AI Spots Vulnerable Plaques, Predicts MI Risk 09/02/25

Welcome to Cardiology Today – Recorded September 02, 2025. This episode summarizes 5 key cardiology studies on topics like coronary flow capacity and cardiovascular events. Key takeaway: AI Spots Vulnerable Plaques, Predicts MI Risk. Article Links: Article 1: Prevalence and Predictors of Neurocognitive Dysfunction in Adults With Congenital Heart Disease: Results From MINDS-ACHD. (Journal of the American College of Cardiology) Article 2: Adverse pregnancy outcomes and long-term risk of stroke: a Swedish nationwide co-sibling study. (European heart journal) Article 3: Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial. (European heart journal) Article 4: Artificial intelligence-based identification of thin-cap fibroatheromas and clinical outcomes: the PECTUS-AI study. (European heart journal) Article 5: Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial. (European heart journal) Full episode page: https://podcast.explainheart.com/podcast/ai-spots-vulnerable-plaques-predicts-mi-risk-09-02-25/ Featured Articles Article 1: Prevalence and Predictors of Neurocognitive Dysfunction in Adults With Congenital Heart Disease: Results From MINDS-ACHD. Journal: Journal of the American College of Cardiology PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40866049 Summary: This prospective study examined neurocognitive dysfunction in adults with moderate to severe complex congenital heart disease. The study found a significant prevalence of neurocognitive deficits in this population, and identified risk factors such as atrial fibrillation, heart failure and repeated cardiac interventions that contribute to cognitive impairment. These findings highlight the need for routine neurocognitive screening and targeted interventions to improve long-term outcomes in adults with congenital heart disease. Article 2: Adverse pregnancy outcomes and long-term risk of stroke: a Swedish nationwide co-sibling study. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40569854 Summary: This large, nationwide study from Sweden evaluated the association between adverse pregnancy outcomes and long-term stroke risk. Results demonstrated that women with a history of preterm delivery or who were small for gestational age experienced a significantly elevated long-term risk of stroke. These findings underscore the importance of considering adverse pregnancy outcomes as a risk factor for later-life cardiovascular disease and stroke prevention strategies. Article 3: Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40439159 Summary: The CENTURY trial investigated whether an intensive medical management strategy guided by coronary flow capacity assessment via positron emission tomography (PET) could improve outcomes in patients with stable chronic coronary artery disease compared to standard care. The study demonstrated that this comprehensive approach, using revascularization only for those with severely reduced coronary flow capacity, led to improvements in risk factors. It also reduced the need for subsequent revascularization procedures. Article 4: Artificial intelligence-based identification of thin-cap fibroatheromas and clinical outcomes: the PECTUS-AI study. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888677 Summary: The PECTUS-AI study evaluated the use of artificial intelligence to identify thin-cap fibroatheromas, a high-risk plaque feature, using optical coherence tomography images in patients after myocardial infarction. The study found that the artificial intelligence algorithm accurately identified thin-cap fibroatheromas and was predictive of future adverse cardiovascular events. This suggests that artificial intelligence can improve risk stratification and potentially guide targeted interventions in patients with coronary artery disease. Article 5: Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888584 Summary: The OPINION trial investigated the efficacy of surgical left atrial appendage occlusion in patients undergoing valvular surgery who did not have atrial fibrillation but had a CHA₂DS₂-VASc score of 2 or greater. The study did not demonstrate a significant reduction in postoperative thromboembolic events with surgical left atrial appendage occlusion compared to no occlusion. Therefore, prophylactic surgical left atrial appendage occlusion cannot be recommended for stroke prevention in this patient population. Transcript Today’s date is September 02, 2025. Welcome to Cardiology Today. Here are the latest research findings. Article number one. Prevalence and Predictors of Neurocognitive Dysfunction in Adults With Congenital Heart Disease: Results From MINDS-ACHD. This prospective study examined neurocognitive dysfunction in adults with moderate to severe complex congenital heart disease. The study found a significant prevalence of neurocognitive deficits in this population, and identified risk factors such as atrial fibrillation, heart failure and repeated cardiac interventions that contribute to cognitive impairment. These findings highlight the need for routine neurocognitive screening and targeted interventions to improve long-term outcomes in adults with congenital heart disease. Article number two. Adverse pregnancy outcomes and long-term risk of stroke: a Swedish nationwide co-sibling study. This large, nationwide study from Sweden evaluated the association between adverse pregnancy outcomes and long-term stroke risk. Results demonstrated that women with a history of preterm delivery or who were small for gestational age experienced a significantly elevated long-term risk of stroke. These findings underscore the importance of considering adverse pregnancy outcomes as a risk factor for later-life cardiovascular disease and stroke prevention strategies. Article number three. Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial. The CENTURY trial investigated whether an intensive medical management strategy guided by coronary flow capacity assessment via positron emission tomography (PET) could improve outcomes in patients with stable chronic coronary artery disease compared to standard care. The study demonstrated that this comprehensive approach, using revascularization only for those with severely reduced coronary flow capacity, led to improvements in risk factors. It also reduced the need for subsequent revascularization procedures. Article number four. Artificial intelligence-based identification of thin-cap fibroatheromas and clinical outcomes: the PECTUS-AI study. The PECTUS-AI study evaluated the use of artificial intelligence to identify thin-cap fibroatheromas, a high-risk plaque feature, using optical coherence tomography images in patients after myocardial infarction. The study found that the artificial intelligence algorithm accurately identified thin-cap fibroatheromas and was predictive of future adverse cardiovascular events. This suggests that artificial intelligence can improve risk stratification and potentially guide targeted interventions in patients with coronary artery disease. Article number five. Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial. The OPINION trial investigated the efficacy of surgical left atrial appendage occlusion in patients undergoing valvular surgery who did not have atrial fibrillation but had a CHA₂DS₂-VASc score of 2 or greater. The study did not demonstrate a significant reduction in postoperative thromboembolic events with surgical left atrial appendage occlusion compared to no occlusion. Therefore, prophylactic surgical left atrial appendage occlusion cannot be recommended for stroke prevention in this patient population. Thank you for listening. Don’t forget to subscribe. Keywords coronary flow capacity, cardiovascular events, heart failure, artificial intelligence, preterm delivery, atrial fibrillation, stroke prevention, optical coherence tomography, myocardial infarction, medical management, cardiovascular risk, small for gestational age, surgical left atrial appendage occlusion, valvular heart disease, thin-cap fibroatheroma, adverse pregnancy outcomes, myocardial revascularization, cardiac interventions, stroke, positron emission tomography, neurocognitive dysfunction, congenital heart disease, thromboembolic events, chronic coronary artery disease. 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