of MACE after the first three months.
• They also faced a 50% lower risk of CV death after six months.
• Semaglutide also lowered composite heart failure risk by 59% and reduced all-cause death by 40% after six months.

While the data doesn’t provide any insights into how these benefits occurred, researchers did note that “there was early reduction in heart disease events observed with semaglutide prior to what is typically considered significant weight loss.”

• Some researchers suggest this means patients who are obese with established CVD should start semaglutide as soon as possible.
• But these results also mean semaglutide could help people who are not obese lower their risk of MACE or CV mortality since the benefits appear weight-independent.

The Takeaway

This sub-analysis confirms that semaglutide‘s cardiac benefits happen quickly and build-up over time, with the eventual extra weight loss further intensifying them. That said, we still don’t have a clear answer on why this happens until semaglutide is tested on CVD patients without obesity.

AI Analysis of ATTR-CM

ATTR-CM is a progressive and fatal cardiomyopathy with a rising number of diagnoses and a highly variable clinical course. See how Us2.ai’s fully automated machine learning algorithm analyzes echocardiographic DICOM images without human interaction to improve tracking ATTR-CM progression and treatment responses.

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.

From CPACS to CVIS

Cardiovascular imaging has come a long way from CPACS. Explore the evolution of cardiology image and data management in this Merge by Merative executive brief, and see what makes CVIS such a significant advancement.

The Wire

• Blood Protein Test Breakthrough: Prevencio received FDA Breakthrough Device Designation for its HART CADhs AI-driven blood test that detects obstructive CAD. HART CADhs is a multi-protein test that accurately detects blockage in the heart’s arteries by using a non-invasive blood draw to scan for multiple cardiac proteins with proprietary machine learning algorithms. The blood test currently has a 2 to 10-day turnaround, however Prevencio hopes to develop it into a rapid in-vitro diagnostic with a one-hour result time.

• Heart Failure’s Iron Man: Empagliflozin (Jardiance) appears to increase red blood cell production in heart failure by activating erythropoietin, erythroferrone, and transferrin receptor-1 production while suppressing hepcidin. In the EMPEROR trials, this led to an average 0.6–0.9 g/dL hemoglobin bump by 12 weeks, even as serum iron and transferrin saturation dropped, suggesting increased iron use. Importantly, empagliflozin’s heart failure benefits held steady regardless of iron status.

• Affina’s AFTX-201: Tackling a rare disease with no treatment, Affinia Therapeutics announced encouraging new preclinical data for its gene therapy AFTX-201 that treats BAG3 dilated cardiomyopathy. AFTX-201 is delivered as a one-time intravenous injection and uses a novel cardiotropic capsid (viral shell protein) that allows it to easily pass into cardiac cells at low doses. Affina’s preclinical data suggests that AFTX-201 restored cardiac function and showed a favorable safety profile in BAG3 haploinsufficient mice and primates.

• UEAs Found Safe and Effective: A nationwide JAHA study suggests that cardiac ultrasound enhancing agents (UEAs) are safe and effective for improving ultrasound image quality. Researchers examined data from 500k patients who underwent transthoracic echocardiography for signs of adverse events within two days of administration and found that the odds of death were lower in those receiving UEAs (0.02% vs. 0.14%) and were not different across agents (Bracco’s Lumason: 0.03% vs. GE’s Optison: 0.01% vs. Lantheus’ Definity: 0.02%).

• TricValve’s First Patient: Interventional cardiologists at Tampa General Hospital and USF Health have completed the first TricValve System procedure as part of an FDA Early Feasibility Study for treating tricuspid regurgitation. The cardiology team performed the procedure with a minimally invasive transcatheter, implanting P&F Products and Features’ bicaval TricValve System into both the inferior and superior venae cavae. The technique allowed the team to avoid open surgery and reduced the backward blood flow found in severe tricuspid regurgitation which helped relieve the patient’s symptoms.

• GI Bleeds After TAVR: Although upper GI bleeding after TAVR is common, a new BMJ study suggests it can be used to predict which patients are at greater risk of CV mortality. Researchers examined 3.1k patients and found that those who experienced major or life-threatening upper GI bleeding had higher cardiovascular mortality compared with those without upper GI bleeding (31.6% vs 7.3%). AFib (aHR: 2.98) and previous upper GI bleeding (aHR: 3.51) were both independent predictors.

• 4D Flow vs. TTE: Another BMJ study suggests that four-dimensional flow cardiovascular MRI (4D flow CMR) could be better than transthoracic echocardiography (TTE) for assessing aortic stenosis. The study recruited 30 patients with 17 undergoing aortic valve intervention, finding that 4D flow VPeak measurements significantly predicted AV intervention (HR: 2.51), while TTE-derived VPeak showed no significant association (HR=0.54).

• Less Food, Sicker Hearts: While it may sound counterintuitive, a recent JAMA study found that children who grow up with food insecurity tend to have higher BMIs as young adults, and ultimately worse CV health. The study followed 1.1k children into young adulthood and found that those who lived in households with food insecurity (39%) had a lower LE8 score in young adulthood (β: −2.2). Children who grew up with food insecurity were also more likely to have a BMI of 30 or more (OR: 1.40).

• BP Pills Before Bed: A recent JAMA study found that taking antihypertensives before bed doesn’t make them more effective. The trial randomized 3.3k patients with hypertension to take their antihypertensives either before bed or in the morning and confirmed that bedtime administration had no effect on death or MACE (2.3 per 100 patient-years vs. 2.4 per 100 patient-years for morning use). There was also no difference in visual, cognitive, or fall-related safety outcomes.

• Lp(a)’s Lingering ASCVD Risk: We already know higher levels of lipoprotein(a) increase the risk of ASCVD in healthy individuals, but is this also true for recurrent ASCVD? Researchers analyzed data from 274k ASCVD patients and found that higher lipoprotein(a) levels were associated with continuously increasing risk of recurrent ASCVD over a 5.4 year follow-up. People with Lp(a) levels from 15–79 nmol/L, had a hazard ratio of 1.04 with ASCVD recurrence risk increasing to 1.45 for Lp(a) levels ≥300 nmol/L.

• Veradigm GLP-1 Data: Veradigm debuted a GLP-1 real-world evidence resource to help researchers uncover insights into areas like side effects, discontinuation reasons, and outcomes tracking. By applying AI to EHR data within the Veradigm Network, the curated GLP-1 dataset has already uncovered some interesting findings, including that 85% of obese patients discontinued use after two years (mainly due to GI issues or high OOP costs) and that providers often input “semaglutide injection” without clarifying its source.

A Single Cardiac Service Line Platform

Transitioning across multiple imaging platforms is a daily reality for many cardiologists, but it doesn’t have to be. See how three leading cardiac imagers are leveraging Circle CVI’s unified multi-modal software across their diverse caseloads, without switching to other platforms.

The CardioMEMS HF System is Now Covered by Medicare Advantage

Find reimbursement resources and more information about the expanded coverage for your heart failure patients if coverage criteria is met.

Vista AI Reduces Patient Backlog

Cardiac MRI is infamous for its complexity and backlogs, but it doesn’t need to be that way. See how Vista Cardiac delivered a 50% reduction in scan time variability, enabling shorter scheduling blocks and eliminating a one-month backlog.

The Resource Wire

• Explore Vitrea Advanced Visualization: Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflow

• A Better Way to Coordinate Post-Stroke Care: Think your EHR messaging system might be holding back your post-stroke care? See how UC San Diego Medical Center streamlined its neuro and EP teams’ post-stroke workflow with Viz Connect, and the impact it had on cardiac monitor placements in inpatient and outpatient settings.

• Identify and Treat Cardiovascular Disease: Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.

• Heartflow Plaque Analysis: Accurate CAD Assessment Now Covered Across the US: Heartflow’s Plaque Analysis is now reimbursable thanks to Medicare’s new coverage for AI-enabled plaque analysis of eligible patients with coronary artery disease.

• Addressing Coronary Artery Disease: Learn how the AGENT™ Drug-Coated Balloon provides a new treatment option for in-stent restenosis in the U.S. Rx Only. (Sponsored by Boston Scientific)

• 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!

• Structural Heart + Enterprise Imaging: Has your structural heart reporting evolved at the same pace as your structural heart procedures? See how Optum’s enterprise imaging gives interventional cardiologists the imaging tools they need as structural heart procedures become more common and more complex. 

• Cut Waste with GE HealthCare’s Inventory Management: Want to make your hospital’s inventory practices more efficient? Tune in to this webinar on how GE HealthCare’s data-driven insights can optimize inventory management and reduce cardiac procedure times by 30-45 minutes.

• Monebo’s Approach to Cardiac Health Monitoring: The heart works day and night, so your cardiac monitoring software should too. Learn about how Monebo’s latest innovation superimposes long-term monitoring results onto a 24-hour circadian cycle scale, creating a comprehensive map of circadian variations.

The Industry Wire

1. UnitedHealth Group under criminal investigation for Medicare fraud.
2. Time publishes 100 most influential people in health for 2025.
3. Sutter Heath names Jonathan Ma as CFO.
4. Texas Children’s and MD Anderson get $150M for cancer center.
5. Epic hit with lawsuit alleging anticompetitive practices.
6. Northwell CEO Michael Dowling to step down in October.
7. 25 hospital transparency fines ranked highest to lowest.
8. Bon Secours Mercy Health names new CIO.
9. CommonSpirit cuts operating loss despite payor challenges in Q3.
10. Hospitals slam Newsom for ‘broken promise’ amid proposed Medi-Cal cuts.