Aficamten Superior to Metoprolol in HCM? 09/02/25
Welcome to Cardiology Today â Recorded September 02, 2025. This episode summarizes 5 key cardiology studies on topics like hospitalization and older adults. Key takeaway: Aficamten Superior to Metoprolol in HCM?.
Article Links:
Article 1: Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. (The New England journal of medicine)
Article 2: Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction. (The New England journal of medicine)
Article 3: Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy. (The New England journal of medicine)
Article 4: RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults. (The New England journal of medicine)
Article 5: High-Dose Influenza Vaccine to Reduce Hospitalizations. (The New England journal of medicine)
Full episode page: https://podcast.explainheart.com/podcast/aficamten-superior-to-metoprolol-in-hcm-09-02-25/
đ Featured Articles
Article 1: Beta-Blockers after Myocardial Infarction in Patients without Heart Failure.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888716
Summary: This open-label randomized trial in Denmark and Norway found no significant difference in the composite outcome of death from any cause, new myocardial infarction, or hospitalization for heart failure between patients with a left ventricular ejection fraction of 40 percent or greater who received long-term beta-blocker therapy and those who did not after myocardial infarction. Specifically, the study challenges the routine use of beta-blockers in this patient population in the era of modern reperfusion and secondary prevention. The findings suggest a need to re-evaluate guidelines regarding long-term beta-blocker use post myocardial infarction in patients without heart failure or reduced ejection fraction.
Article 2: Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888702
Summary: This open-label randomized trial in Spain and Italy evaluated beta-blocker therapy versus no beta-blocker therapy in acute myocardial infarction patients with or without ST-segment elevation, but without reduced ejection fraction. The study found no significant difference in the primary composite outcome of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, or major bleeding at a median of 3.5 years, suggesting that routine beta-blocker use in this contemporary setting may not provide additional benefit. This calls into question current guideline recommendations that are based on older trials before routine reperfusion and complete revascularization strategies.
Article 3: Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888697
Summary: This international, double-blind, randomized trial compared aficamten monotherapy to metoprolol monotherapy in patients with symptomatic obstructive hypertrophic cardiomyopathy. The study concluded that aficamten led to a statistically significantly greater reduction from baseline in the Valsalva left ventricular outflow tract gradient at week 12 compared to metoprolol; aficamten also resulted in a greater proportion of patients achieving an improvement of at least one New York Heart Association functional class. These findings suggest aficamten may be a more effective monotherapy option than metoprolol for managing symptomatic obstructive hypertrophic cardiomyopathy.
Article 4: RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888695
Summary: This pragmatic, open-label trial evaluated the Respiratory Syncytial Virus prefusion F protein-based vaccine in adults 60 years or older. The study found that the vaccine did not significantly reduce the risk of hospitalization for Respiratory Syncytial Virus-related lower respiratory tract disease, though there was a trend towards lower hospitalization rates. The researchers suggest further research is warranted to assess the vaccine’s effectiveness in preventing more severe Respiratory Syncytial Virus outcomes in this population.
Article 5: High-Dose Influenza Vaccine to Reduce Hospitalizations.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888694
Summary: This registry-based, open-label trial evaluated the effectiveness of high-dose inactivated influenza vaccine versus standard-dose vaccine in adults 65 years or older. Results showed no significant reduction in hospitalizations for influenza or pneumonia with the high-dose vaccine compared to the standard-dose vaccine. This suggests that, despite prior evidence of superior protection against laboratory-confirmed influenza, the high-dose vaccine does not significantly reduce hospitalizations in this age group.
đ Transcript
Today’s date is September 02, 2025. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. This open-label randomized trial in Denmark and Norway found no significant difference in the composite outcome of death from any cause, new myocardial infarction, or hospitalization for heart failure between patients with a left ventricular ejection fraction of 40 percent or greater who received long-term beta-blocker therapy and those who did not after myocardial infarction. Specifically, the study challenges the routine use of beta-blockers in this patient population in the era of modern reperfusion and secondary prevention. The findings suggest a need to re-evaluate guidelines regarding long-term beta-blocker use post myocardial infarction in patients without heart failure or reduced ejection fraction.
Article number two. Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction. This open-label randomized trial in Spain and Italy evaluated beta-blocker therapy versus no beta-blocker therapy in acute myocardial infarction patients with or without ST-segment elevation, but without reduced ejection fraction. The study found no significant difference in the primary composite outcome of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, or major bleeding at a median of 3.5 years, suggesting that routine beta-blocker use in this contemporary setting may not provide additional benefit. This calls into question current guideline recommendations that are based on older trials before routine reperfusion and complete revascularization strategies.
Article number three. Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy. This international, double-blind, randomized trial compared aficamten monotherapy to metoprolol monotherapy in patients with symptomatic obstructive hypertrophic cardiomyopathy. The study concluded that aficamten led to a statistically significantly greater reduction from baseline in the Valsalva left ventricular outflow tract gradient at week 12 compared to metoprolol; aficamten also resulted in a greater proportion of patients achieving an improvement of at least one New York Heart Association functional class. These findings suggest aficamten may be a more effective monotherapy option than metoprolol for managing symptomatic obstructive hypertrophic cardiomyopathy.
Article number four. RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults. This pragmatic, open-label trial evaluated the Respiratory Syncytial Virus prefusion F protein-based vaccine in adults 60 years or older. The study found that the vaccine did not significantly reduce the risk of hospitalization for Respiratory Syncytial Virus-related lower respiratory tract disease, though there was a trend towards lower hospitalization rates. The researchers suggest further research is warranted to assess the vaccine’s effectiveness in preventing more severe Respiratory Syncytial Virus outcomes in this population.
Article number five. High-Dose Influenza Vaccine to Reduce Hospitalizations. This registry-based, open-label trial evaluated the effectiveness of high-dose inactivated influenza vaccine versus standard-dose vaccine in adults 65 years or older. Results showed no significant reduction in hospitalizations for influenza or pneumonia with the high-dose vaccine compared to the standard-dose vaccine. This suggests that, despite prior evidence of superior protection against laboratory-confirmed influenza, the high-dose vaccine does not significantly reduce hospitalizations in this age group.
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đ Keywords
hospitalization, older adults, mortality, metoprolol, secondary prevention, beta-blockers, Respiratory Syncytial Virus, Respiratory Syncytial Virus vaccine, influenza vaccine, myocardial infarction, respiratory illness, aficamten, all-cause mortality, cardiac myosin inhibitors, revascularization, pneumonia, left ventricular outflow tract gradient, left ventricular ejection fraction, high-dose vaccine, ejection fraction, hypertrophic cardiomyopathy.
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Concise summaries of cardiovascular research for professionals.
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