Macrophage Burden Predicts MACE Post-Endarterectomy 02/28/26

Welcome to Cardiology Today – Recorded February 28, 2026. This episode summarizes 5 key cardiology studies on topics like myocardial infarction and ventricular contractility. Key takeaway: Macrophage Burden Predicts MACE Post-Endarterectomy. Article Links: Article 1: Heart failure in the elderly: epidemiology, mechanisms, and management. (European heart journal) Article 2: Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study. (European heart journal) Article 3: Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy. (European heart journal) Article 4: Myocardial Microcirculation Combined With Lactate Measurements Predicts Ventricular Contractility in a Canine DCD Orthotopic Heart Transplantation During Ex Situ Machine Perfusion. (Transplantation) Article 5: Long Troponin T to Separate Troponin Elevations Among Patients With Atrial Fibrillation Versus Myocardial Infarction. (Journal of the American Heart Association) Full episode page: https://podcast.explainheart.com/podcast/macrophage-burden-predicts-mace-post-endarterectomy-02-28-26/ Featured Articles Article 1: Heart failure in the elderly: epidemiology, mechanisms, and management. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41760079 Summary: The majority of patients with heart failure (H. F.) are of advanced age. The lifetime risk for developing H. F. is approximately 25 percent, with a sharp increase in incidence observed after the age of 70. While the lifetime risk is nearly equal for men and women, women show a higher propensity to develop heart failure with preserved ejection fraction (H. F. pEF), whereas men are more prone to heart failure with reduced ejection fraction (H. F. rEF). Article 2: Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41758696 Summary: A previous European trial found that switching from well-managed warfarin to direct oral anticoagulants (DOACs) in frail elderly patients with atrial fibrillation was associated with a higher bleeding risk. This underscores the clinical importance of evaluating the safety and effectiveness of such switches in diverse populations. Understanding outcomes in frail elderly Asian patients is particularly crucial due to potential demographic and clinical differences impacting anticoagulant management. This research addresses a significant therapeutic challenge in optimizing anticoagulation for a vulnerable patient group. Article 3: Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy. Journal: European heart journal PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41758068 Summary: This study found that the burden of macrophages within carotid plaques and specific inflammatory lipid-associated macrophage markers serve as predictors for secondary major adverse cardiovascular events (MACE) following endarterectomy. The data establishes a direct link between the cellular content of atherosclerotic lesions and future cardiovascular outcomes. These findings indicate that detailed characterization of macrophage populations in carotid plaques provides crucial prognostic information. This information can guide risk stratification for patients after carotid endarterectomy. Article 4: Myocardial Microcirculation Combined With Lactate Measurements Predicts Ventricular Contractility in a Canine DCD Orthotopic Heart Transplantation During Ex Situ Machine Perfusion. Journal: Transplantation PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41757830 Summary: This canine orthotopic heart transplantation study demonstrated that combining myocardial microcirculation data with lactate measurements accurately predicts ventricular contractility in donation after circulatory death (DCD) hearts during ex situ machine perfusion. The research verified novel prediction parameters for heart transplant viability that were previously developed in porcine models. These findings indicate that integrating microcirculation assessment improves the evaluation of transplantable hearts. This provides a more robust method beyond relying solely on lactate levels. Article 5: Long Troponin T to Separate Troponin Elevations Among Patients With Atrial Fibrillation Versus Myocardial Infarction. Journal: Journal of the American Heart Association PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41757465 Summary: Patients presenting to the emergency department with atrial fibrillation often show elevated troponin levels, which are rarely due to myocardial infarction. However, current high-sensitivity cardiac troponin T assays measure both intact and fragmented forms, failing to distinguish between myocardial injury from atrial fibrillation and actual myocardial infarction. This situation presents a significant diagnostic challenge for clinicians. There is a clear need for methods to accurately separate these distinct causes of troponin elevation for appropriate patient management. Transcript Today’s date is February 28, 2026. Welcome to Cardiology Today. Here are the latest research findings. Article number one. Heart failure in the elderly: epidemiology, mechanisms, and management. The majority of patients with heart failure (H. F.) are of advanced age. The lifetime risk for developing H. F. is approximately 25 percent, with a sharp increase in incidence observed after the age of 70. While the lifetime risk is nearly equal for men and women, women show a higher propensity to develop heart failure with preserved ejection fraction (H. F. pEF), whereas men are more prone to heart failure with reduced ejection fraction (H. F. rEF). Article number two. Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study. A previous European trial found that switching from well-managed warfarin to direct oral anticoagulants (DOACs) in frail elderly patients with atrial fibrillation was associated with a higher bleeding risk. This underscores the clinical importance of evaluating the safety and effectiveness of such switches in diverse populations. Understanding outcomes in frail elderly Asian patients is particularly crucial due to potential demographic and clinical differences impacting anticoagulant management. This research addresses a significant therapeutic challenge in optimizing anticoagulation for a vulnerable patient group. Article number three. Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy. This study found that the burden of macrophages within carotid plaques and specific inflammatory lipid-associated macrophage markers serve as predictors for secondary major adverse cardiovascular events (MACE) following endarterectomy. The data establishes a direct link between the cellular content of atherosclerotic lesions and future cardiovascular outcomes. These findings indicate that detailed characterization of macrophage populations in carotid plaques provides crucial prognostic information. This information can guide risk stratification for patients after carotid endarterectomy. Article number four. Myocardial Microcirculation Combined With Lactate Measurements Predicts Ventricular Contractility in a Canine DCD Orthotopic Heart Transplantation During Ex Situ Machine Perfusion. This canine orthotopic heart transplantation study demonstrated that combining myocardial microcirculation data with lactate measurements accurately predicts ventricular contractility in donation after circulatory death (DCD) hearts during ex situ machine perfusion. The research verified novel prediction parameters for heart transplant viability that were previously developed in porcine models. These findings indicate that integrating microcirculation assessment improves the evaluation of transplantable hearts. This provides a more robust method beyond relying solely on lactate levels. Article number five. Long Troponin T to Separate Troponin Elevations Among Patients With Atrial Fibrillation Versus Myocardial Infarction. Patients presenting to the emergency department with atrial fibrillation often show elevated troponin levels, which are rarely due to myocardial infarction. However, current high-sensitivity cardiac troponin T assays measure both intact and fragmented forms, failing to distinguish between myocardial injury from atrial fibrillation and actual myocardial infarction. This situation presents a significant diagnostic challenge for clinicians. There is a clear need for methods to accurately separate these distinct causes of troponin elevation for appropriate patient management. Thank you for listening. Don’t forget to subscribe. Keywords myocardial infarction, ventricular contractility, endarterectomy, aging, Heart failure, frailty, donation after circulatory death, major adverse cardiovascular events, Warfarin, atrial fibrillation, direct oral anticoagulants, macrophages, Atrial fibrillation, bleeding risk, cardiac injury biomarkers, Myocardial microcirculation, diagnostic challenge, Carotid plaque, elderly, ejection fraction, prognosis, machine perfusion, troponin, epidemiology, lactate, atherosclerosis, heart transplantation. About Concise summaries of cardiovascular research for professionals. Subscribe • Share • FollowThe post Macrophage Burden Predicts MACE Post-Endarterectomy 02/28/26 first appeared on Cardiology Today.