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JACC Global: Daily Summaries Delivered
by American College of Cardiology
Explore cardiovascular science from a global perspective with JACC Global. This podcast highlights original research, regional innovations, and urgent challenges in heart health across diverse healthcare settings worldwide.
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The most recent episodes — sign up to get AI-powered summaries of each one.
- Yesterday35 min
PACs: Benign Bystanders or AF in Disguise? | JACC Baran
Premature atrial complexes (PACs) are among the most common arrhythmias encountered in daily practice and are often dismissed as benign. But are they truly harmless—or could some represent the earliest stage of atrial fibrillation (AF)? Hosts Mitsuaki Sawano, MD, and Hiroyuki Sato, MD welcome Satoshi Higuchi, MD (Tokyo Women's Medical University) to discuss his JACC: Clinical Electrophysiology study, Atrial Effective Refractory Periods in Patients With Frequent Premature Atrial Complexes: Implications for Atrial Fibrillation. Building on translational work from experimental models, the study compares atrial effective refractory periods (AERP) in patients with frequent PACs, paroxysmal AF, and persistent AF to better define the electrophysiologic substrate underlying these conditions. The episode explores how electrical remodeling differs between PACs and AF, why pulmonary vein AERP shortens before more diffuse atrial remodeling develops, and what these findings reveal about the progression from atrial ectopy to sustained arrhythmia. The discussion also examines the emerging concept of PAC-induced atrial cardiomyopathy, the challenge of distinguishing "benign" from potentially malignant PACs, and the future of risk stratification and preventive intervention before AF becomes established.
- 1 weeks ago39 min
Cancer VTE + DOAC: Who Will Bleed? | JACC Baran
Patients with active cancer face a difficult balance: preventing recurrent venous thromboembolism while avoiding major bleeding during anticoagulation. But which patients are truly at highest bleeding risk? Hosts Mitsuaki Sawano, MD welcome Tomoyuki Nagai, MD (Kyoto Prefectural University of Medicine) and Naohiko Nakanishi, MD (Kyoto Prefectural University of Medicine) to discuss their JACC: CardioOncology study introducing the ONCO-DOAC BLEED Score. Using more than 1,100 patients from COMMAND VTE Registry-2 with external validation in two independent cohorts, the investigators identified eight readily available clinical factors that stratify bleeding risk during DOAC therapy in patients with cancer-associated VTE. The conversation explores why existing bleeding scores fall short in patients with active cancer, how cancer type and disease stage influence bleeding risk, the challenges of developing and validating a practical bedside risk score, and what clinicians should consider when balancing thrombosis prevention against bleeding in everyday practice.
- 2 weeks ago37 min
HFpEF Without Obesity: What Coronary Microcirculation Tells Us | JACC Baran
Host Mitsuaki Sawano, MD, welcomes Kai Nogami, MD (Mayo Clinic), to discuss his JACC Brief Report, "Higher Prevalence of Coronary Microvascular Dysfunction in Patients With HFpEF Without Obesity." Why do some patients develop HFpEF despite not being obese? In this episode, Dr. Nogami explains how combining invasive coronary function testing with exercise hemodynamics revealed a remarkably high prevalence of coronary microvascular dysfunction (CMD) in patients with non-obese HFpEF. The discussion explores why CMD may be a key driver of this distinct HFpEF phenotype, what these findings could mean for Japanese and other Asian populations, and how Mayo Clinic's unique invasive physiology platform provided new insights into HFpEF pathophysiology. Dr. Nogami also shares lessons from transforming the work into a JACC Brief Report and reflects on the enduring legacy of his mentor, the late Dr. Amir Lerman.
- 3 weeks ago45 min
What Autopsy Reveals About MINOCA and Sudden Cardiac Death | JACC Baran
Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, Hiroyuki Sato, MD, and Shun Kosaka, MD welcome Dr. Kosuke Nakasuka, MD, PhD to discuss his JACC study, Sudden Cardiac Death Due to Myocardial Infarction With Obstructive and Nonobstructive Coronary Arteries. Using one of the world's most comprehensive population-based autopsy cohorts, this study challenges a decades-old assumption that myocardial infarction accounts for nearly 80% of sudden cardiac death. The conversation explores why autopsy remains the gold standard for uncovering the true causes of sudden death, what these findings reveal about MINOCA and right coronary artery infarction, and how survivor bias may have shaped our current understanding of sudden cardiac death and ICD risk stratification.
- 4 weeks ago42 min
Remnant Cholesterol: Small Name, Big ASCVD Risk | JACC Baran
Hosts Mitsuaki Sawano, MD, Nobuhiro Ikemura, MD, and Satoshi Shoji, MD welcome Takahito Doi, MD, PhD to discuss his JACC Brief Report, “Risk of Atherosclerotic Cardiovascular Disease in Familial Remnant Hyperlipidemia and Familial Hypercholesterolemia.” Using prospective population cohorts from Copenhagen and the UK Biobank, this study examined whether familial remnant hyperlipidemia, historically known as type III hyperlipidemia or dysbetalipoproteinemia, is associated with higher ASCVD risk. The episode explores why remnant cholesterol matters beyond LDL-C and Lp(a), how genetically elevated remnant lipoproteins may identify an underrecognized high-risk group, and what this means as new triglyceride- and remnant-lowering therapies move closer to clinical practice.
- Jun 23, 202644 min
Post-AF Ablation Anticoagulation: How Long Is Long Enough? | JACC Baran
Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Hiroyuki Sato, MD welcome Tomoya Iwawaki, MD and Satoshi Yanagisawa, MD to discuss their JACC: Clinical Electrophysiology study, “Optimal Timing for Oral Anticoagulant Discontinuation and Prognosis After Successful Catheter Ablation for Atrial Fibrillation.” Using data from 2,448 patients undergoing first-time AF ablation, the investigators performed 537 sequential landmark analyses to identify when the balance between thromboembolic protection and bleeding risk most favors oral anticoagulant discontinuation. The episode explores how stroke and bleeding risks evolve after ablation, the concept of reverse net clinical benefit, why the first several months after discontinuation may be particularly vulnerable, and whether a data-driven approach can help guide one of the most common questions in contemporary AF management: when is it truly safe to stop anticoagulation after a successful ablation?
- Jun 16, 202633 min
Ultra-Low-Dose CAC in the Photon-Counting Era | JACC Baran
Hosts Mitsuaki Sawano, MD, and Shun Kohsaka, MD welcome Dr. Suguru Araki, MD and Dr. Satoshi Nakamura, MD (Mie University) to discuss their JACC: Cardiovascular Imaging study, “Validation of Ultra-Low-Dose Coronary Artery Calcium Scoring Using Photon-Counting Computed Tomography.” As cardiac CT becomes increasingly central to cardiovascular diagnosis and prevention, radiation exposure remains an important concern, especially in Japan, one of the world’s most CT-intensive countries. This episode explores how photon-counting CT, combined with Sn100 kVp high-pitch acquisition and 65 keV virtual monochromatic imaging, enabled coronary artery calcium scoring at nearly one-ninth the radiation dose of standard scanning while preserving Agatston score accuracy. The discussion highlights how ultra-low-dose CAC scanning may fit into future preventive cardiology, screening, and cardiac CT workflows while maintaining compatibility with established risk stratification methods.
- Jun 9, 202636 min
The Rise of PROs: What Traditional Risk Scores May Be Missing | JACC Baran
Hosts Mitsuaki Sawano, MD, and Satoshi Shoji, MD welcome Dr. Kazuya Nagao, MD (Kyoto University) to discuss his JACC: Heart Failure study, “Multidimensional Patient-Reported Outcomes in Acutely Decompensated Heart Failure: Prognostic Implications in a Real-World Cohort.” Using JROADHF-NEXT, this study examined three different PRO tools—KCCQ, EQ-5D-5L LSS, and PHQ-9—in patients hospitalized with acute heart failure. The episode explores why PROs repeatedly appear in JACC, how patient-reported health status captures information not reflected in traditional clinician-derived risk scores, and why mental health and overall quality of life may provide important prognostic signals beyond standard clinical assessment.
About JACC Global
Explore cardiovascular science from a global perspective with JACC Global. This podcast highlights original research, regional innovations, and urgent challenges in heart health across diverse healthcare settings worldwide.
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