It has become a weekly ritual for me—and for many of the cardiologists in my practice—to listen to Dr. John Mandrola’s This Week in Cardiology every Friday afternoon. Dr. Mandrola provides a thoughtful, critical appraisal of the latest clinical trials that often goes far beyond the enthusiastic interpretations frequently seen in journals, press releases, and social media. He is admittedly a bit of a curmudgeon and, at times, displays some bias against certain therapies (LAAO, ARNIs, FFR-CT, and TAVR in low-risk patients) while showing perhaps a bit too much enthusiasm for others (PFA). That said, he is consistently thought-provoking, intellectually honest, and informative. I am a better cardiologist because of what I’ve learned from his podcast. Thank you, Dr. Mandrola.

This podcast is perfect for a trainee. I just finished residency and chief year; I find this podcast digestible with the right mix of clear breakdowns of trials and statistics within them with the sort of folksy advice and soapboxes you want from an attending. I am genuinely developing a sense of good and bad trials and approaches to clinical medicine. This is not milquetoast, this is a real doctor teaching.

Dr. Mandrola is an excellent speaker and brings important information from current trials. I love his “but…but” comments—it’s always a clue to listen more closely as an astute observation is about to be shared.

Love this podcast. Dr Mandrola reviews the most important cardiology trials every week and adds his commentary that are very insighful. Easy way to keep up with the ever changing field of cardiology.

Fabulous podcast. Pragmatism in medicine and some appropriate cynicism regarding industry involvement in CV medicine. Patient centered evidence based discussions.

Honest take on the review of current literature in cardiology with a bend towards EP

Much needed podcast and hope others esteemed colleagues with similar platforms can follow suit .

Clarity in presentation, and humbleness to pivot prior perspectives when new data is presented. I hope Dr. Mandrola’s podcast career extends towards the end of my career. Incredible amount of work goes into making this podcast . Thank you

John Mandrola gives clear and helpful perspectives on current literature.

I love your podcast and listen every week. Over the past couple of years I’ve noticed a growing number of trials—especially early DAPT discontinuation trials—using composite endpoints that combine competing outcomes in noninferiority designs. The most recent example was just last week. On November 27, NEJM published the TARGET-FIRST trial, which declares noninferiority based on a composite endpoint that mixes ischemic events with major bleeding. These outcomes reliably move in opposite directions when you drop aspirin. You cannot statistically lump them together in a noninferiority trial without biasing the entire analysis toward a “no difference” result. A reduction in bleeding can literally cancel out an increase in MI or stent thrombosis within the same composite. That’s not clinical equipoise—it’s a statistical trick. It’s honestly surprising that NEJM would publish a noninferiority claim built that way. What makes this even more striking is that other trials are doing it correctly. The NEO-MINDSET trial—published in August—uses the proper approach: • test ischemic outcomes alone for noninferiority, • then test bleeding separately for superiority. No sleight of hand. No burying opposing-direction effects inside one number. Yes, as cardiologists we absolutely need to weigh bleeding versus ischemic risk. But we can only do that if we know the true risk of each outcome. A composite-driven “no difference” result that mixes the signals together doesn’t help at all.

Well worth the time for me. Keeps cardiology fascinating. Thank you for this project.

Very analytical review and great way to stay appraised of new trials for an interesting lens

I love the way this podcast rigorously reviews the methods and validity of studies, going way beyond just summarizing the abstract to see if it’s valid and what implications it has for practice. Well done!

Aimed squarely at practicing cardiologists, the This Week in Cardiology podcast—anchored by Dr. John Mandrola—delivers an engaging, highly opinionated review of recently published cardiovascular studies. With a strong command of statistical methods, Dr. Mandrola frequently dissects trial designs, drawing attention to how endpoints, inclusion criteria, or analysis plans may have been “gamed” to yield favorable outcomes. This skeptical lens is often refreshing and, more than once, spot on. Dr. Mandrola brings a unique voice to the cardiology discourse. His conservative, Midwestern worldview underpins many of his takes, and listeners are likely to find both intellectual stimulation and challenge in his commentary. Having listened to over 40 episodes, I can say with confidence that the podcast reliably provokes thought, even when I disagree with his conclusions. That said, there is an evolving tone that merits critique. His criticism of the WATCHMAN device, for instance, borders on the obsessive. No data, however supportive, appears sufficient to shift his entrenched view. In contrast, his support for therapies like GLP-1 receptor agonists seems to come with a degree of confirmation bias—rarely does he interrogate potential confounders, such as the role of smoking cessation in the semaglutide trials’ cardiovascular benefit. Moreover, the humility and curiosity that characterized earlier episodes seem diminished. As his influence has grown, so too has his tendency to pontificate beyond his core area of expertise. This is compounded by a recurrent tendency to impugn the motives of trialists and industry players, which at times detracts from the scientific critique and veers into cynicism. Finally, while Dr. Mandrola is careful to acknowledge when he mispronounces European names, there was a recent episode in which a South Asian name was mispronounced without comment. These small cues matter—particularly in a field striving for greater global inclusivity. In sum, This Week in Cardiology remains a must-listen for those who want to stay sharp, think critically, and occasionally be provoked. It would, however, benefit from a reintroduction of the humility and balance that once made it not just contrarian—but wise.

I taught EBM for many years, and was lucky to have George Diamond as my mentor early in my career. George would have agreed with me in saying this podcast should be mandatory listening for all med students and clinicians! Thank you!

Very clear, non biased exploration of topics. Highly recommend.

I have recommended this podcast to numerous colleagues. John plays “devils advocate” very well when diving into the most pertinent studies that have real world clinical value.

John provides exactly the voice, commentary, and insight that is more needed now than ever before, in cardiology and medicine in general. His is a voice of reason in a world where it’s easy to become jaded that objective science is being overtaken by corporate influence. Thank you, John, from a fellow EP nerd who’s working towards an era of common randomization, abundant quality evidence, and good science above all.

As a retired hospitalist, who went through CoVid, I find John’s skeptical, but scientific approach to medicine, as what we need. The rigid adherence of my system to Remdesivir and 6 mg of po decadron, have scarred me towards organized medicine. To use a drug that has been found ineffective, and to not vary your steroid dose according to the patient’s inflammatory state, were the height of idiocy. We need to bring the skeptical physician attitude back. Kudos to Dr. John!

Dr. John Mandrola’s This Week in Cardiology stands out for its combination of critical appraisal of current cardiology literature and his personal opinions. He skillfully analyzes clinical trials, guidelines, and studies, focusing on methodology, biases, and real-world applicability, often challenging mainstream interpretations. I and my colleagues are enjoying to listen his podcast every week! Kudos to Dr. Mandrola and his team for the wonderful work for the cardiology community!

I really appreciate the critical review of current topics in cardiology. A great balance to all of the glowing reports from reps. Thank you.

As an aging cardiologist from the Mayo system, I find this young man’s insights with his summations informative and delightful. His candor is refreshing and objectivity incredibly reassuring. Continue and hold on to your independence. I am a fan. John R

This podcast offers concise and critical reviews of emerging literature in cardiology. I’m very grateful of Dr. Mandrola for committing the time it takes to run such a service.

Absolutely love this podcast and how extraordinarily well Dr Mandrola demonstrates the skill of critical thinking. Always thought provoking

No-nonsense review of current cardiology literature. After many years of listening, I remain a committed fan. After a decade of listening, with each episode Dr. Mandrola continues to take me back to training and feels like my attending imparting wisdom on rounds. Please keep doing the hard work!

Can you do a segment on echo RV strain?

Dr. Mandrola continues to provide an essential voice in cardiology. We need more of his voice and other like him to provide thoughtful review of our field - devoid of misaligned incentives whether they be financial or personal.

Every Saturday morning I look forward to riding my bicycle listening to Dr Mandrola. He brings insights into recent journal articles filtered thru his years of experience and healthy scepticism. I enjoy this podcast above all others.

Thank you John for all you do . I and the two NP’s who I work with are always talking about your podcasts. We particularly respect your perspective on early consideration of palliative care . A Favorite quote from us when discussing treatment options is “ What would John Mandrola say and do” . 😀

The latest trials presented in an easily digestible format, approached with a discerning and practical eye. Discussion often includes critical comparisons to previous studies and how findings may translate to real-life practice. I think of it as a very efficient journal club and try to catch each week’s episode!

I am a CT surgeon and enjoy the podcast. I look forward and listen to the new episode each week. I appreciate the data driven analyses of the contemporary literature. I feel like I have a trusted colleague and expert on my morning drive with me once every week….i wish it were more frequent. Thank you for you work, Dr. Mandrola. You are helping humanity more than you may be aware.

I am an emergency physician who listens to Dr. Mandrola’s weekly podcast. In it he takes an unbiased look at evidence-based cardiology (and other medical topics) eschewing, at times, consensus for what the evidence does or does not suggest. As important, he brings a frank, heart-felt voice to all doctors looking for best practices and solid reasons for why they do what they do. His view is the long view - we are only here temporarily and that duration is unknowable, so make a difference in people’s lives not through professional accolades but who you are as a person. Thank you, Dr. Mandrola, for the humanity you reference and infuse in your weekly podcast.

This presented in a very concise manner without all of the delaying pleasantries and greetings. He gets right to the meat of the topics and gives a great analysis of the data. I learn a lot in a short period of time.

I look forward to each podcast since John takes so much time to critique the articles and not parrot the paper (unlike JACC Podcast). John is truly an iconoclast questioning the validity of published articles. Bravo.

Cardiology fellow here. I love this podcast. I listen to it every week. Great way to stay up to date in a world of so much info/data. Thank you Dr. Mandrola for your efforts.

I’m not a medical professional. At age 60 I decided to educate myself about Americas #1 killer. Over the years I’ve learned the terminology, rarely if ever have to resort to google, and thanks to TWIC should something happen in the future, I won’t sit like a deer in the headlights when a cardiologist while a cardiologist tries to create a “shared decision” protocol while I’m wondering if I live or die … not that I expect this to ever happen … but .. to s5ent or not to stent … that is the question … at least for now … many thanks … I truly enjoy listening to your explanation of the studies. I feel I’ve learned some valuable lessons …

John Madrola’s thoughtful, scientifically rigorous and patient-centered analysis is invaluable in helping me keep abreast with the rapidly evolving data in cardiovascular medicine.

Very informative and helps us truly understand the evidence. Helps us go beyond the noise and tells us the actual evidence behind a medication/procedure!

Dr John Mandrola is the “Man” I have come to listen and appreciate over the last few months. Wonderful insightful look at the evidence and review of trials. You have made me a better cardiologist. Thank you !

The perfect podcast for the most up to date reviews on the latest cardiology trials and news.

Mandrola: Honest critical appraisal based on well considered, fair, informed review of the available information, wrapped in a professional, warm, decent package. I listen and he speaks, yet it feels like a collaborative learning process. And, not unimportantly, all with a polished style and pleasantly listenable voice.

This is the podcast for the cardiologist young or old who is looking to do the right things. Trying to muddle through the advertising and spin and financial incentives for everything we do for people is hard, but I think John Mandrola and his team tries their hardest to do this. It is hard to say we don’t know to patients who want us to know everything. It is hard to say maybe when everyone is saying definitely yes or no. It sounds weak, but it is strong because it is honest. Thank you and your team for doing this work and helping us muddle through more efficiently. I hope you continue this for as long as you all remain passionate about it! It helps so many of us.

Love this podcast! Between you and Dr. Alo's podcast, I should never get heart disease! Thank you!

Thanks for keeping us abreast of the emerging cardiology research trials and keeping a critical eye towards analysis and outcomes. Great bite size podcast to listen on the way home.

Amazing podcast, probably one of the best for critical appraisal of Cardiac literature. Keep up the good fight and holding these trialists and “new fancy devices” to the standards that they should be held to. I love the skepticism and we need more of it, not just in Cardiology.

Great source for information and, most importantly, scientific reflection about trials and debatable conclusions.

I love your thoughtful analysis. I feel led out of Plato‘s cave of industry sponsored group think. Thank you.

Excellent review of the recent literature across the cardiology subspecialties.

Unbelievable enjoyable and thought provoking and professionally gratifying. Your March 13 podcast completely changed my view of this pandemic and humbled me. Thank you.

Enjoy and learn from you every week Can you review lifevests Seems to me to be a lot of expense and hassle Is it worth it Thx