Cardiology tips updates

03/23/2026

🫀 FDA-Approved Therapies in ATTR Amyloidosis

🔹 ATTR Cardiomyopathy (Heart):
• Tafamidis
• Acoramidis
• Vutrisiran

🔹 ATTR Polyneuropathy (Nerve):
• Patisiran
• Vutrisiran
• Inotersen
• Eplontersen

📌 Key Concept:
• Stabilizers → prevent TTR misfolding
• Gene silencers → reduce TTR production

👉 ATTR is now a treatable disease with multiple disease-modifying options.

Review ;
🟣 FDA-Approved for ATTR Polyneuropathy

✔️ Patisiran (Onpattro)
• FDA approved 2018
• First RNAi therapy for hATTR-PN 

✔️ Vutrisiran (Amvuttra)
• FDA approved 2022 for hATTR-PN 
• Later expanded to cardiomyopathy (2025) 

✔️ Inotersen (Tegsedi)
• FDA approved 2018 for hATTR-PN 

✔️ Eplontersen (Wainua)
• FDA approved Dec 2023 for hATTR-PN

03/23/2026

Know the treatment of ATTR Amyloidosis ( HEART VS. NERVE)

03/23/2026

DO YOU KNOW THIS ! Journal review;

📊 Aficamten vs Metoprolol in Obstructive HCM (NEJM 2025)

🔬 Why this matters:
Beta-blockers have been first-line therapy for symptomatic obstructive hypertrophic cardiomyopathy (HCM), but strong comparative evidence has been limited. This trial directly compares aficamten (cardiac myosin inhibitor) vs metoprolol.

👥 Study Design:
• Phase 3, randomized, double-blind, head-to-head
• 175 patients with symptomatic obstructive HCM
• 24-week follow-up
• Primary endpoint: change in peak VO₂

💊 Intervention:
• Aficamten (5–20 mg)
• Metoprolol (50–200 mg)

📈 Key Results:
• Aficamten significantly IMPROVED exercise capacity (↑ peak VO₂)
• Mean difference: +2.3 mL/kg/min (p < 0.001)
• Metoprolol showed a decline in peak VO₂
• Adverse events: similar between groups

⚠️ Limitations:
• Short duration (24 weeks)
• Long-term outcomes unknown
• Beta-blocker dosing strategy may vary in practice

🏁 Bottom Line:
👉 Aficamten monotherapy is SUPERIOR to metoprolol in improving functional capacity in symptomatic obstructive HCM, with comparable safety.

⸻

02/03/2026

SGLT2 inhibitors show strong heart benefits in cancer patients undergoing chemotherapy, reducing deaths and heart issues, supporting their use in cardio-oncology, especially for high-risk patients.

-Oncology

AbstractBackground. Chemotherapy is associated with significant cardiotoxicity. Although other guideline directed medications for heart failure are effecti

02/03/2026

ATTR vs AL Amyloidosis — Quick Clinical Basics

AL amyloidosis
• Caused by monoclonal light chains
• κ or λ only (λ predominates ~70–75%)
• Heavy chains do NOT form cardiac amyloid
• Must be excluded first with serum & urine immunofixation + free light chains

ATTR amyloidosis
• Caused by misfolded transthyretin (TTR)
• Not an immunoglobulin disease
• Can be diagnosed non-invasively once AL is excluded
• Targeted therapies now available

Key rule

Exclude AL first. Then evaluate for ATTR.

12/30/2025

Welcome to Cardiology Tips Updates

This page is dedicated to evidence-based cardiology education, with a focus on:
• ECG interpretation
• Echocardiography
• Cardiac imaging & clinical pearls

Content is designed for clinicians, trainees, and learners worldwide, emphasizing practical understanding and exam-relevant concepts.

📌 Posts are educational in nature and intended to support learning and discussion.
📌 Clinical decisions should always follow local guidelines and physician judgment.

Thank you for learning with us.

12/19/2025

Chest pain after myocardial infarction is not all the same. Timing provides the diagnosis.

Early causes (hours–days):
• Reinfarction → rising troponin, ischemic ECG
• Early pericarditis → diffuse ST elevation ± PR depression

Mechanical complications (days):
• Papillary muscle rupture → acute MR, flash pulmonary edema
• VSD rupture → new harsh holosystolic murmur
• Free wall rupture → tamponade, PEA arrest

Late causes:
• Dressler syndrome (weeks) → fever, ↑ ESR/CRP
• LV aneurysm (weeks–months) → persistent ST elevation

Clinical pearl:
Early = ischemia or mechanical complication
Late = inflammatory or remodeling process

12/19/2025

In patients undergoing CABG for acute coronary syndrome, routine addition of ticagrelor to aspirin did not improve cardiovascular outcomes compared with aspirin alone and was associated with higher bleeding risk.

Key takeaways:
• Aspirin monotherapy performed similarly
• No ischemic benefit from routine DAPT post-CABG
• Bleeding risk increased with ticagrelor

Clinical context matters: Aspirin remains the foundation after CABG, while DAPT should be reserved for selected high-risk scenarios.

Reference: Jeppsson A, et al. NEJM 2025. DOI:10.1056/NEJMoa2508026