Medicare's GLP-1 Bridge Opens July 1: A Cardiologist's Guide to Eligibility, Cost, and Cardiovascular Stakes

A time-limited CMS demonstration finally gives Part D enrollees a $50/month path to GLP-1 therapy — here's what the eligibility criteria, drug economics, and cardiovascular evidence mean for practice.

Medicare has never directly covered an anti-obesity medication, a gap that is finally narrowing this week.

Starting July 1, 2026, the Medicare GLP-1 Bridge will let eligible Part D enrollees obtain certain GLP-1 receptor agonists for a flat $50 monthly copay.

The demonstration is authorized under the Secretary's Section 402 demonstration power rather than statutory Part D coverage, which is why CMS frames it as time-limited rather than permanent.

It runs through December 31, 2027, after a planned six-month pilot was extended because too few Part D plans volunteered for the follow-on coverage model.

For cardiologists, this is not simply a benefits-administration story.

A large share of the newly eligible population carries hypertension, prediabetes, established atherosclerotic disease, or heart failure — exactly the phenotype in which GLP-1 therapy has shown cardiovascular benefit.

Case Vignette

A 74-year-old retired teacher with a BMI of 32, longstanding hypertension, and a myocardial infarction four years ago asks whether she can finally afford Wegovy.

She has Medicare Part D coverage, no diabetes diagnosis, and has never filled a GLP-1 prescription through her drug plan.

Her BMI-plus-cardiovascular-history profile places her squarely within the Bridge program's 30–35 BMI eligibility tier.

Her cardiologist documents the prior infarction, submits the prescription, and her office completes the prior authorization so she can begin therapy at the $50 copay tier.

Who Qualifies

Eligibility is tiered by body mass index and stacked cardiometabolic risk factors rather than BMI alone.

Enrollees with a BMI of 35 or higher qualify without additional criteria.

Those with a BMI of 30 to under 35 need at least one of: uncontrolled hypertension, prediabetes, prior myocardial infarction or stroke, symptomatic peripheral arterial disease, Stage 3a-or-higher chronic kidney disease, or diastolic heart failure.

Those with a BMI of 27 to under 30 need prediabetes, a prior infarction or stroke, or symptomatic peripheral arterial disease.

Enrollees already receiving a GLP-1 through Part D for an approved indication — type 2 diabetes, moderate-to-severe obstructive sleep apnea, or noncirrhotic MASH — are excluded from the Bridge and stay on their existing Part D pathway.

Bridge Eligibility Tiers by BMI and Required Comorbidity

BMI ≥ 35

No additional criteria required

BMI 30–34.9

HTN, prediabetes, prior MI/stroke, PAD, CKD ≥3a, or HFpEF

BMI 27–29.9

Prediabetes, prior MI/stroke, or symptomatic PAD

Excluded

Already on Part D GLP-1, T2D, OSA, or MASH coverage

Covered Products and Pricing

Three GLP-1-class products are covered: Wegovy (semaglutide, injection and tablet) from Novo Nordisk A/S (NYSE: NVO), Zepbound KwikPen (tirzepatide) from Eli Lilly and Company (NYSE: LLY), and Lilly's newer oral agent Foundayo (orforglipron).

Single-dose Zepbound vials and pens are explicitly excluded from the demonstration, so practices should confirm the dispensed formulation before assuming coverage.

Under the negotiated arrangement, manufacturers supply the drugs to Medicare at roughly $245 for a month's supply, with the beneficiary's copay fixed at $50 regardless of dosage tier.

That $50 copay does not count toward the Part D deductible or out-of-pocket maximum, and Extra Help low-income subsidies cannot be layered on top of it.

Outside the Bridge, cash-pay pricing for these agents has historically run between roughly $150 and $650 a month depending on product and dose, which is the affordability barrier the pilot is designed to address.

Drug (Generic)	Brand	Manufacturer (Ticker)	Bridge Copay	Typical Cash Price/mo*
Semaglutide	Wegovy	Novo Nordisk (NVO)	$50	~$350–$650
Tirzepatide	Zepbound (KwikPen only)	Eli Lilly (LLY)	$50	~$350–$650
Orforglipron	Foundayo	Eli Lilly (LLY)	$50	~$150–$350

*Pre-Bridge cash pricing varies by dose and pharmacy channel; figures are approximate.

The Cardiovascular Rationale

This program lands in cardiology because the eligibility criteria were built around cardiometabolic risk, not cosmetic weight loss.

Semaglutide's cardiovascular outcomes data already support its labeled indication for reducing major adverse cardiovascular events in overweight or obese patients with established cardiovascular disease.

For patients with diastolic heart failure — a condition explicitly named in the BMI 30–35 eligibility tier — GLP-1 therapy has separately been studied for improvements in heart-failure-specific symptoms and functional capacity in the obesity-HFpEF phenotype.

Practically, this means cardiologists may now be the ones documenting the qualifying diagnosis — prior infarction, peripheral arterial disease, or HFpEF — that unlocks a patient's Bridge eligibility, even when a primary care physician or endocrinologist writes the prescription.

Estimated Monthly Out-of-Pocket Cost: Before vs. After the Bridge

$450

Cash-pay,
pre-Bridge

$245

Negotiated
Medicare cost

$50

Beneficiary
copay, Bridge

Scope, Cost, and Durability of the Program

Independent analysts at KFF estimate that roughly 3.8 million Part D enrollees — about 8% of the Part D population — could meet Bridge eligibility criteria.

If participation lands in the 10%–25% range through the end of 2027, KFF projects program cost to Medicare in the range of $1.3 billion to $3.3 billion, before accounting for any downstream reduction in cardiovascular and metabolic care costs.

A successor voluntary model for Part D plans, known as the BALANCE Model, was originally slated to begin in January 2027 but has been delayed indefinitely because too few insurers opted in, which is why the Bridge itself was extended through the end of 2027.

Practices should treat current Bridge eligibility as time-limited rather than a permanent benefit redesign, and counsel patients accordingly when initiating long-term GLP-1 therapy.

Quick Reference: Bridge Program at a Glance

Feature	Detail
Launch date	July 1, 2026
Program end	December 31, 2027
Beneficiary copay	$50/month, fixed
Counts toward deductible/OOP max?	No
Extra Help (LIS) stacking allowed?	No
Plan opt-in required?	No — operates outside standard Part D risk flow
Estimated eligible population	~3.8 million (KFF)

Bottom Line

The Medicare GLP-1 Bridge gives cardiologists a practical new lever for patients whose obesity sits alongside hypertension, prior vascular events, or HFpEF.

Eligibility hinges on documented cardiometabolic comorbidity, not BMI alone, which puts cardiology notes squarely in the prior-authorization chain.

Because the program sunsets at the end of 2027 with no guaranteed successor, treatment plans should account for the possibility that the $50 price point will not persist.

References

1. Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge program overview.
2. CMS. Medicare GLP-1 Bridge: information for pharmacies (covered products and NDCs).
3. Medicare.gov. Weight loss drugs coverage information.
4. KFF. Program on Medicare Policy analysis of GLP-1 Bridge eligibility and cost.
5. StockAnalysis.com. Eli Lilly and Company (LLY) financial data.
6. StockAnalysis.com. Novo Nordisk A/S (NVO) financial data.

Disclaimer: This article is intended for physician education only and does not constitute clinical, financial, or investment advice. Drug pricing, program rules, and eligibility criteria are subject to change; verify current details directly with CMS before counseling patients. Investment-related content reflects general market information available at the time of publication and should not be construed as a recommendation to buy or sell any security.

The Great Reshuffling: Mapping the 2025 Cardiology Workforce by State

What state-level shifts in cardiologist and cardiovascular technologist employment signal for practice planning, recruitment, and patient access

A new workforce analysis of Bureau of Labor Statistics data shows striking state-by-state divergence in cardiology staffing between 2024 and 2025.

Only four states — Connecticut, South Carolina, Texas, and Virginia — posted simultaneous growth in both employed cardiologists and cardiovascular technologists.

Eight states moved in the opposite direction, shedding both roles year over year, a pattern that should concern anyone tracking regional cardiovascular care capacity.

For physicians weighing relocation, recruitment, or service-line expansion, these numbers offer a real-time pulse on where cardiology capacity is being built and where it is eroding.

The states gaining ground on both fronts

Texas added the most cardiologists in absolute terms, growing from roughly 1,530 to 2,050 clinicians, a 34% increase, while its cardiovascular technologist workforce grew nearly 20%.

Virginia and South Carolina posted even sharper percentage gains in cardiologist headcount, at 58.8% and 61.5% respectively, alongside double-digit technologist growth.

Connecticut rounded out the four-state cohort with a 23.1% rise in cardiologists and a 17% rise in technologists.

Florida posted the single largest cardiologist percentage gain nationally at 67.3%, though its technologist count slipped slightly, keeping it outside the dual-growth group.

Teal = year-over-year growth in employed cardiologists; amber = decline. Source: BLS-derived state employment estimates.

The states losing ground on both fronts

Alabama, Delaware, Georgia, Iowa, Maine, Ohio, Tennessee, and Washington each recorded simultaneous declines in cardiologist and cardiovascular technologist headcount.

Georgia stands out within this group, losing 24.3% of its cardiologist workforce and nearly 15% of its technologists in a single year, a combination that warrants scrutiny of regional referral patterns and access.

Iowa's 47.4% cardiologist decline was the second-steepest in the country, trailing only New Mexico's 71% drop.

Small base numbers amplify these percentages, so a single retirement, relocation, or employment-classification change in a low-volume state can swing the year-over-year figure dramatically.

State-by-state employment snapshot

The full dataset below reflects 2025 total employment and the percent change from 2024 for both roles, drawn from BLS occupational employment statistics.

State	Cardiologists, 2025	% Change	CV Techs, 2025	% Change
Connecticut	320	+23.1%	620	+17.0%
South Carolina	210	+61.5%	890	+7.2%
Texas	2,050	+34.0%	6,140	+19.7%
Virginia	810	+58.8%	2,410	+14.2%
Florida	920	+67.3%	5,640	-3.4%
New Mexico	90	-71.0%	400	+53.8%
New York	2,260	0.0%	3,540	+10.6%
Alabama	130	-23.5%	930	-15.5%
Georgia	1,150	-24.3%	2,580	-14.9%
Iowa	100	-47.4%	380	-13.6%
Ohio	760	-1.3%	2,140	-6.1%
Tennessee	560	-1.8%	1,030	-14.2%
Washington	200	-23.1%	1,110	-4.3%

Abbreviated table; full 51-jurisdiction dataset available via the source report linked above.

Why the technologist side matters just as much

Alaska and the District of Columbia each doubled their cardiovascular technologist workforce year over year, though both started from a small base.

West Virginia saw the steepest technologist decline nationally at 25.5%, a notable signal given the state's already limited cardiology footprint.

Technologist supply directly constrains echocardiography, stress testing, and cardiac catheterization lab throughput, so a shrinking tech workforce can bottleneck care even where physician staffing holds steady.

Programs expanding physician headcount without a parallel technologist pipeline risk creating scheduling backlogs rather than genuine capacity gains.

Circle area is illustrative of relative count, not statistically scaled.

Reading these numbers in context

National-level data show roughly 17,290 practicing cardiologists and about 63,000 cardiovascular technologists in 2025, with cardiologists earning a mean annual wage near $454,940 and technologists near $76,940.

These state swings unfold against a broader backdrop of projected physician shortfall, with the Association of American Medical Colleges projecting a shortage of tens of thousands of physicians by the mid-2030s.

Roughly half of U.S. counties lack a practicing cardiologist, and the gap is far more severe in rural areas, where the large majority of counties have no cardiologist at all.

Against that backdrop, a single state adding or losing a quarter of its cardiologist workforce in one year is not noise — it is a meaningful shift in regional access.

Compensation and demand context

Metric	2025 figure	Source
National cardiologist mean annual wage	$454,940	BLS OEWS
National CV technologist mean annual wage	$76,940	BLS OEWS
Median full-time cardiologist compensation	$694,954	MedAxiom 2025 survey
Average cardiologist starting salary	$470,000	AMN Healthcare

Case vignette

A mid-career non-invasive cardiologist at a hospital-employed practice in the Midwest is approached by a recruiter from a Gulf Coast health system.

Before responding, the physician asks Claude-style workforce data to compare cardiologist and cardiovascular technologist growth trends between the home state and the prospective state.

Seeing that the home state is among those losing both cardiologists and technologists year over year, while the destination state is in the four-state dual-growth group, the physician recognizes that the practice environment, call burden, and support staffing may differ substantially.

This kind of state-level workforce comparison becomes a useful, objective input alongside compensation and lifestyle factors when evaluating a job offer or a service-line expansion proposal.

What this means for practice and policy planning

Group practices and health systems in dual-decline states may need to budget for higher recruitment incentives and longer time-to-fill for both physician and technologist roles.

Systems in high-growth states should validate that echocardiography lab, cath lab, and electrophysiology support staffing is scaling proportionally with physician hiring, not lagging behind it.

For physicians considering relocation, pairing this workforce data with regional American College of Cardiology chapter resources can help benchmark call schedules and program maturity before signing a contract.

Bottom line

Only four states grew both their cardiologist and cardiovascular technologist workforces in 2025, while eight states shrank in both categories simultaneously, a divergence that physicians should factor into recruitment, relocation, and service-line planning decisions alongside compensation and lifestyle considerations.

References

1. Becker's Cardiology Review. State and metro concentration of cardiologists and cardiovascular technologists, 2025.
2. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Physicians and Surgeons.
3. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Cardiovascular Technologists and Technicians.
4. Association of American Medical Colleges. Physician supply and demand projections.
5. American College of Cardiology. Cardiovascular Team Section resources.

This article is intended for physician education and general informational purposes only, does not constitute career, legal, or financial advice, and should not be used as the sole basis for employment or business decisions.

Expert Analysis · Arrhythmias & Clinical EP

LAAO vs. Medical Therapy in High-Risk AF: What CLOSURE-AF Means for Practice

Cardiology Blog Team | Physician Education Series | Updated June 2026

A new randomized trial is reshaping how cardiologists think about left atrial appendage occlusion in the sickest atrial fibrillation patients.

For years, catheter-based LAAO has been pitched as a stroke-prevention strategy for patients who cannot tolerate long-term anticoagulation.

The CLOSURE-AF trial tested that premise specifically in patients at high risk for both stroke and bleeding, and the results complicate the prevailing narrative.

What CLOSURE-AF Tested

CLOSURE-AF was a pragmatic, multicenter randomized trial conducted across 42 German centers.

The trial enrolled 888 patients with a mean age of 78 years and substantial comorbidity burden, reflected in a mean CHA2DS2-VASc score of 5.2 and a mean HAS-BLED score of 3.0.

Patients were randomized to catheter-based LAAO (446 patients) or physician-directed best medical therapy (442 patients), of whom 85% received a direct oral anticoagulant (DOAC).

The primary composite endpoint combined stroke, systemic embolism, major bleeding, and cardiovascular or unexplained death over a median follow-up of three years.

The Headline Result

LAAO failed to demonstrate noninferiority against medical therapy for the primary composite endpoint.

Event rates were numerically higher in the device arm, at 16.8 versus 13.3 events per 100 patient-years.

Stroke rates were nearly identical between groups, at 2.6 versus 2.7 events per 100 patient-years.

Critically, major bleeding was not reduced with LAAO despite the avoidance of long-term anticoagulation, undercutting a core rationale for offering the procedure to bleeding-prone patients.

Serious adverse events occurred more often in the device arm, 82.5% versus 77.4%, and periprocedural complications affected 5.7% of implanted patients.

Endpoint	LAAO (per 100 pt-yrs)	Medical Therapy (per 100 pt-yrs)
Primary composite endpoint	16.8	13.3
Stroke	2.6	2.7
Serious adverse events (overall, %)	82.5%	77.4%
Periprocedural complications	5.7%	—

Figure 1. CLOSURE-AF primary composite endpoint and stroke rates, LAAO vs. medical therapy.

How This Fits With Prior Evidence

Earlier randomized trials had already established noninferiority of LAAO against DOAC therapy in broader AF populations.

CLOSURE-AF is distinct because it specifically enrolled patients at high risk for both stroke and bleeding, a population not directly represented in those earlier studies.

That distinction matters because this is precisely the population in which clinicians most often consider LAAO as an anticoagulation-sparing option.

Two other trials help frame the broader landscape: the CHAMPION-AF trial found that device-based closure with the Watchman FLX system was noninferior to NOAC therapy and reduced non-procedure-related bleeding at three years, while the ongoing CATALYST trial is evaluating the Amplatzer Amulet device against NOAC therapy.

Taken together, these trials suggest that patient selection, rather than the LAAO concept itself, may be the determining factor in whether device-based closure outperforms medical therapy.

Devices, Manufacturers, and Cost Context

The two leading commercial LAAO platforms are the Watchman FLX device, manufactured by Boston Scientific (NYSE: BSX), and the Amplatzer Amulet device, manufactured by Abbott Laboratories (NYSE: ABT).

For context, BSX shares trade in the mid-$40s and ABT shares trade in the mid-$90s, with both companies maintaining substantial structural-heart device franchises.

A typical Medicare beneficiary's out-of-pocket cost for the Watchman implant is estimated at no more than $3,318 under current Part A and Part B cost-sharing rules, a figure that excludes the facility and device acquisition costs borne by the health system.

Device	Generic/Class	Manufacturer (Ticker)	Typical Medicare Patient OOP Cost
Watchman FLX	Percutaneous LAA closure device	Boston Scientific (BSX)	≤$3,318
Amplatzer Amulet	Percutaneous LAA closure device	Abbott (ABT)	Comparable Medicare cost-sharing structure
DOAC therapy (class)	Direct oral anticoagulant	Multiple manufacturers	Variable by plan and formulary tier

Case Vignette

A 79-year-old with permanent AF, prior gastrointestinal bleed, and a CHA2DS2-VASc score of 6 is referred for LAAO after his primary team flags him as a poor anticoagulation candidate.

Before proceeding, the consulting cardiologist now has trial-level evidence that LAAO in patients with this combined high stroke-and-bleeding profile has not shown a net benefit over optimized medical therapy, including bleeding rates.

This prompts a more structured shared decision-making conversation, including a trial of dose-adjusted DOAC therapy with bleeding-mitigation strategies before defaulting to device closure.

Limitations Worth Knowing

CLOSURE-AF was not powered to detect differences in individual endpoint components, limiting conclusions about any single outcome such as bleeding alone.

The trial was conducted exclusively in Germany in a predominantly White cohort, which limits generalizability to more diverse populations.

The study also underwent two sample-size reductions based on interim analyses, a design feature that can affect statistical power.

Practice Implications

For patients at high combined risk of stroke and bleeding, CLOSURE-AF reinforces that DOAC therapy should remain the default strategy whenever tolerated.

LAAO still has a defined role for patients with a true contraindication to long-term anticoagulation, but this trial argues against expanding that role to dual high-risk patients simply because bleeding risk is elevated.

Procedural risk is not trivial in this older, sicker population, and the 5.7% periprocedural complication rate should factor directly into the consent conversation.

Ongoing trials including CHAMPION-AF and CATALYST will help define which specific subgroups, if any, derive a net benefit from device-based closure.

Bottom Line

In patients at high risk for both stroke and bleeding, catheter-based LAAO did not outperform optimized medical therapy in CLOSURE-AF, and bleeding rates were not reduced despite anticoagulation avoidance.

Careful patient selection, not blanket extension to all high-bleeding-risk patients, should guide referral for LAAO until further trial data clarify which subgroups benefit.

Figure 2. Comparative trial landscape for LAAO in atrial fibrillation, by population risk profile.

References

1. American College of Cardiology. CLOSURE-AF: LAA Closure Noninferior to Medical Therapy in High-Risk AFib Patients. Journal Scan, March 2026.
2. American College of Cardiology. CHAMPION-AF: Left Atrial Appendage Closure vs. Anticoagulation for AFib. ACC.26 Coverage, March 2026.
3. Boston Scientific. WATCHMAN LAAC Medicare Patient Cost Information for Physicians, 2026.

This article is intended for physician education and does not constitute personalized medical, legal, or financial advice; clinical decisions should be individualized and any investment-related content reflects general financial education only, not a recommendation to buy or sell any security.

Health Policy & Quality Improvement

Closing the Gap: What the AHA Target: AS Registry Reveals About Real-World Aortic Stenosis Care

A year of registry data shows diagnosis is getting faster, but timely treatment is holding steady at roughly 1-in-6 patients still missing the window.

Aortic stenosis remains one of the most consequential and most frequently mismanaged valve diseases in adult cardiology.

The Target: AS registry, sponsored nationally by Edwards Lifesciences (NYSE: EW, ~$91/share), just produced its first large-scale, multi-center analysis of whether a structured quality program actually changes practice patterns.

Findings were presented at New York Valves 2026 and published simultaneously in Circulation.

The cohort included 8,097 patients with moderate or severe AS across 58 active sites enrolled by 2023, drawn from a broader registry of nearly 17,600 patient records spanning 92 centers.

Over one year, the proportion of patients receiving a timely diagnosis, defined as symptom assessment, LVEF, and stroke volume index and/or multimodal imaging within 30 days of echocardiography, rose from 54.2% to 61.4%.

Despite that gain, the rate of timely treatment among patients with a class 1 indication for aortic valve replacement (AVR) was essentially unchanged, 82.2% versus 84.7%, meaning roughly one in six eligible patients still missed the 90-day treatment window.

Timely Diagnosis Components, 2023 vs. 2024 (Long-Term Sites)

Symptom assessment

76.8%→84.0%

Stroke volume index on echo

64.7%→81.6%

Multimodal imaging use

13.4%→24.5%

Multidisciplinary team evaluation

77.6%→83.9%

Improved significantly (P<0.05) Improved but still low absolute rate

Where the System Is Still Leaking Patients

The registry's most clinically actionable finding is not the headline diagnosis number but the granular breakdown of where care still stalls.

Echocardiography reports included key structural findings 83-85% of the time, yet a discrete clinical recommendation appeared in only 9.0% (2023) and 6.8% (2024) of reports, a gap that discussant Dharam Kumbhani called highly amenable to system-level fixes like structured echo templates.

Even at long-standing sites, surveillance echocardiograms were missed in 40.2% of patients with severe AS and 37.1% of those with moderate AS by 2024, undermining the entire premise of watchful waiting.

Multimodal testing, which captures cases where resting Doppler is equivocal and CT-based aortic valve calcium scoring or stress echocardiography is needed to confirm severity, nearly doubled but started from a very low base (13.4% to 24.5%).

The AS Care Continuum — Where Patients Are Lost

Echo identifies moderate/severe AS

Key findings documented in report (83-85%)

Timely diagnosis completed (54.2%→61.4%)

Explicit clinical recommendation in echo report (≤9%)

Timely AVR in class 1 candidates (82.2%→84.7%)

Why the Registry May Itself Be the Intervention

A parallel and complementary signal comes from the ALERT trial, a cluster-randomized study presented at ACC 2026 showing that automated EHR notifications, generated using an AI platform from Tempus AI, increased 90-day evaluation or intervention rates from 19.9% to 24.3% across 35 hospitals.

That trial was funded in part by Medtronic (NYSE: MDT, ~$81/share), and builds on the earlier single-system DETECT AS trial, which showed similar automated alerts narrowed sex-based disparities in AVR referral.

Taken together with Target: AS, the data suggest that simply measuring and reporting back quality metrics, independent of any specific clinical intervention, may itself nudge practice patterns, though the authors caution this could partly reflect a Hawthorne effect rather than durable system change.

Procedural outcomes have already been transformed by the device side of this story: TAVR using the SAPIEN 3 platform (Edwards Lifesciences) now shows durability comparable to surgical valves out to seven years in low-risk patients, based on data from the STS/ACC TVT Registry presented at New York Valves 2026.

The clinical irony the registry exposes is that procedural excellence has outpaced the upstream referral pathway that gets patients to the cath lab or OR in the first place.

Key Players in the AS Quality and Device Ecosystem

Entity	Role	Ticker / Price (approx.)
Edwards Lifesciences	National sponsor of Target: AS; SAPIEN TAVR platform	NYSE: EW, ~$91
Medtronic	ALERT trial co-funder; CoreValve/Evolut TAVR platform	NYSE: MDT, ~$81
Abbott Laboratories	Structural heart portfolio (Navitor TAVR, MitraClip)	NYSE: ABT, ~$93
Boston Scientific	ACURATE and emerging structural heart pipeline	NYSE: BSX, ~$44

Prices approximate as of late June 2026; for general orientation only, not a trading recommendation.

Case Vignette A 78-year-old man undergoes echocardiography for dyspnea and is found to have a peak aortic velocity of 4.3 m/s with preserved ejection fraction, consistent with severe high-gradient AS.

The report documents the gradient and valve area but includes no explicit recommendation for heart-team referral, and the patient is not flagged for follow-up.

Three months later he returns with syncope; only then is he referred for multidisciplinary evaluation, ultimately undergoing transcatheter AVR but after a preventable delay.

This is precisely the failure mode the Target: AS data quantify at a population level, a structurally sound diagnostic system that does not reliably translate findings into action.

Practical Takeaways for Practice

Target: AS Registry — Selected Process Metrics, 2023 vs. 2024

Metric	2023	2024	P value
Overall timely diagnosis	54.2%	61.4%	0.001
Timely AVR in class 1 candidates	82.2%	84.7%	0.299
Multidisciplinary team evaluation	77.6%	83.9%	<0.001
Echo report with clinical recommendation	9.0%	6.8%	—
Missed surveillance echo, severe AS (long-term sites)	—	40.2%	—

For employed cardiologists and structural heart programs, the actionable lesson is that structured echo reporting templates with a forced clinical-recommendation field, paired with an automated referral pathway to the valve team, are the two interventions with the clearest evidence base right now.

The proposed changes to the TAVR National Coverage Determination (NCD) make this more than an academic exercise, since referral-pathway performance may increasingly intersect with how programs are evaluated and reimbursed.

The American Heart Association's Heart Valve Initiative, the planned successor to Target: AS, intends to expand the same accountability framework to mitral and tricuspid disease across up to 200 hospitals.

Bottom Line Registry participation appears to genuinely accelerate diagnostic processes in aortic stenosis, but treatment-rate gains have lagged, and the data point squarely to the echo-to-referral handoff as the highest-yield target for local quality improvement.

This article is intended for physician education and general clinical awareness; it does not substitute for individualized patient assessment, institutional protocols, or current society guidelines. Investment-related content is for general informational purposes only, does not constitute personalized financial advice, and past stock performance does not predict future results.

References

1. American Heart Association. Target: Aortic Stenosis program overview.
2. TCTMD. Clinician EHR Alerts Lead to Speedier Evaluation, Treatment of Valve Disease (ALERT trial), 2026.
3. TCTMD. RCT, Real-World Data Show TAVI Durability Up to 7 Years in Low-Risk Patients, New York Valves 2026.
4. American Heart Association Newsroom. Heart Valve Initiative announcement.

$40 Million Malpractice Verdict: What Every Cardiologist Must Learn from a Missed Hypertension Call

Medicolegal Risk, Documentation Standards, and Clinical Decision-Making in Hypertensive Patients — A Physician Education Review

Figure 1 — Clinical Timeline: From Missed BP to Catastrophic Stroke

A $40 million medical malpractice verdict entered in March 2024 against Advocate Health and a primary care provider is reshaping how physicians must think about a single elevated blood pressure reading in a young patient.

The case centered on a 37-year-old man who presented to his primary care physician (PCP) in January 2015 with a two-month history of worsening cough and was found to have a blood pressure of 190/102 mmHg.

He was diagnosed with acute bronchitis and prescribed azithromycin, Tessalon Perles, Cheratussin AC, and Pulmicort — but was sent home without antihypertensive therapy.

Six weeks later, in March 2015, the patient was found in his car in respiratory distress with right-sided weakness and aphasia, with a prehospital systolic blood pressure reportedly as high as 290 mmHg.

He sustained a 5 × 4 cm basal ganglia hemorrhage, and today requires round-the-clock assistance with all activities of daily living.

The jury awarded $6 million for future medical expenses, nearly $20 million for past and future disability, and additional amounts for pain, suffering, and lost wages — covering what could be more than 30 years of total dependence.

Was This Actually a Hypertension Diagnosis?

Both the American College of Cardiology (ACC) and American Heart Association (AHA) recommend confirming elevated readings on multiple occasions before establishing a formal hypertension diagnosis.

This patient's prior blood pressure was 132/82 mmHg six months earlier at an outside clinic — a reading consistent with Stage 1 hypertension by current 2017 ACC/AHA criteria (≥130/80) but still below the 140/90 threshold used under 2015-era guidelines.

The critical question — whether a single-visit BP of 190/102 in the context of a respiratory illness warranted formal diagnosis and immediate pharmacotherapy — remains clinically debated.

JNC 8, published in 2014 and operative at the time of this encounter, recommended initiating pharmacologic treatment for diastolic BP >90 mmHg (Grade A) and systolic BP >140 mmHg (Grade E) — thresholds this patient clearly exceeded.

Plaintiff attorneys argued the patient's cough was a symptom of hypertension-driven heart failure, not bronchitis — a retrospective reframing that proved compelling to the jury.

The Pulmonary Embolism Allegation: Was It Valid?

The plaintiff's expert alleged the physician was negligent for not sending the patient to the emergency department to rule out a pulmonary embolism (PE) — despite the fact that a risk-stratification tool analysis based on available complaint data places this patient as low risk by Wells Criteria (approximately 1.3% pre-test probability).

Applying the PERC Rule, this patient would likely have been ruled out for PE without further imaging — a standard, evidence-based approach.

The expert witness opinion was widely criticized as being legally rather than clinically authored, and the allegation that any patient in their mid-30s with a two-week cough and a single elevated blood pressure reading requires a full workup including CBC, troponins, D-dimer, ABG, PFTs, echocardiogram, CXR, ECG, chest CT, and cardiopulmonary consultations does not reflect any published guideline standard.

American College of Emergency Physicians (ACEP) guidelines on asymptomatic hypertension state explicitly that routine laboratory screening is not required and that even markedly elevated asymptomatic readings do not mandate emergent intervention in the absence of target organ injury.

BP Category (2017 ACC/AHA)	Systolic (mmHg)	Diastolic (mmHg)	Recommended Action
Normal	<120	<80	Lifestyle counseling; recheck in 1 year
Elevated	120–129	<80	Lifestyle modification; recheck in 3–6 months
Stage 1 HTN	130–139	80–89	Lifestyle ± pharmacotherapy based on CV risk
Stage 2 HTN	≥140	≥90	Lifestyle + pharmacotherapy; follow up in 1 month
Hypertensive Crisis	>180	>120	Immediate evaluation; assess for target organ damage

Table 1. 2017 ACC/AHA Blood Pressure Classification and Clinical Action Thresholds. Patient's January 2015 reading of 190/102 mmHg falls in the hypertensive crisis range. Prior reading of 132/82 meets current Stage 1 criteria.

Documentation: The Real Battleground

A discrepancy between physician and medical assistant notes — the physician documented "coughing fits without dyspnea" while the MA documented "hard time breathing" — became a cornerstone of the plaintiff's narrative of carelessness.

When conflicting histories exist in a chart, best practice is to re-interview the patient with both providers present, or to explicitly document reconciliation of the discrepancy in the physician's note.

A brief addendum such as "MA note reviewed; patient specifically denied dyspnea on direct questioning" may have substantially altered the jury's perception of thoroughness.

Abnormal vital signs require documented acknowledgment — if the plan is watchful waiting or repeat measurement rather than immediate treatment, that clinical reasoning must appear in the chart.

A note reading "BP 190/102 — white coat effect possible; return in 2 weeks for repeat BP measurement" demonstrates that the finding was recognized and addressed, rather than ignored.

Return precautions — instructing patients to seek care if symptoms worsen, fail to improve, or new symptoms emerge — are a simple, high-leverage documentation tool that can shift contributory liability to the patient in cases of delayed follow-up.

The patient's February 6th phone call for URI symptoms — handled entirely as a prescription refill without any reassessment of blood pressure — represented a missed second opportunity to address an unresolved cardiovascular risk factor.

Documentation Element	Why It Matters Medicolegally	Example Language
Acknowledge abnormal vitals	Demonstrates the finding was not overlooked	"BP 190/102 noted; likely related to pain/anxiety — to be rechecked after 5 minutes"
Reconcile conflicting notes	Prevents narrative of physician carelessness	"MA note reviewed; patient denied dyspnea on direct questioning by examiner"
Document clinical reasoning for deferring treatment	Shows thoughtful decision, not negligent omission	"Initiating antihypertensives deferred pending repeat BP confirmation in 2–4 weeks"
Shared decision-making notation	Protects against failure-to-refer allegations	"Chest CT discussed; patient declined after risks/benefits explained — documented refusal"
Return precautions	Shifts burden if patient self-discharges against advice	"Patient instructed to return immediately if worsening dyspnea, chest pain, headache, or vision changes"
Follow-up plan with timeframe	Establishes standard of care was met prospectively	"Return in 2 weeks for repeat BP and reassessment"

Table 2. High-Yield Documentation Checklist for Hypertensive Encounters. Each element functions as prospective medicolegal protection.

Figure 2 — $40 Million Verdict Breakdown by Damage Category

Implications for Cardiologists and Cardiovascular Risk Management

Although this case involved a primary care encounter, cardiologists frequently receive curbside calls, serve as consultants, and co-manage patients in whom elevated blood pressure is an "incidental" finding during a visit for another indication.

Hypertensive urgency — defined as severely elevated BP (typically >180/120) without acute target organ damage — does not mandate emergent hospitalization but does require a documented management plan with close outpatient follow-up.

Hypertensive emergency, by contrast, requires immediate IV therapy and inpatient monitoring — and the distinction hinges entirely on evidence of acute target organ damage (AKI, pulmonary edema, encephalopathy, aortic dissection, NSTEMI).

In retrospect, this patient's cough — if truly related to new-onset heart failure from hypertensive cardiomyopathy — may have represented a missed sign of target organ damage, though this remains speculative given the clinical record.

The National Practitioner Data Bank (NPDB) reports that cardiovascular conditions, including hypertension-related strokes, remain among the top diagnostic categories in paid malpractice claims — making this case representative, not exceptional.

Brief Case Vignette

Clinical Scenario — Applying These Lessons

A 44-year-old male with no prior cardiac history presents to your cardiology clinic for evaluation of exertional dyspnea of 6 weeks' duration.

Triage vital signs show a blood pressure of 178/108 mmHg; the nurse attributes it to "clinic anxiety."

Your echocardiogram reveals concentric LV hypertrophy with an ejection fraction of 50% and Grade I diastolic dysfunction.

You initiate amlodipine 5 mg daily, counsel on dietary sodium restriction, and schedule repeat blood pressure assessment in 4 weeks — and you document all of this explicitly, including the vital sign, your clinical interpretation, and a return precaution for worsening symptoms.

Three months later, the patient's blood pressure is 128/80 on combination therapy, and the echo shows regression of LV wall thickness — an outcome achievable only because the abnormal vital sign was recognized, documented, and acted upon at the index visit.

This case illustrates that hypertension found incidentally in a cardiology clinic is never truly incidental — it is an actionable finding requiring the same rigor as the primary complaint.

Bottom Line for Clinicians

A single BP of 190/102 mmHg in a 37-year-old without initiating treatment or a documented follow-up plan became the foundation for a $40 million verdict nine years later.

Physicians do not need to be perfect — they need to document their reasoning, acknowledge abnormal findings, and create a clear follow-up path.

In an era of increasingly complex patients and megaverdicts, the chart is both the clinical record and the legal narrative.

References

1. Sullivan W. $40 Million Medical Malpractice Verdict for Stroke Victim. SullivanLegal.us. Published July 2024.
2. Whelton PK, et al. 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal of the American College of Cardiology. 2018.
3. James PA, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014.
4. American College of Emergency Physicians. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients in the Emergency Department with Asymptomatic Elevated Blood Pressure. ACEP. 2013.
5. MDCalc. Wells Criteria for Pulmonary Embolism. MDCalc.com.
6. National Practitioner Data Bank. NPDB Public Use Data File. U.S. Health Resources & Services Administration.

Physician Education Disclaimer: This article is intended for licensed healthcare professionals for educational purposes only. It does not constitute legal advice, medical advice, or a standard of care determination for any individual patient. Clinical decision-making should always be based on the full clinical context and current evidence-based guidelines. For medicolegal concerns, consult a qualified attorney with experience in healthcare law.

Cardiology Review · Structural & Heart Failure

Transthyretin Cardiac Amyloidosis: Diagnosis, Imaging, and the Therapeutic Frontier

A practical synthesis of red flags, the current imaging armamentarium, and where stabilizers, silencers, depleters, and gene editing now stand.

Transthyretin cardiac amyloidosis (ATTR-CM) has moved from autopsy curiosity to a mainstream differential in heart failure with preserved ejection fraction.

Population estimates suggest that a meaningful minority of older adults hospitalized for heart failure with preserved ejection fraction harbor unrecognized wild-type disease.

The shift from a uniformly fatal diagnosis to one with three approved disease-modifying drugs has happened almost entirely within the last seven years.

This review summarizes the clinical clues, the current imaging hierarchy including emerging PET tracers, the approved treatment landscape, and the antibody- and gene-editing-based therapies now advancing through phase 3 trials.

Clinical Tell-Tale Features

The single most useful diagnostic habit in ATTR-CM is pattern recognition across organ systems rather than reliance on any one cardiac finding.

A history of bilateral carpal tunnel syndrome frequently precedes overt cardiac disease by roughly a decade and should prompt a deliberate look-back in any patient with unexplained left ventricular hypertrophy.

Lumbar spinal stenosis, atraumatic biceps tendon rupture, and disproportionate need for hip or knee arthroplasty round out the classic orthopedic triad described in the ACC expert consensus pathway on cardiac amyloidosis.

A so-called "natural cure" of hypertension, in which a previously well-controlled patient needs progressive antihypertensive de-escalation, is a clinical clue that deserves more attention than it typically receives.

Intolerance to standard heart-failure pharmacotherapy, particularly beta-blockade, reflects the fixed, preload-dependent stroke volume of the infiltrated ventricle rather than true rate-related decompensation.

Low QRS voltage relative to left ventricular wall thickness is a classic but insensitive sign, present in well under half of confirmed cases.

Paradoxical low-flow, low-gradient aortic stenosis in an older patient is now a recognized indication for opportunistic amyloid screening, since the two diseases coexist far more often than chance would predict.

Figure 1. Three converging red-flag clusters that should trigger amyloid-specific testing.

Diagnostic Workup: From Suspicion to Confirmation

Every workup begins with excluding a monoclonal protein, since light-chain disease is a hematologic emergency that scintigraphy alone cannot rule out.

The screening triad is serum free light chains, serum immunofixation electrophoresis, and urine immunofixation electrophoresis.

If all three are negative, bone-avid radionuclide scintigraphy can establish a non-invasive ATTR-CM diagnosis without biopsy.

Grade 2 or grade 3 myocardial uptake on single-photon emission CT, obtained two to three hours after injection, is considered diagnostic per the ACC consensus pathway.

If the monoclonal screen is positive, or if scintigraphy shows only grade 0–1 uptake despite strong clinical suspicion, tissue biopsy with mass spectrometry typing becomes mandatory.

Genetic sequencing of the TTR gene is recommended in every confirmed case to distinguish hereditary (ATTRv) from wild-type (ATTRwt) disease and to trigger cascade testing of first-degree relatives.

Two ATTR genotypes, p.Phe84Leu and p.Val50Met, are recognized causes of false-negative scintigraphy and should prompt biopsy when suspicion remains high despite a negative scan.

Figure 2. Stepwise non-invasive diagnostic pathway from clinical suspicion to confirmed ATTR-CM.

Imaging: Available and Emerging Tracers

Echocardiography remains the first imaging test obtained for nearly every patient and typically shows concentric left ventricular hypertrophy with biatrial enlargement and a restrictive filling pattern.

The relative apical sparing strain pattern on speckle-tracking echocardiography is sensitive and visually distinctive, though it performs better as a qualitative gestalt than as a rigid quantitative cutoff.

Cardiac MRI adds diffuse, often subendocardial-to-transmural late gadolinium enhancement plus elevated native T1 and extracellular volume, and a published comparison found native T1 and ECV measurements outperformed strain-based apical sparing for separating amyloidosis from hypertrophic cardiomyopathy.

Bone-avid scintigraphy using 99mTc-pyrophosphate, DPD, or HMDP remains the diagnostic workhorse precisely because it can establish the diagnosis without biopsy when the monoclonal screen is negative.

A 2025 multisociety update emphasized that three-hour SPECT/CT imaging, rather than one-hour planar-only acquisition, gives the most balanced sensitivity and specificity for grading uptake.

Beyond bone tracers, a family of amyloid-binding PET agents first developed for cerebral amyloid imaging is now being repurposed for the heart, including florbetapir, flutemetamol, and Pittsburgh compound B.

[18F]Florbetaben received FDA Fast Track designation specifically for cardiac amyloidosis diagnosis, with an ongoing phase 3 validation trial comparing its diagnostic accuracy against standard-of-care confirmation.

An investigational pan-amyloid tracer, 124I-evuzamitide, is notable because it binds amyloid fibrils irrespective of the precursor protein, raising the possibility of a single whole-body scan that detects AL and ATTR disease alike.

Early antibody-depletion trials have used serial PYP scintigraphy and CMR-derived extracellular volume as surrogate markers of falling cardiac amyloid burden, although one case report found imaging improvement without matching hemodynamic benefit, underscoring that imaging response and clinical response are not yet interchangeable endpoints.

Table 1. Diagnostic Imaging Comparison in ATTR-CM

Modality	Primary Signal	Strength	Limitation
Echocardiography	Concentric LVH, apical-sparing strain	First-line, ubiquitous, no contrast	Lower specificity in isolation; subtle in early disease
Cardiac MRI	Elevated native T1/ECV, diffuse LGE	Best at excluding HCM and other infiltrative disease	Gadolinium limits in renal impairment; cost
99mTc-PYP / DPD / HMDP scintigraphy	Perugini grade 2–3 uptake ≥ rib	Diagnostic without biopsy when monoclonal screen negative	False positives (prior MI, hydroxychloroquine); false negatives in select variants and early disease
Amyloid PET (florbetapir, florbetaben, flutemetamol)	Quantitative SUV / myocardial retention	Whole-body assessment; potential treatment-response biomarker	Mostly investigational for cardiac indication; limited site availability
124I-evuzamitide PET	Pan-amyloid fibril binding	Subtype-agnostic; single scan for AL and ATTR	Investigational; isotope logistics restrict availability

Current Treatment: Stabilizers and Silencers

Three drugs now carry FDA approval specifically for ATTR-CM, and all three act upstream of fibril deposition rather than reversing existing amyloid.

Tafamidis was the first approved agent and works as a TTR tetramer stabilizer, binding the thyroxine pocket to prevent the dissociation step that precedes misfolding.

Acoramidis is a newer stabilizer designed for near-complete tetramer occupancy, and preclinical work cited in a recent review found it stabilized roughly 98% of wild-type TTR tetramers in serum compared with about 49% for tafamidis, though the clinical significance of that biochemical gap remains uncertain.

Vutrisiran works by an entirely different mechanism, an RNA-interference therapy that silences hepatic TTR messenger RNA and lowers production of both wild-type and variant protein at the source.

Vutrisiran's ATTR-CM approval made it the first agent cleared by the FDA for both polyneuropathy and cardiomyopathy phenotypes of ATTR amyloidosis, based on a roughly 28% reduction in a composite of all-cause mortality and recurrent cardiovascular events.

A frequently overlooked point is that the three pivotal trials enrolled meaningfully different populations, with the tafamidis trial skewed toward more severe heart failure, which makes naive cross-trial efficacy comparisons statistically unsound.

An older, far less expensive stabilizer, diflunisal, remains an off-label option in resource-limited settings but carries renal and gastrointestinal risk that limits its use in this older, comorbid population.

General heart-failure pharmacology requires adaptation in ATTR-CM, since beta-blockers are frequently poorly tolerated and mineralocorticoid antagonism has more retrospective support than ACE inhibition or ARNI therapy in this specific phenotype.

Table 2. FDA-Approved Disease-Modifying Therapies for ATTR-CM

Drug	Mechanism	Pivotal Trial	Administration	Approval Landmark
Tafamidis	TTR tetramer stabilizer	ATTR-ACT	Oral, once daily	First ATTR-CM approval, 2019
Acoramidis	Near-complete TTR stabilizer	ATTRibute-CM	Oral, twice daily	Approved Nov 2024
Vutrisiran	Hepatic TTR-silencing siRNA	HELIOS-B	Subcutaneous, every 3 months	ATTR-CM indication added Mar 2025; first agent spanning ATTR-PN and ATTR-CM

Case Vignette

A 74-year-old man presents with progressive dyspnea and is found to have HFpEF with an echocardiogram showing 15 mm septal thickness and reduced longitudinal strain with apical sparing.

His surgical history includes bilateral carpal tunnel release eight years earlier and a lumbar laminectomy, and he has needed his antihypertensives steadily reduced over the past two years.

Serum free light chains and immunofixation studies are unremarkable, prompting bone scintigraphy that shows grade 3 myocardial uptake on SPECT/CT.

Genetic testing confirms wild-type disease, and he is started on a TTR-stabilizing or silencing agent while his family is counseled that cascade screening is unnecessary given the wild-type result.

Future Directions: Depleters and Gene Editing

Stabilizers and silencers slow disease progression, but neither removes amyloid already deposited in the myocardium, which has motivated a parallel push toward fibril-clearing antibodies.

NI006 (also designated ALXN-2220) is a recombinant anti-ATTR antibody that selectively binds misfolded, amyloid-conformation TTR and triggers antibody-mediated phagocytic clearance while sparing native tetramers.

Its phase 1 trial reported no drug-related serious adverse events and showed reductions in cardiac tracer uptake and extracellular volume over twelve months, alongside falling NT-proBNP and troponin levels.

Coramitug is a second amyloid-depleting antibody targeting a distinct TTR epitope, and its phase 2 trial in 105 patients with ATTR-CM met its NT-proBNP endpoint at 52 weeks while missing the co-primary six-minute walk distance endpoint, leading to an FDA Fast Track designation and a phase 3 program now enrolling roughly 1,280 patients.

On the gene-editing side, nexiguran ziclumeran (nex-z, formerly NTLA-2001) uses in vivo CRISPR-Cas9 to permanently inactivate the hepatic TTR gene after a single intravenous infusion.

Longer-term phase 1 follow-up reported in an Intellia Therapeutics update showed mean serum TTR reductions of roughly 90% sustained out to three years after a single dose.

The phase 3 cardiomyopathy program was placed on clinical hold in late October 2025 after a patient developed grade 4 liver transaminase elevation, and the related polyneuropathy trial's hold was subsequently lifted by the FDA in January 2026 with enhanced liver-monitoring safeguards, while the cardiomyopathy trial hold remained under active discussion at that time.

This episode is a useful reminder that durable, one-time gene-editing approaches carry a different risk calculus than reversible oral or injectable therapies, particularly in a population that is elderly and frequently has competing comorbidity.

Looking further out, combination strategies that pair a stabilizer or silencer to halt new fibril formation with an antibody depleter to clear existing deposits represent the most plausible path toward true disease regression rather than mere stabilization.

Bottom Line

ATTR-CM should be on the differential for any older patient with HFpEF, especially when carpal tunnel syndrome, spinal stenosis, biceps rupture, or low-flow low-gradient aortic stenosis appear alongside cardiac findings.

A negative monoclonal protein screen plus grade 2–3 bone scintigraphy uptake confirms the diagnosis without biopsy in most cases, and genetic testing should follow in every confirmed patient.

Three disease-modifying drugs are now approved, working through tetramer stabilization or hepatic TTR silencing, while amyloid-depleting antibodies and one-time CRISPR-based gene editing are advancing through later-phase trials with a safety profile that still warrants close monitoring.

This article is intended for physician education and general clinical reference, summarizing publicly available literature and society guidance current as of mid-2026; it does not constitute individualized medical advice, and clinicians should consult full prescribing information, current guidelines, and their own clinical judgment before applying any of this content to patient care.

References

1. American College of Cardiology – 2023 Expert Consensus Decision Pathway on Cardiac Amyloidosis: Key Points
2. Journal of the American College of Cardiology – Transthyretin Amyloid Cardiomyopathy: State-of-the-Art Review (PMC)
3. Taiwan Society of Cardiology / Society of Nuclear Medicine – 2025 Consensus on 99mTc-Pyrophosphate Scintigraphy (PMC)
4. Transthyretin Amyloid Cardiomyopathy – 2025 Update on Diagnosis and Emerging Therapies (PMC)
5. ClinicalTrials.gov – Efficacy of [18F]Florbetaben PET for Diagnosis of Cardiac Amyloidosis (NCT05184088)
6. Pharmacy Times – FDA Fast Track Designation for [18F]Florbetaben
7. TCTMD – Vutrisiran FDA Approval Coverage for ATTR-CM
8. Disease-Modifying Therapies for ATTR-CM: Current and Emerging Medications (PMC)
9. Coramitug Phase 2 Randomized Trial in ATTR-CM (PMC)
10. Intellia Therapeutics – Longer-Term Phase 1 Data for Nexiguran Ziclumeran
11. Intellia Therapeutics – FDA Lift of Clinical Hold on MAGNITUDE-2
12. Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance (PMC)