Daniel McDevitt, MD FACS FSVS

Cardiology Pharmaceuticals

CKM’s True Medication Burden

As cardiology begins to look at the spectrum of cardiovascular-kidney-metabolic disease, new research in JAMA suggests that CKM treatments might face serious adoption challenges due to the sheer number of Americans who both have the disease and qualify for medications.

• It’s well documented that obesity and CKM syndrome continue to rise, but just how many people qualify for treatment has been unclear.
• Physicians have a diverse range of pharmaceuticals to choose from for treating CKM, including GLP-1s, SGLT2is, and nsMRAs.

In a search for just how many eligible patients are out there, researchers examined FDA-approved indications across 250M people in the U.S., finding a staggering eligibility burden.

• Between 42-61% of adults (~125M) showed indications for one or more CKM medications.
• GLP-1 eligibility dominated at 46-56% of all adults, followed by SGLT2is (14-33%) and nsMRAs (1-5%).
• Overlapping eligibility for multiple classes was substantial with 12-17% qualifying for both GLP-1s and SGLT2is, while 1-5% met criteria for all three classes.

These findings reveal a massive gap between CKM treatment availability and the population-level implementation required to serve all of these eligible patients.

• For example, the 1-5% of Americans (up to 11.7M) who need triple therapy represents a patient population larger than many common chronic diseases like cancer and dementia.
• Meanwhile, GLP-1 eligibility alone (up to 137M adults) dwarfs the current prescription patterns when addressing the number of obese Americans.

So where does this CKM treatment disconnect stem from? The answer is likely a combination of the relatively short time that many of these medications have been available and systemic pressures.

• Current practice focuses on single-medication therapies and healthcare systems are still catching up on expanding indications, prior authorization navigation, and cost barriers.

There’s also another way to read this data. While the number of patients who are eligible for these medications is immense, that doesn’t mean upping prescriptions is the only way to help them.

• Many studies have already shown how healthier diets, more physical activity (even light walks), and weight loss (with or without drugs) can significantly reduce CKM risk.

The Takeaway

This far-reaching analysis looks at over two thirds of the U.S. population and asks the very broad question of “how many people need CKM treatment.” The data it gives us suggests that we’re just getting started when it comes to pharmaceutically treating CKM on the population level, even if more drugs shouldn’t be the only option.

A CVUS Platform You Can Trust

Being able to count on your cardiovascular ultrasound every day, all day, is vital. Find out why cardiac imagers trust Fujifilm’s Lisendo 880 CVUS, and how its premium imaging quality and speed have helped change sonography workflows for clinicians and technologists alike.

Tempus Receives FDA 510(k) Clearance for Tempus ECG-Low EF

Tempus announces the expansion of its Tempus ECG-AI portfolio with Tempus ECG-Low EF, software intended for use to analyze 12-lead ECG recordings and detect signs associated with having a low left ventricular ejection fraction (LVEF less than or equal to 40%) in patients 40 years of age or older at risk of heart failure. It is not intended as a stand-alone diagnostic and positive results may suggest the need for further clinical evaluation. For Full Indications for Use, visit here.

Circle CVI’s CAD-RADS Rundown

Ever wondered how CAD-RADS enhances the communication of coronary artery disease findings from imaging studies? Check out this guide from Circle Cardiovascular Imaging about the evolution of CAD-RADS and how to incorporate it into your practice.

The Wire

• Vanderbilt’s REUP Technique: A single-center study out of Vanderbilt found that Rapid Recovery with Extended Ultraoxygenated Preservation (REUP) safely recovers “donation after circulatory death” hearts without reanimation. By using an oxygenated flush instead of costly machines, REUP achieved 95.8% 30-day survival with zero discards. At $2,000 per transplant, the method supports ischemic times up to 8 hours and older donors, offering a cost-effective, ethically sound alternative to current perfusion and reanimation platforms.

• HFrEF Quadruple Therapy Residual Risk: A recent Medicare beneficiaries study found that even with quadruple therapy (ARNI, beta-blocker, MRA, SGLT2i), HFrEF patients still face high residual risk after leaving the hospital. One year post-discharge, 19.3% died and 26% were rehospitalized for heart failure, with median healthcare costs reaching $27,956. Despite optimal prescription, researchers also found that older patients remain at high risk for the poorest clinical outcomes, though this isn’t surprising given the role that frailty plays in HF severity.

• Apple Watch Beats Standard AFib Detection: New research in JACC suggests that the Apple Watch might be even better than the current standard of care for detecting atrial fibrillation. The study randomized 437 senior patients with elevated stroke risk to either wear an Apple Watch (12 hours+ per day) or receive standard care for six months. New-onset AFib was diagnosed in 9.6% of patients in the Apple Watch group (57% of whom were asymptomatic), versus just 2.3% in the control (all of whom experienced symptoms).

• AI-Enabled POCUS Screening: A Frontiers in Digital Health study demonstrated that AISAP’s AI model can detect valvular disease and ventricular dysfunction from a single POCUS image. Validated against 120k echocardiograms, the model achieved real-world AUCs of 0.97 for reduced ejection fraction and 0.95 for ventricular dysfunction when used by non-cardiologists. This technology could effectively remove technical barriers to cardiac imaging, enabling rapid, point-of-care diagnosis before formal laboratory testing.

• Cardiology Independence Remains Stalled: The American Board of Cardiovascular Medicine (ABCVM) released a statement that it remains committed to independent certification despite its application being rejected by the ABMS in early 2025. ABCVM admitted to a lack of progress with the ABIM and is exploring alternative partnerships with other licensing bodies with the goal of establishing certification that includes adaptive assessments tailored to each cardiac sub-specialty.

• AI-Assisted Stethoscope Gains: Recently released results from the TRICORDER study found that Eko Health’s AI-enabled stethoscopes significantly increased early cardiac disease detection in primary care. Over 12 months, detection rates rose 2.3x for heart failure, 3.5x for atrial fibrillation, and 1.9x for valvular disease compared to standard care. While workflow challenges limited overall uptake, the findings validate AI-powered stethoscopes as a powerful tool for catching conditions before emergency intervention.

• pLFLG AS Outcomes After TAVR: Research published in JSCAI suggests patients with paradoxical low-flow, low-gradient (pLFLG) aortic stenosis face higher mortality after TAVR. A study of 1,700 patients found 1-year all-cause mortality was 15.5% for pLFLG versus 10.8% for high-gradient AS. Heart failure hospitalization rates were also significantly higher for the pLFLG group, highlighting it as a high-risk subgroup that may require non-echocardiographic parameters like cardiac MRI for better risk stratification.

• Radiation Exposure Outliers: Another JSCAI study revealed that the top 10% of high-radiation coronary cases account for over 60% of an operator’s cumulative dose. Specifically, STEMI procedures carry a sixfold higher risk of being radiation outliers, often due to emergent workflows bypassing safety protocols. These findings suggest that median dose is a poor safety metric, underscoring a need for real-time monitoring and enhanced protection devices to reduce disproportionate risk.

• Ultraprocessed Foods Have Risks: To absolutely no one’s surprise, a recent NHANES analysis found that adults who consume the highest amounts of ultra-processed foods have higher CV risk. Researchers compared adults who ate the most processed foods to those who ate the least and found they had a 47% higher cardiovascular disease risk. Notably, the study used the NOVA classification system to categorize ultra-processed food intake, and found that the average participant got 26.1% of their total calories from ultra-processed foods.

• Banner Makes AMENDs: Banner University Medicine performed the first U.S. surgery repairing a leaky heart valve using Valcare’s AMEND ring, a catheter-delivered device replicating open-heart surgery techniques. The minimally invasive procedure implanted a semi-rigid annuloplasty ring without stopping the heartbeat and was well received by the patient. The technology may provide an alternative to other transcatheter valve repair and replacement options for 2.5M Americans with mitral valve leakage by combining the benefits of surgical annuloplasty with a less invasive approach.

• A MitraClip Competitor in China: Abbott’s MitraClip might have a competitor on the way after a new study out of China showed promise for iASO Medical’s Clip2Edge transcatheter mitral valve edge-to-edge repair system. The study of 129 HF patients with functional mitral regurgitation showed that Clip2Edge achieved 98% technical success and 94% device success at 30 days. At 12 months, 93.22% of patients had MR grade ≤2+, with significant improvements in NYHA functional class (89.74% class I/II) comparable to established MitraClip outcomes.

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.

Vista AI Grows CMR Volume

Are your patients waiting weeks or months for cardiac MRIs? See Brigham and Women’s Hospital’s real-world results showing how Vista AI’s software for automated MRI scanning led to 50% more scan slots, without adding more scanners or staff.

Merge & Us2.ai for Accessible Cardiac AI

AI isn’t the future anymore, it’s an irreplaceable feature for cardiac imaging. Dive deeper into how Merge & Us2.ai are integrating FDA-cleared algorithms with advanced imaging systems to help clinicians focus on what matters most – their patients.

The Resource Wire

• Siemens Healthineers ACUSON Origin Ultrasound System is Redefining CVUS: ACUSON Origin meets the demands of today’s cardiovascular care with AI-powered efficiency across adult and pediatric echo, vascular, structural heart, and EP. Streamlined workflows, intuitive walk-up usability, and advanced ergonomics empower clinicians to deliver confident, high-quality care—supporting a wide range of complex cases and clinical applications.

• The Largest Registry on Plaque Analysis in CAD: What if 50% of your CCTA patients could benefit from an adjustment to their treatment plan? Read more about Heartflow’s DECIDE registry that demonstrates how Heartflow Plaque Analysis using its Plaque Staging software empowers physicians with clinical insights that lead to real-world impact.

• 9 Merge Cardio Features to Change Your Cardiology Workflows: Having the right tools is essential for efficient cardiology imaging workflows and delivering exceptional patient care. Read this article on how Merge Cardio can make the biggest difference to your imaging workflows, care team user experiences, and patient care delivery.

• PIA’s Post-Processing Solution: Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency.

• Heart Failure Hospitalization Doubles Risk of Cardiovascular Death: 21% of patients with symptomatic heart failure escalate to hospitalization for heart failure or cardiovascular death, and 25% of those who experience hospitalization are readmitted due to heart failure within one year of discharge. Watch Bayer’s Dr. Alanna Morris-Simon discuss heart failure hospitalizations and when to assess care plans.

The Industry Wire

1. Confusion reigns over last-minute deal to avoid government shutdown. 
2. U.S. life expectancy rebounds to hit all-time high.
3. How are hospital executives getting ready for 2026?
4. The most important healthcare trends to watch in 2026.
5. Health systems call for better oversight of patient data-sharing.
6. CMS working on smoother rollout of Medicaid work requirements.
7. CMS officials defend decision not to raise MA payment rates.
8. HCA warns of $1B revenue drop due to ACA subsidy lapse.
9. FDA updates rules on medical device inspections.
10. Federal research funding cuts impact first-year PhD students.