In this episode, Editor-in-Chief Harlan Krumholz explores the evolving landscape of cardiovascular medicine, beginning with a call for responsible stewardship of artificial intelligence. Highlights include a major registry study on percutaneous aspiration for right-sided endocarditis, the predictive power of polygenic risk scores in heart failure, and the diverse causes of myocardial infarction in younger adults—especially women. The episode also covers a randomized trial on Intensive versus conventional intraoperative blood pressure management on cardiovascular events after major abdominal surgery, a state-of-the-art review on stressor-associated atrial fibrillation, and insights into long-term antithrombotic therapy after PCI. Each segment underscores the need for precision, equity, and innovation in clinical practice.

In this episode, Dr. Harlan Krumholz introduces the September 16, 2025 issue of JACC, which features studies that challenge conventional clinical thinking, including a detailed ECMO physiology study showing that higher ECMO flow does not uniformly raise pulmonary capillary wedge pressure, suggesting the need for individualized management. A novel analysis of the ISCHEMIA trial revealed distinct angina symptom trajectories, emphasizing that recovery is not binary and supporting a more personalized approach to treatment and monitoring. A landmark target trial emulation found that statins significantly reduce cardiovascular risk in patients with type 1 diabetes—filling a key evidence gap. Additional highlights include a call to redefine early cardiogenic shock, a nuanced review of moderate secondary mitral regurgitation, and an editorial reaffirming JACC's commitment to independent, transparent science in alignment with new "Gold Standard Science" principles.

In this episode, Dr. Harlan Krumholz reviews the September 9, 2025 issue of JACC, covering key studies on artificial intelligence in cardiovascular research, the effects of tirzepatide in heart failure with preserved ejection fraction (HFpEF), and how social, racial, and genetic factors influence heart failure risk. He discusses the growing burden of heart failure in the elderly, the need to disaggregate data in Asian American and Pacific Islander populations, and the role of rare genetic variants in atrial fibrillation outcomes. The episode also features perspectives on clinical trial design, complex case reports, and emphasizes the need for AI submissions to meet high standards of clinical relevance, feasibility, and long-term impact.