Harlan M. Krumholz

Rethinking Physician Certification: A Call for a Modern, Meaningful Standard

Physician certification should not be an ordeal; it is in vast need of improvement.
My @jaccjournals.bsky.social Journals Editor’s Page explores how we can modernize physician certification to be relevant, humane, and effective.
🔗 www.jacc.org/doi/10.1016/...

Tools, Not Ghosts: Artificial Intelligence, Writing, and Responsibility Download article citation: If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

In this Editor’s Page, I outline why we believe authors can use AI tools to improve scientific writing—if they fully own what they submit.

At JACC, we won’t stigmatize responsible use of AI. But we will insist on accountability.

jacc.org/doi/10.1016/...

@jaccjournals.bsky.social

Tools, Not Ghosts: Artificial Intelligence, Writing, and Responsibility Download article citation: If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

In this Editor’s Page, I outline why we believe authors can use AI tools to improve scientific writing if they fully own what they submit.
At JACC,we won’t stigmatize responsible use of AI. We will insist on accountability.
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @yalemed.bsky.social

Inflammation and Cardiovascular Disease: 2025 ACC Scientific Statement: A Report of the American College of Cardiology

For anyone who has wanted a clear, authoritative summary of inflammation and cardiovascular disease, and where the science is heading, here it is.
The 2025 ACC Scientific Statement on Inflammation and Cardiovascular Disease. @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...

This is an extraordinary report from @ihmeuw.bsky.social and published in @jaccjournals.bsky.social; it demonstrates that cardiovascular disease is a global scourge. And we are failing to leverage what we know to save lives. www.jacc.org/doi/10.1016/...

Congratulations to @uvmlarnermed.bsky.social medical student, Sarah Krumholz, for winning the Outstanding Research Publication award for her study in REGARDS investigating risk of hypertension by sRAGE level! Very well deserved!

Her paper: pubmed.ncbi.nlm.nih.gov/40708351/

The next leap is computable quality.

Living, real-time intelligence from routine clinical data that will:

-Support accountability
-Fuel improvement
-Accelerate discovery

But most current measures fail this test.

Registries = richer than claims but costly, delayed, and not built for improvement

Claims = coarser, even more delayed

Neither delivers what clinicians need at the point of care.

Door-to-balloon time proved what’s possible.

When hospitals had real-time feedback, mortality for STEMI dropped—without new drugs or devices.
The lesson?

👉 Quality improves when data are timely, trusted, and actionable.

Quality measurement was once a breakthrough.
But today it’s too slow, too costly, and too disconnected from daily care.

It’s time to reinvent it.

🆕 My Editor’s Page in JACC: www.jacc.org/doi/epdf/10....

@jaccjournals.bsky.social @yalemed.bsky.social

“Everyone thinks their genes are the cause for them getting an age-related disease, it’s actually your immune system.” - @erictopol.bsky.social the author of Super Agers on #HealthandVeritas podcast
pod.link/1588414491/e... @thehowie.bsky.social @hmkyale.bsky.social

Eric Topol: The Keys to Healthy Aging Howie and Harlan are joined by physician, scientist, and author Eric Topol to discuss his new book, Super Agers: An Evidence-Based Approach to Longevity; the potential of individualized polygenic risk...

A conversation on Healthy Aging with @hmkyale.bsky.social and @thehowie.bsky.social @yaleschoolofmed.bsky.social
insights.som.yale.edu/podcasts/hea...

Guiding the AI Revolution in Cardiovascular Medicine:

New @JACCJournals: Guiding the AI Revolution in CV Medicine
I lay out 5 operational principles—from rigorous validation to bias reduction—to make AI safe, equitable & impactful in cardiology.
➡️ www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @yalemed.bsky.social @yaleschoolofmed.bsky.social

Fat, Reframed A Turning Point in Heart Disease

Biology, not blame.
That’s the message from #ESCCongress.
Fat is not just storage, it’s an organ.
Its signals may drive heart failure and more.
Read my take: Fat, Reframed: A Turning Point in Heart Disease.
substack.com/home/post/p-... @jaccjournals.bsky.social @yaleschoolofmed.bsky.social

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Rehabilitation can ⬆️ Functional Independence and ⬇️ Long-term Cognitive Impairment among #ICU survivors. But how often do hospitals deliver it?

Led by @yalemedicine.bsky.social resident Jose Victor, our paper bit.ly/41p9fPT in @accpchest.bsky.social provides insights

New @JACCJournals Editor’s Page: A Disquieting Plateau
🫀 Cardiovascular mortality progress has stalled
📉 In some areas, it’s reversing
💡 We must confront what’s happening on our watch—and what comes next
👉 authors.elsevier.com/a/1lfjn2d9GI...
#CardioTwitter #HealthEquity @jaccjournals.bsky.social

Never Delegate Understanding Making health and science understandable. Click to read Never Delegate Understanding, by Harlan Krumholz, a Substack publication. Launched 3 days ago.

In my new Substack post...

Did you know air pollution can raise blood pressure?

I break down a just-published JACC trial testing HEPA filters in homes near highways—and what it means for heart health.

@jaccjournals.bsky.social

👉 neverdelegateunderstanding.substack.com/p/00314b6f-e...

Podcast Episode: Environmental Exposure as Intervention: HEPA Filtration and Blood Pressure Near Traffic Corridors | JACC Deep Dive In this Deep Dive, Editor-in-Chief Dr. Harlan Krumholz explores a pragmatic, randomized crossover trial testing whether in-home HEPA filtration can reduce blood pressure in adults living near high-traffic roadways. The findings offer early insights into how targeted environmental interventions may influence cardiovascular risk—especially among individuals with elevated baseline systolic blood pressure.

Can a HEPA filter protect the heart?
My latest JACC #DeepDive explores a new trial of in-home air filtration—what it found, why the effect size matters, and how it fits into decades of research on air pollution and CVD risk.
🎧 www.jacc.org/digital-cont...
@jaccjournals.bsky.social

Podcast Episode: Pacing Strategies, Air Quality, and the Path to Equity | JACC This Week In this week's JACC Deep Dive podcast, Dr. Harlan Krumholz highlights new science with direct clinical implications: a randomized trial showing conduction system pacing outperforms RV pacing in AV block, a pragmatic study suggesting HEPA filtration may modestly lower blood pressure, and long-term data from FLAVOR comparing FFR and IVUS-guided PCI. Also featured are a state-of-the-art review on heart failure therapy implementation, a brief report refining NT-proBNP thresholds for pre–heart failure, and an updated JACC Report Card revealing persistent cardiovascular mortality disparities among Black Americans.

🎙️ New JACC This Week podcast!
This issue features:
🔹 CSPACE RCT — CSP vs RV pacing in AV block
🔹 HEPA filtration & blood pressure
🔹 FLAVOUR 6-year follow-up—FFR vs IVUS
🔹 Editor’s Page: excess CV mortality in Black Americans

🎧 Listen: www.jacc.org/digital-cont...
@jaccjournals.bsky.social

Did COVID Age Our Arteries? A Closer Look at the Evidence

Did COVID-19 really age our arteries?

A major new study says yes—esp in women. But is it true?

I take a deeper look to see if the evidence matches the headlines.

Read it here → neverdelegateunderstanding.substack.com/p/did-covid-...

#COVID19 @virusesimmunity.bsky.social @yalemed.bsky.social

Subscribe to Never Delegate Understanding Making health and science understandable. Click to read Never Delegate Understanding, by Harlan Krumholz, a Substack publication. Launched 2 days ago.

“Never delegate understanding.”

That quote stuck with me—and it’s now the title of my new Substack.

I’ll be writing about health, science, & how these things can be understandable.

Subscribe here → neverdelegateunderstanding.substack.com/subscribe

#health #science #medicine @yalemed.bsky.social

Podcast Episode: Master DAPT | JACC Deep Dive In this episode of JACC Deep Dive, Dr. Harlan Krumholz explores new insights from a post hoc analysis of the MASTER DAPT trial, highlighting the real-world burden of ischemic and bleeding events in high bleeding risk patients after PCI. By examining recurrent—not just first—events, the study sheds light on how abbreviated dual antiplatelet therapy (DAPT) impacts total clinical outcomes. Key findings include reduced bleeding without increased ischemic risk and a notable clustering of ischemic events following bleeding. This analysis advances the conversation around patient-centered endpoints and the evolving science of recurrent event modeling in cardiology.

🎙️ New #JACC Deep Dive
MASTER DAPT recurrent events analysis goes beyond the first event, revealing total burden of ischemia & bleeding in PCI patients.
Why we published it, what we learned, & how it changes the view.
🎧 Listen: www.jacc.org/digital-cont...
#CardioTwitter #DAPT #HBR #PCI

Podcast Episode: Device Safety, DAPT Strategy & Structural Innovation | JACC This Week In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz explores device safety, abbreviated DAPT, drug-coated balloons, and a novel surgical polymer valve. Plus: expert insights on car...

From device safety to novel valve design—the new JACC This Week podcast covers:
🔹 Clinician-led device safety
🔹 MASTER DAPT recurrent events
🔹 Drug-coated balloons for complex ISR
🔹 Polymer surgical mitral valve
Listen: bit.ly/4ove0Bn
#JACCPodcast #Cardiology @jaccjournals.bsky.social

Podcast Episode: Amyloidosis in Focus: Biomarkers, Structural Insights & Therapeutic Strategy | JACC This Week In this mini focus issue of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz explores the evolving landscape of cardiac amyloidosis care. From structural and biomarker findings in the HELIOS-B subs...

🎙️ New JACC This Week:
🧬 Mini-Focus on Amyloid Heart Disease
🫀 Vutrisiran echo + biomarker insights
✍️ Editor’s Page on access + innovation
🩼 Bonus: VVS trial + DOACs in frailty
Listen now ⤵️
🔗 www.jacc.org/digital-cont...
@jaccjournals.bsky.social #cardiotwitter #amyloidosis

We’re drowning in data, but are we helping patients? In this #JACC Editor’s Page, Dr. @hmkyale.bsky.social challenges us to ask better questions in #HeartFailure care. If you think you know HF, read this: www.jacc.org/doi/10.1016/... #CardioSky #MedSky

Podcast Episode: Heart Failure in Practice: Dual Therapy Insights, Digital Innovation & the Future of Risk Models | JACC This Week In this focus issue on Heart Failure in Practice, JACC Editor-in-Chief Dr. Harlan Krumholz examines how contemporary research continues to refine and at times challenge our understanding of heart fail...

🎧 New JACC This Week podcast:

• SOGALDI-PEF: Dual therapy in HFpEF—worth it?
• HFimpEF: Big data, big risk
• Finerenone withdrawal
• LMNA stroke risk
• DSP & sex-specific risk
• Rethinking ICDs

🎙️ Listen: www.jacc.org/digital-cont...

#CardioTwitter @jaccjournals.bsky.social

Podcast Episode: ACURATE neo2 Under-Expansion | JACC Deep Dive JACC's July 29 issue explores why the ACURATE neo2 valve failed in its IDE trial, with a post-hoc analysis pointing to under-expansion in heavily calcified anatomies as a potential culprit. Though the...

🎙️ New JACC Deep Dive:
Why did ACURATE neo2 fail in the IDE trial?

Post hoc analysis suggests valve underexpansion may be part of the answer.
Even with normal gradients.
Even with a good echo.
We explore what happened—and what’s next.

🔗 www.jacc.org/digital-cont... @jaccjournals.bsky.social

Podcast Episode: Structural Heart Disease, Obesity-Related Heart Failure, Private Equity Ownership in Hospitals | JACC This Week In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz introduces the journal’s new design and highlights key studies from the July 29, 2025 issue. Topics include the under-expansion a...

🎧 New #JACC This Week podcast

🔬 Valve underexpansion & outcomes in ACURATE IDE
💉 Body composition & tirzepatide in HFpEF
🏥 Private equity & heart failure care
🫀 Multivalve disease challenges
🧾 Brief reports+more

▶️ Listen: www.jacc.org/digital-cont...
#cardiotwitter @jaccjournals.bsky.social

Katelyn Jetelina: A Visit from Your Local Epidemiologist Howie and Harlan are joined by public health communicator Katelyn Jetelina for updates on COVID-19 and other issues, and to discuss how her emails to students and colleagues in the early days of the p...

“...my biggest goal is to not turn people off that are curious… that means leading with a lot of empathy.” —
@kkjetelina.bsky.social

A powerful conversation on science, trust, and public health on Health & Veritas

🔗 insights.som.yale.edu/podcasts/hea...
#PublicHealth #ScienceCommunication

🎙️New Health & Veritas:
A Visit from Your Local Epidemiologist

We talk w/@kkjetelina.bsky.social about:
• Building trust in public health
• Making science clear—not scary
• What’s next for COVID, H5N1, measles & more

@yalesph.bsky.social
@yalesom.bsky.social
@thehowie.bsky.social