The Biggest News of 2023: TCTMD’s Top 10

The stories that made headlines in 2023 reflect the broad interests of TCTMD members. They include a big regulatory decision by the US Food and Drug Administration, major clinical trial results, two controversies that gained even more steam on social media, and several other topics—spanning from opioid use to COVID-19 vaccinations and NSAID risks—with much wider social and medical footprints. Scroll on to read our top 10 news stories of the last 12 months, as well as Feature, Opinion, Video, and Podcast highlights.

1. FDA Approves Colchicine for Decreasing CV Events

The FDA approval of this older drug, more commonly used in gout, marked a turning point for the “inflammatory hypothesis” in cardiovascular disease. Cardiologists are already worried that the drug, sold as Lodoco (Agepha Pharma), is far too expensive for many patients.

2. Placebo-Controlled ORBITA-2 Shows PCI Eases Symptoms in Stable Angina

More than 6 years after the placebo-controlled ORBITA trial set the interventional cardiology galaxy whirling, the ORBITA-2 trial, aimed at isolating the treatment effects of PCI alone, showed that an invasive strategy does in fact reduce angina symptoms in patients with stable disease not taking antianginal meds.

3. Full SELECT Results Affirm CV Risk Reduction With Semaglutide in Nondiabetics

The SELECT trial of the GLP-1 agonist semaglutide (Wegovy; Novo Nordisk) in overweight or obese adults got a dedicated late-breaking session at the American Heart Association, where obesity specialists and cardiologists alike hailed the results as a turning point in cardiometabolic health with the potential for a “huge population impact.”

4. Free Spike Protein of mRNA COVID-19 Vaccines Implicated in Myocarditis

While cardiology research has largely turned away from studying the CV effects of both the SARS-CoV-2 virus and the COVID-19 vaccines, scientists have nevertheless been perplexed as to why some people develop vaccine-associated myocarditis when the vast majority do not. A circulating spike protein was found that may point to a potential mechanism.

5. Reports of Arrhythmias, Cardiac Arrests Linked to Nonprescription Opioids

In many parts of the world, the fallout from the opioid pandemic continues to take lives and sow misery, even as the COVID-19 pandemic has eased. A new study suggests that prescription-opioid alternatives like kratom and loperamide will likely remain a public health threat for the foreseeable future, with dire implications for the heart.

6. Nurse Practitioners Doing TAVI? What’s Gained and Lost

Back in June, a photo posted by the cardiology Twitter account at Glenfield Hospital, England, congratulating an advanced nurse practitioner (ANP) for performing a TAVI procedure as first operator, touched off a firestorm on social media and caught professional societies off guard. Can ANPs be the lead operators in complex structural heart procedures? Should they?

7. At STS 2023, Outgoing President’s Address Spurs Shock and Anger

Early in 2023, outgoing Society of Thoracic Surgeons President John Calhoon, MD, gave a plenary talk at the group’s annual meeting that urged surgery training programs to “search for the best candidate” with the message that “affirmative action is not equal opportunity.” Outrage and uproar ensued.

8. Some Surprises in Low-Risk TAVI Follow-up: PARTNER 3 and Evolut Trials

Mid-term follow-up data from two landmark trials of low-risk TAVI suggest that the procedure remains a safe, effective, and durable treatment option for aortic valve replacement. But cardiologists watching those data presented live at TCT 2023 couldn’t help but observe that TAVI benefits were attenuated and mortality trended higher in PARTNER 3 at 5 years. In the Evolut Low Risk trial, however, TAVI maintained its edge at 4 years.

9. Study Alleges Mortality Miscount in FOURIER Trial; TIMI Group Disagrees

A “reanalysis” of mortality data from FOURIER, the large cardiovascular outcomes trial of the PCSK9 inhibitor evolocumab (Repatha; Amgen), suggests that some deaths may have been misclassified, leading the authors to conclude that the potential harm from treatment was higher than initially reported. That claim was roundly rejected not only by some clinical trialists, including Marc Sabatine, MD, MPH, but also by the drug’s manufacturer as flawed and sensationalistic.

10. NSAIDs Tied to HF Hospitalization in Patients With Diabetes

In patients with diabetes and no history of heart failure (HF), the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of hospitalization for incident HF, a Danish registry study suggested. TCTMD spoke with CV clinical pharmacy specialist Craig Beavers, PharmD, to put these findings in perspective.

 

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TOP FEATURES

Longer-form features let us tell deeper stories, offering more points of view, and hopefully spur readers to question their own biases and preconceptions. These were some of TCTMD’s best of 2023.

Go Red for Women: Nearly 20 Years of Much Progress, Some Setbacks

As Violent Attacks on Healthcare Workers Rise, Cardiology Takes Note

ChatGPT et al? Not So Fast, Say Journal Editors

As US Abortion Access Grows Patchier, Cardiologist Concerns Mount

Find all TCTMD features here.

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Top Opinions

Our invitation-only Off Script blog plumbed some deeper topics in 2023, as did Fellow Talk by early-career physicians and our Conversations in Cardiology series led by Morton Kern, MD. Here are some of the most memorable opinions of the year gone by.

A Doctor May or May Not See You Now

Abuse, Humiliation, and ‘Pimping’ Will Not Toughen Up Our Trainees

Conversations in Cardiology: How Are Operators Comped for Being On Call?

A New Cardiovascular Board? A Few Things For Cardiology Leaders to Consider

What Role Do Textbooks Play in Cardiology Training Today?

Find all TCTMD blogs and opinions here.

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Top Videos

Live cases are back this year, thanks to in-person meetings, and TCTMD correspondents were live again in studio. We also made the most of our pandemic-forged expertise in remote video recordings. Sit back and enjoy some of our top on-camera moments of 2023.

LIVE CASE Saint Luke’s Mid America Heart Institute, Kansas City, MO - Complex Coronary PCI (MVD) and Ischemic Cardiomyopathy

BEYOND THE DATA Beyond the Data: ORBITA-2

CONFERENCE WRAP-UP AHA 2023 Wrap-Up

ON RECORD On Record: Out With ABIM, In With a CV Board

BEYOND THE DATA Semaglutide in Heart Failure—a Big STEP-HFpEF Forward?

Find the TCTMD video center here.

Top Podcasts

Talking Points The INVICTUS Trial

Heart Sounds October 2023: Singer-Songwriter Suzie Brown

Rox Heart Radio Making Time for Summer

Heart Sounds July 2023: These Vital Signs

Rox Heart Radio The Business of Medicine

Find all TCTMD podcasts here.