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Premature Menopause, Triple G Agonists, and CV Care Costs
March 23, 2026
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“I’ve come to realize how easy it has become to treat patients without really thinking about them. There is so much algorithmic and guideline-based medicine that every specific patient problem — their chief complaint — suggests an evaluation and treatment. In an era in which medical centers advertise personalized care, this sort of medicine is impersonal and generic.”

Adam Cifu, MD

Women’s Cardiac Health

The CV Risks of Premature Menopause

Keeping a close eye on women’s reproductive health could give insights into their future cardiovascular risk after a new JAMA study found that women who experience premature menopause face higher lifetime risk of coronary heart disease (CHD).

  • The average age for menopause for most women is 51, with premature menopause occurring in women under 40.
  • Current cardiovascular risk assessment doesn’t really incorporate reproductive history factors despite early estrogen loss influencing ASCVD progression.
  • It also hasn’t been clear how premature menopause impacts women of different racial/ethnic backgrounds.

To answer these questions, researchers followed 10k postmenopausal women (65% White, 35% Black) free of baseline coronary heart disease from 1964-2018, finding that lifetime risk calculations revealed concerning patterns…

  • Premature menopause increased lifetime CHD risk by 40% between the two groups with a hazard ratio of 1.41 for Black women and 1.39 for White women.
  • However, PM occurred over three-fold more frequently in Black women (15.5%) versus White women (4.8%), leading to higher absolute CHD burden despite similar risk.

These results suggest that premature menopause is an important risk-enhancing factor for women, so adding it into the consideration is important, but it also serves as a stress test for a woman’s body.

  • That’s because menopause at any age changes a woman’s body in drastic ways, with lipids and BP often increasing, while energy and muscle mass decrease.
  • This ultimately leads to a less active lifestyle and the compounding of cardiovascular risk factors like increased body fat, hypertension, and hormonal changes.

The Takeaway

As the research on women’s cardiovascular health expands, one thing becomes increasingly clear – cardiologists cannot evaluate and treat the female heart the same as the male. Special considerations are needed for women whose bodies drastically change from fertility, to pregnancy, to eventually menopause.

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The Wire

  • Taking Tirzepatide Before TAVR: TAVR and tirzepatide? It sounds catchy, but a recent study found that obese patients taking Eli Lilly’s GLP-1 faced better outcomes following valve replacement. Researchers randomized 260 patients with an obese BMI score to either take tirzepatide for four weeks before (plus 12 months after) their TAVR or standard care. Patients on the GLP-1 had a 61% relative risk reduction of leaflet thickening and a 58% lower risk of paravalvular leak. It’s unclear what drove these benefits (likely weight loss).
  • HEARTio’s Funding Start: HEARTio closed a $4.25M seed financing round to advance ECGio, its AI-driven platform that aims to predict coronary occlusion using a standard electrocardiogram. ECGio uses AI to analyze standard 12-lead ECGs to detect coronary artery disease by interpreting subtle, often-missed ECG signals. It’s already been validated in a study of over 16k patients, and the newly secured funds will act as the primary catalyst for the company’s upcoming pivotal study as it seeks FDA clearance.
  • Triple G Agonist for T2D: Eli Lilly already one-upped its tirzepatide with triple hormone agonist, retatrutide, for T2D. The U.S. pharma titan released topline results from the TRANSCEND-T2D-1 trial that showed the GLP/GIP/Glucagon agonist led to an average decrease in HbA1c from baseline of 1.7% to 2.0% and body weight decreases of 11.5% to 16.8% depending on the dose amount. The drug also improved other CV risk factors like non-HDL cholesterol, triglycerides, and systolic blood pressure.
  • CM Genes and AFib: A massive meta-analysis of over 655k individuals from the UK Biobank and All of Us cohorts revealed that genetic variants linked to cardiomyopathies (DCM, HCM, and ARVC) are also potent independent drivers of atrial fibrillation. Remarkably, this increased risk (HR 1.73) persists even in patients who have not developed overt ventricular disease or heart failure. The study highlights that “cardiomyopathy genes” often have an equal or greater impact on atrial health, suggesting that AFib may be a major manifestation.
  • TAVR vs. SAVR Similarities: Confirming what we already know, the PARTNER 3 trial found that patients feel the same seven years after TAVR or SAVR for severe aortic stenosis. The latest read out of the trial now suggests that although TAVR seemed better in the early years, seven-year outcomes for either procedure were equally likely to show a KCCQ-OS score of >60 without a decline of more than 10 points from baseline. However, the analysis showed statistically significant lower mental component scores at years 4 and 5 with TAVR, but no difference by years 6 and 7.
  • CV Healthcare is Still Unaffordable: What good are cardiovascular meds if no one can afford them? As part of a JACC special issue, investigators examined data from 4k adults with various forms of CVD and found that patient contributions to insurance premiums plus spending on CV medical care and medicines increased from $4.8k to $5.3k from 2007 to 2022. That increase was driven by a rise in insurance premiums ($3.3k to $3.9k) and 34% of patients spent more than 10% of their income on those premiums.
  • Echo Surveillance Improves AS Outcomes: Guideline-directed echocardiographic surveillance for aortic stenosis is effective, but still not optimally applied across the United States. A JAHA study followed 20.5k patients with AS who hadn’t received AVR over a 5.2-year follow-up, finding patients with guideline directed care had lower death rates (28.8% vs. 42.2%), and higher AVR rates (26.6% vs. 14.5%). Guideline adherence for echo surveillance was 74% for mild AS ranging as low as 49% for severe AS.
  • Wolters Kluwer & the AHA: In a move that could improve access to high-quality research, Wolters Kluwer and the AHA partnered on a new journal publication platform that will offer CV and brain research in both a subscription-based and Open Access model. The duo believes the new platform will provide access to quality resources that will support clinicians, researchers, and policymakers worldwide. The AHA studies published by Wolters Kluwer will now be featured in the Lippincott portfolio of medical and scientific journal publications.
  • MyOme’s PRS Results: Whole-genome analysis company, MyOme, announced research showing that integrating polygenic scores (PRSs) with clinical risk factors produces more precise coronary artery disease predictions than either approach alone. Per the study, combining PRS with traditional tools like the PREVENT-ASCVD equation for individual-level predictions led to more accurate long-term prognosis of a patient’s CAD risk. That means these findings are most relevant to patients who are near guideline-relevant thresholds for medications like statins or other lipid lowering treatments.
  • The Consequences of Inaction: An Alabama judge awarded a $50M verdict to the family of a man who died in his sleep at home following a heart catheterization. After complaints of pain and cardiac testing, his cardiologist performed a catheterization, and found a blockage. Instead of treating it with blood thinners, he sent him home from the hospital, cleared him for an elective eye surgery a week later, and instructed him to begin blood thinners after the surgery, leading to his death. The family’s lawyers argued that this was a failure to meet the required standard of care.
  • The Risk of CHIP: A large-scale analysis of over 360k participants from two major U.S. biobanks confirmed that clonal hematopoiesis of indeterminate potential (CHIP) is a significant risk factor for pericarditis. The study found that individuals with CHIP have a 1.65-fold increased risk of developing incident pericarditis, an association primarily driven by the DNMT3A gene variant. While the link to myocarditis showed a similar positive trend, it did not reach statistical significance, likely due to a smaller number of events.

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The Resource Wire

  • 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.
  • Diagnosing Cardiac Amyloidosis Using Echo AI: Catching cardiac amyloidosis early is critical to giving patients the best possible outcome. Read Us2.ai’s latest paper in Circulation to learn how their echocardiography AI solution and new Us2.ca model helped clinicians diagnose cardiac amyloidosis with higher sensitivity and specificity.
  • The Power of AI in Cardiovascular Imaging: Cardiac labs are under more pressure than ever to deliver more with greater speed and precision. Hear from ACUSON Origin customer, Tony Gallagher about how Siemens Healthineers’ cardiovascular ultrasound system is improving exam efficiency and showing positive impact on ROI.
  • Beyond the Calcium Score with Circle CVI: The coronary artery calcium score has been the non-invasive gold standard for a quick look at heart disease risk, but it only tells part of the story. Learn more about how Circle Cardiovascular Imaging is using AI-enabled coronary plaque analysis to redefine heart risk beyond what a CAC score can tell us.
  • 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.

The Industry Wire

  1. Scientists take on psychedelic antidepressant hype.
  2. What to know about the new Alzheimer’s blood tests.
  3. An unexpected organ could play a role in longevity.
  4. One in ten 2025 ACA enrollees are now uninsured.
  5. 10K Corewell Health nurses authorize labor strike.
  6. Providence considering sale of health plan.
  7. 24 profitable health systems in 2025.
  8. MedArrive acquires tech assets from Inbound Health.
  9. Perplexity launches consumer-focused AI health tool.
  10. Verily banks $300M to fuel AI, separates from Alphabet.