Carotid Stenosis: Revascularize or Meds? 11/22/25

Welcome to Cardiology Today – Recorded November 22, 2025. This episode summarizes 5 key cardiology studies on topics like omics sciences and retrospective cohort study. Key takeaway: Carotid Stenosis: Revascularize or Meds?. Article Links: Article 1: Medical Management and Revascularization for Asymptomatic Carotid Stenosis. (The New England journal of medicine) Article 2: Coronary revascularization: a long-term perspective. (European heart journal) Article 3: Indirect mitral annuloplasty in patients with reduced or preserved ejection fraction: A real-world, single-centre experience. (ESC heart failure) Article 4: Rationales Behind Physiology-Guided Revascularization: Diagnostic Impact of Quantitative Flow Ratio in the FAVOR III China Trial. (JACC. Cardiovascular interventions) Article 5: Cardiac Risk Factors in Drug-Resistant Tuberculosis Patients on Bedaquiline: A Retrospective Cohort Study. (Cardiology) Full episode page: https://podcast.explainheart.com/podcast/carotid-stenosis-revascularize-or-meds-11-22-25/ Featured Articles Article 1: Medical Management and Revascularization for Asymptomatic Carotid Stenosis. Journal: The New England journal of medicine PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41269206 Summary: The clinical approach for asymptomatic carotid stenosis remains uncertain, particularly whether revascularization offers benefits beyond intensive medical management alone. Two parallel, observer-blinded clinical trials were conducted to address this critical question. These trials enrolled patients with high-grade (70 percent or greater) asymptomatic carotid stenosis across 155 centers in five countries. The research directly compared stenting or endarterectomy against intensive medical management to determine optimal patient care strategies. Article 2: Coronary revascularization: a long-term perspective. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41271218 Summary: This paper provided a long-term perspective on advancements in coronary revascularization, building on successful predictions made in 2000 regarding innovations like drug-eluting stents and coronary computed tomography angiography. The authors highlighted the evolving landscape of coronary artery disease treatment. They specifically emphasized the transformative role of artificial intelligence and omics sciences. Imagenomics, which integrates imaging and omics, was identified as a key future tool for precision in coronary revascularization by 2040. Article 3: Indirect mitral annuloplasty in patients with reduced or preserved ejection fraction: A real-world, single-centre experience. Journal: ESC heart failure PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41255167 Summary: This single-center retrospective study evaluated the real-world effectiveness and safety of the Carillon Mitral Contour System (C. M. C. S.) for indirect annuloplasty in 204 consecutive patients. The study cohort presented with Heart Failure (H. F.) and moderate or moderate to severe (grade two plus or three plus) secondary mitral regurgitation (S. M. R.), with an average age of 83 years, 68 percent female, and 72 percent having Heart Failure with Reduced Ejection Fraction (H. F. rEF). Echocardiographic variables, B-type natriuretic peptide (B. N. P.) levels, and clinical outcomes were systematically recorded. These comprehensive data were collected at baseline, 6-month, and 1-year follow-up to characterize the treatment’s impact on this specific patient group. Article 4: Rationales Behind Physiology-Guided Revascularization: Diagnostic Impact of Quantitative Flow Ratio in the FAVOR III China Trial. Journal: JACC. Cardiovascular interventions PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41263729 Summary: Physiology-guided percutaneous coronary intervention (P. C. I.) is known to offer clinical benefits by optimizing treatment plans beyond what coronary angiography alone can achieve. This study investigated the diagnostic impact of quantitative flow ratio (Q. F. R.) within this framework. A post hoc analysis of the multicenter randomized F. A. V. O. R. three China Trial focused on patients with coronary artery disease. The research explored how quantitative flow ratio contributes to enhancing the precision of interventional strategies. Article 5: Cardiac Risk Factors in Drug-Resistant Tuberculosis Patients on Bedaquiline: A Retrospective Cohort Study. Journal: Cardiology PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41269907 Summary: Bedaquiline significantly improves treatment outcomes in patients with drug-resistant tuberculosis (D. R. T. B.), but it is known to prolong the Q. T. interval, necessitating thorough cardiac safety evaluation. This retrospective cohort study assessed the cardiac safety profile of Bedaquiline-containing regimens. It included 202 patients diagnosed with drug-resistant tuberculosis who received treatment between March 2019 and May 2024. Patients were followed for 180 days to gather data on cardiac events and potential risk factors associated with Bedaquiline use. Transcript Today’s date is November 22, 2025. Welcome to Cardiology Today. Here are the latest research findings. Article number one. Medical Management and Revascularization for Asymptomatic Carotid Stenosis. The clinical approach for asymptomatic carotid stenosis remains uncertain, particularly whether revascularization offers benefits beyond intensive medical management alone. Two parallel, observer-blinded clinical trials were conducted to address this critical question. These trials enrolled patients with high-grade (70 percent or greater) asymptomatic carotid stenosis across 155 centers in five countries. The research directly compared stenting or endarterectomy against intensive medical management to determine optimal patient care strategies. Article number two. Coronary revascularization: a long-term perspective. This paper provided a long-term perspective on advancements in coronary revascularization, building on successful predictions made in 2000 regarding innovations like drug-eluting stents and coronary computed tomography angiography. The authors highlighted the evolving landscape of coronary artery disease treatment. They specifically emphasized the transformative role of artificial intelligence and omics sciences. Imagenomics, which integrates imaging and omics, was identified as a key future tool for precision in coronary revascularization by 2040. Article number three. Indirect mitral annuloplasty in patients with reduced or preserved ejection fraction: A real-world, single-centre experience. This single-center retrospective study evaluated the real-world effectiveness and safety of the Carillon Mitral Contour System (C. M. C. S.) for indirect annuloplasty in 204 consecutive patients. The study cohort presented with Heart Failure (H. F.) and moderate or moderate to severe (grade two plus or three plus) secondary mitral regurgitation (S. M. R.), with an average age of 83 years, 68 percent female, and 72 percent having Heart Failure with Reduced Ejection Fraction (H. F. rEF). Echocardiographic variables, B-type natriuretic peptide (B. N. P.) levels, and clinical outcomes were systematically recorded. These comprehensive data were collected at baseline, 6-month, and 1-year follow-up to characterize the treatment’s impact on this specific patient group. Article number four. Rationales Behind Physiology-Guided Revascularization: Diagnostic Impact of Quantitative Flow Ratio in the FAVOR III China Trial. Physiology-guided percutaneous coronary intervention (P. C. I.) is known to offer clinical benefits by optimizing treatment plans beyond what coronary angiography alone can achieve. This study investigated the diagnostic impact of quantitative flow ratio (Q. F. R.) within this framework. A post hoc analysis of the multicenter randomized F. A. V. O. R. three China Trial focused on patients with coronary artery disease. The research explored how quantitative flow ratio contributes to enhancing the precision of interventional strategies. Article number five. Cardiac Risk Factors in Drug-Resistant Tuberculosis Patients on Bedaquiline: A Retrospective Cohort Study. Bedaquiline significantly improves treatment outcomes in patients with drug-resistant tuberculosis (D. R. T. B.), but it is known to prolong the Q. T. interval, necessitating thorough cardiac safety evaluation. This retrospective cohort study assessed the cardiac safety profile of Bedaquiline-containing regimens. It included 202 patients diagnosed with drug-resistant tuberculosis who received treatment between March 2019 and May 2024. Patients were followed for 180 days to gather data on cardiac events and potential risk factors associated with Bedaquiline use. Thank you for listening. Don’t forget to subscribe. Keywords omics sciences, retrospective cohort study, ejection fraction, Q. T. interval prolongation, artificial intelligence, revascularization, quantitative flow ratio, secondary mitral regurgitation, medical management, F. A. V. O. R. three China Trial, cardiac safety, asymptomatic carotid stenosis, heart failure, indirect mitral annuloplasty, drug-resistant tuberculosis, coronary angiography, carotid-artery stenting, Carillon Mitral Contour System, carotid endarterectomy, imagenomics, coronary artery disease, coronary revascularization, physiology-guided percutaneous coronary intervention, drug-eluting stents, Bedaquiline. About Concise summaries of cardiovascular research for professionals. Subscribe • Share • FollowThe post Carotid Stenosis: Revascularize or Meds? 11/22/25 first appeared on Cardiology Today.