'GLP-1 Drugs Make Promising Debut in TAVR, Carotid Artery Stenting'

 Cardiovascular protection with GLP-1 receptor agonists may benefit patients undergoing certain transcatheter procedures, according to two observational studies.

When used as an adjunct to transcatheter aortic valve replacement (TAVR), tirzepatide (Mounjaro, Zepbound) reduced heart failure (HF) events in the 1 year after the procedure, reported Ibrahim Mortada, MD, of the University of Texas Medical Branch at Galveston, and colleagues.

Separately, major adverse cardiovascular events (MACE) at 1 year were also significantly reduced among GLP-1 drug users undergoing carotid artery stenting (CAS), reported Abdullah Ghuman, MD, and Maumita Das, MD, both of TidalHealth Peninsula Regional in Salisbury, Maryland.

Both studies were presented at the Society for Cardiovascular Angiography and Interventions (SCAI) annual meeting in Montreal and published in JSCAI.

GLP-1 receptor agonists are a recently established medication class for cardiovascular risk reduction beyond glycemic control and weight loss. These new findings thus potentially extend the cardiovascular benefits of these drugs to populations with high-risk structural heart and carotid revascularization.

Tirzepatide and TAVR

In the TAVR study, tirzepatide had benefits that appeared specific to HF and renal pathways without a broad effect on atherosclerotic events.

Tirzepatide was associated with reduced HF events when initiated in the 1 year after TAVR, with patients prescribed the dual GIP/GLP-1 drug having fewer events versus non-users (44.9% vs 55.3%, HR 0.68, 95% CI 0.56-0.83). What's more, there was also a signal of reduced acute kidney injury in these patients (9.7% vs 17.1%, HR 0.63, 95% CI 0.43-0.93), Mortada and colleagues reported.

Meanwhile, there were no improvements in acute myocardial infarction (MI; 5.7% vs 8.1%, HR 0.81, 95% CI 0.48-1.37) or ischemic stroke (6.7% vs 10.5%, HR 0.73, 95% CI 0.45-1.17).

"Importantly, the persistence of HF and cardiorenal events after TAVR likely reflects underlying metabolic dysfunction rather than body size alone, highlighting the need for adjunctive therapies targeting cardiometabolic pathways rather than weight classification alone," the authors wrote.

"Taken together, these findings support the hypothesis that metabolic optimization may represent an important adjunctive strategy in the care of patients with obesity undergoing TAVR," they concluded. "As TAVR expands into younger and lower-risk populations with a high prevalence of metabolic disease, the role of adjunctive cardiometabolic therapies warrants further investigation."

GLP-1 Drugs After Carotid Artery Stenting

GLP-1 receptor agonists also showed promise as adjunctive therapy in patients undergoing carotid revascularization.

Rates of MACE at 1 year -- counting MI, cerebral infarction, and all-cause mortality -- were significantly lower in patients undergoing CAS who had GLP-1 medication exposure before or after the procedure (39.7% vs 44.6% for nonexposed peers, risk ratio [RR] 0.89, 95% CI 0.80-0.99), reported Ghuman and Das.

"To our knowledge, data evaluating GLP-1 RA [receptor agonist] therapy specifically in CAS populations are limited, and this analysis provides initial observational evidence in this high-risk population," they wrote. "These findings are hypothesis-generating and warrant prospective evaluation in carotid revascularization populations."

The authors highlighted the persistently elevated periprocedural stroke or death rates with CAS compared with carotid endarterectomy in symptomatic patients.

"Given the high burden of polyvascular atherosclerosis in patients undergoing CAS, and the unique periprocedural stroke risk related to embolic phenomena during plaque manipulation, GLP-1 RAs may represent a biologically plausible adjunct for reducing postprocedural cardiovascular events," they noted. "GLP-1 RAs' demonstrated effects on plaque stabilization, inflammation, and endothelial function may be particularly relevant in this population."

Of note, the benefit with GLP-1 drugs after CAS was driven by a particularly large reduction in all-cause mortality (3.9% vs 8.9%, RR 0.44, 95% CI 0.30-0.64), whereas the difference in MI (8.6% vs 9.2%, RR 0.93, 95% CI 0.69-1.25) and cerebral infarction (32.4% vs 35.3%, RR 0.92, 95% CI 0.81-1.05) did not individually reach statistical significance.

"Our study may have been underpowered to detect differences in individual ischemic components, particularly given the modest effect sizes observed (RR 0.92-0.93)," Ghuman and Das wrote. "Additionally, the 1-year follow-up period may be insufficient to observe the full anti-atherosclerotic effects of GLP-1 RA therapy."

It is also possible that the mechanisms of benefit are unrelated to atherothrombotic protection after all.

Study Details

Both retrospective studies used electronic health record (EHR) data from the TriNetX Global Collaborative Network.

The study by Mortada and colleagues included adults with obesity who underwent TAVR from 2020 to 2025, split between initiators of tirzepatide after TAVR (defined as any documented prescription; n=437) and non-users (n=12,406).

Propensity score matching yielded comparable cohorts of 421 individuals each. These matched cohorts had a mean age just under 73 years, about 90% were white, and patients were roughly split between the sexes. Just over 70% had diabetes, and nearly three in four had obesity. Residual imbalance persisted for anticoagulant use (56.5% with tirzepatide vs 62.2% without) and antilipemic therapy (67.9% vs 72.7%).

As for the other study, Ghuman and Das included 906 adults undergoing CAS from 2015 to 2023 who had GLP-1 drug exposure, defined as at least one prescription of semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), lixisenatide (Adlyxin), or tirzepatide within 12 months of the procedure, and 29,476 controls undergoing CAS with no such exposure.

Propensity score matching yielded 899 matched pairs; baseline characteristics were mostly comparable except the GLP-1 drug group had a higher body mass index and hemoglobin A1c values even after matching. Type 2 diabetes was present in about 88% of the cohort, obesity in 53%, and prior cerebral infarction in nearly half.

The two observational studies left residual confounding a possibility, and the reliance on hospital-based records was a potential source of selection bias. Both studies used prescription data as a proxy for GLP-1 drug use without being able to account for actual medication adherence.

Ghuman and Das also noted that they could not distinguish between pre- and post-procedural initiators of GLP-1 drugs and had to exclude dulaglutide (Trulicity) and exenatide due to EHR database limitations.

"The higher-than-expected MACE rate may also reflect a predominantly symptomatic population or those with high-risk plaque features, which the TriNetX platform cannot adjudicate," Ghuman and Das added. "Whether GLP-1 RA benefits differ between symptomatic versus asymptomatic patients, or those with versus without prior cerebrovascular events, remains unknown and warrants investigation in future prospective studies with adequate power for subgroup analyses."

Disclosures

The TAVR study was supported in part by an NIH grant.

Mortada and Ghuman's groups disclosed no conflicts.

Primary Source

JSCAI

Source Reference: Mortada I, et al "Association of tirzepatide use with clinical outcomes after TAVR in obese patients: a propensity-matched real-world study" J Soc Cardiovasc Angiogr Interv 2026; DOI: 10.1016/j.jscai.2026.105384.

Secondary Source

JSCAI

Source Reference: Ghuman A, Das M "Association of peri-procedural GLP-1 receptor agonist therapy with 1-year major adverse cardiovascular events after carotid artery stenting: a propensity-matched analysis" J Soc Cardiovasc Angiogr Interv 2026; DOI: 10.1016/j.jscai.2026.105387.

https://www.medpagetoday.com/meetingcoverage/scai/120958

Palantir helps IRS mine large volumes of data – The Intercept

 Palantir (PLTR) is reportedly helping the Internal Revenue Service (IRS) analyze dozens of data sets on American citizens to investigate a vast range of financial crimes.

The IRS’ Criminal Investigation Division has used the military contractor’s Lead and Case Analytics platform since 2018 to analyze and aggregate diverse lists of federal databases and data sets, The Intercept reported.

American Oversight, a non-profit watchdog group, obtained public records detailing Palantir’s IRS contract and shared them with the Intercept. The public records revealed the vast amount of data plugged into Palantir’s software.

According to the article, the documents revealed that Palantir’s Lead and Case Analytics platform allows the IRS to search and visualize connections from millions of records with thousands of links between databases maintained by other federal agencies and the IRS. The data includes Affordable Care Act data, individual tax forms and tax returns, bank statements and transactions, and other available data compiled by the Financial Crimes Enforcement Network of the Treasury Department.

The documents suggest that its reach extends to cryptocurrencies, including Bitcoin, Litecoin, Ethereum, and Ripple.

According to the contract documents, the IRS has paid over $130M to the military contractor for its services to date.

Palantir and the IRS did not immediately respond to a Seeking Alpha request for comment.

American Oversight director Chioma Chukwu said in a statement to The Intercept that the real concern is the consolidation of vast amounts of sensitive personal data into a single system with minimal transparency, especially one built and operated by a contractor like Palantir, whose business model is premised on integrating data and expanding surveillance capabilities.

“When the government can map relationships, track behavior, and generate investigative leads across data sets at this scale, the question isn’t just what it can do—it's who it will be used against,” Chukwu said to The Intercept. “Entrusting that infrastructure to a company known for opaque, security-state deployments only heightens those risks.”

https://www.msn.com/en-us/money/markets/palantir-helps-irs-mine-large-volumes-of-data-the-intercept/ar-AA21F9ye

Ford and Geely reportedly discussed joint venture in US

 Ford (F) reportedly held talks with China’s Geely (GELYF) (GELHY) to extend a potential European joint venture to the U.S., but has walked away as a collaboration would be “politically fraught.”

According to The Wall Street Journal, Ford (F) was in talks to license Geely’s (GELYF) (GELHY) technology in the U.S. as a way to capitalize on more advanced automobile technology while sidestepping a U.S. ban on Chinese tech.

While Geely (GELYF) (GELHY) supports any avenue into the U.S. market, Ford (F) remains outwardly opposed to any threats to the U.S. auto industry.

Ford CEO Jim Farley has warned that while Chinese-made cars are cheaper, better built, and technologically superior, allowing Chinese automakers to sell cars in the U.S. would be “devastating” to the American auto industry.

“Manufacturing is the heart and soul of our country, and for us to lose that to exports would be devastating,” Farley said as recently as this week.

While talks to collaborate in the U.S. have stalled, Ford (F) and Geely (GELYF) (GELHY) continue to discuss possible joint ventures in Europe.

https://www.msn.com/en-us/money/companies/ford-and-geely-reportedly-discussed-joint-venture-in-us-wsj/ar-AA21EyF3

Pfizer culls early PD-L1 asset after series of clinical wins, deals in cancer

 

Pfizer’s decision to cut its early-stage cancer asset was due to “strategic business reasons” and not driven by safety or efficacy concerns.

Pfizer has pulled the plug on an early-stage PD-L1 program as it looks to refine its cancer strategy after a series of encouraging readouts and high-value deals in recent months.

The asset, dubbed PF-08046037, was being evaluated in a Phase 1 study, which combined the drug with sasanlimab, another investigational cancer therapy. Pfizer was testing the doublet against a variety of advanced or metastatic cancers, including non-small cell lung cancer, pancreatic ductal adenocarcinoma, and head and neck squamous cell carcinoma. The pharma launched the trial in July 2025 and enrolled eight patients.

The decision to discontinue the study was driven by “strategic business reasons,” according to an update on the U.S. clinical trials database. Pfizer emphasized that the termination was not driven by safety and efficacy issues. The pharma has no other active studies for PF-08046037, according to its website.

PF-08046037 is a monoclonal antibody designed to seek out immune cells expressing the PD-L1 marker, according to a primer on Pfizer’s website. After binding PD-L1, the asset is taken into the cell where it releases its payload, an agonist of the TLR7 protein. Activating TLR7 then kicks off a signaling cascade that helps drive the body’s anti-tumor response.

“Currently, no further studies evaluating PF‑08046037 are planned, however this doesn’t have wider implications towards future research in immune-stimulating ADCs,” a Pfizer spokesperson told BioSpace on Friday.

The last few months have been good for Pfizer’s cancer arm. In February, the pharma reported that an investigational regimen combining its antibody-drug conjugate (ADC) Padcev with Merck’s mega-blockbuster PD-1 drug Keytruda elicited a 47% reduction in the risk of disease progression or death as compared with standard of care in patients with muscle-invasive bladder cancer.

Analysts reacted optimistically to these findings, with Truist Securities in a Feb. 28 note writing that the doublet “rewrites the standard of care” in this indication.

A few weeks later, Pfizer’s atirmociclib, which could potentially succeed the breast cancer drug Ibrance, significantly improved progression-free survival in a Phase 2 study—an effect that stayed consistent even when patients were stratified according to performance status, menopausal status and prior treatment.

Pfizer has been investing heavily into its cancer portfolio. In May 2025, for instance, the pharma fronted $1.25 billion to partner with China’s 3SBio, gaining access to the biotech’s PD-1/VEGF bispecific antibody SSGJ-707—and entering a closely watched frontier in cancer therapeutics. This agreement also put Pfizer on the hook for $4.8 billion.

In January, Pfizer put up to $865 million on the line in a multi-year licensing deal with Cartography Biosciences, leveraging the biotech’s proprietary engine for cancer targets.

https://www.biospace.com/business/pfizer-culls-early-pd-l1-program-after-series-of-clinical-wins-deals-in-cancer

UnitedHealthcare, Aetna, Cigna tout progress to standardize prior authorization

 Major health insurers are advancing efforts to standardize prior authorization requirements as part of an effort to simplify paperwork for providers and reduce delays in medical care.

Two of the industry's leading organizations, AHIP and the Blue Cross Blue Shield Association, said Friday that leading health plans are making significant progress in their efforts to adopt a standardized approach for providers submitting electronic prior authorization requests for the majority of medical services.

The standardized approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services, including CT scans and MRIs, AHIP and BCBSA said. These services span commercial coverage, Medicare Advantage and Medicaid managed care. Additional services will be added over time. 

This initiative is part of an industry-wide commitment announced last summer to smooth out the prior auth process and also improve transparency and communication around determinations. As part of that commitment, in alignment with the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, insurers said they would demonstrate notable progress toward the goals by the beginning of 2026. About 50 plans signed on to the initiative, including all six of the largest, publicly traded insurance conglomerates: Elevance Health, Centene, Cigna, CVS Health's Aetna, Humana and UnitedHealthcare.

Key changes included reducing the number of services subject to prior authorization, as well as implementing solutions to promote electronic prior auth, with plans to establish a framework for both payers and providers by Jan. 1, 2027.

So far, leading health plans reduced prior authorizations for an array of services by 11% in the roughly nine months since the pledge was made. This equates to 6.5 million fewer prior auth requests for patients, AHIP and BCBSA reported earlier this month. Reductions in Medicare Advantage specifically were 15%, according to the groups' report.

“As more providers adopt electronic prior authorization, this standardized approach will mean faster answers for patients, a more consistent experience for providers and less friction for everyone,” Mike Tuffin, AHIP President and CEO, said in a statement.

UnitedHealthcare, the insurance arm of UnitedHealth Group, said it has standardized the documentation process for more than half of its prior authorization volume with plans to have 70% of prior auth requests as part of this standardization process by the end of this year. 

“Today’s announcement is another step in our work to modernize health care, making prior authorization quicker, simpler and more efficient,” said Tim Noel, CEO of UnitedHealthcare, in a statement. “These changes help care providers and patients save time and money and set the stage for a more seamless electronic experience, and our work will continue as we pursue a modern, touchless authorization process.”

Aetna said it has standardized 88% of its prior authorization volume, touting that it maintains the "fewest medical services requiring prior authorization among national health plans."

“Aetna is proud to lead, and most importantly, to deliver better, faster care to people who need it,” said Aetna President Steve Nelson in a statement. “Prior authorization should enable care, not delay it. We’re modernizing the process with speed, transparency, and clinical judgment to benefit everyone we serve.”

The health insurer said its efforts have resulted in more than 95% of eligible prior authorizations approved within 24 hours, 83% processed in real time, exceeding AHIP’s 2027 industry commitment of 80% and more than 1 million provider calls eliminated through automation and digital tools.

Aetna also noted its efforts to integrate medical and pharmacy decisions into single, condition-specific reviews and newly launch bundled prior authorization programs, including a comprehensive musculoskeletal offering, that build on earlier cancer bundles.

The Cigna Group said it expects to standardize more than 70% of its prior authorization volume for medical services by the end of 2026, with additional services added on a rolling basis. The health plan said its already reduced volume of medical prior authorizations by about 15%.

“We want patients to get the care they need when they need it, and we want doctors and their teams to be able to focus on patients – not paperwork,” Amy Flaster, M.D., chief medical officer at the The Cigna Group, said in a statement. “We are leading much-needed improvements to make prior authorization clearer and more consistent. While this is important progress, we know there’s more to do as we continue our journey to deliver a simpler, more personalized health care experience to all those we serve.”

https://www.fiercehealthcare.com/payers/unitedhealthcare-aetna-tout-progress-standardize-prior-authorization-part-industry-wide

HCA concern on exchange-related coverage attrition, rising uninsured

HCA beats Q1 2026 estimates, reaffirms 2026 guidance despite volume/weather hit and $600–$900 million exchange EBITDA headwind
Q1 2026 EPS was $7.15 and revenue $19.1B, both beating analyst estimates.
Q1 revenue grew 4.3% YoY; adjusted EBITDA up ~2% and adjusted EPS up ~11%.
Patient volumes were weaker than expected, with sharp declines in respiratory-related admissions and ER visits.
Volumes were soft in January from mild respiratory season and winter storms, but rebounded by March.
Respiratory and weather factors cut EBITDA by ~$180 million, viewed as temporary rather than structural.
Medicaid supplemental programs added ~$200 million incremental EBITDA YoY, $120 million above expectations, helping offset softness in patient volumes.
2026 guidance reaffirmed; volume outlook of 2–3% growth maintained despite Q1 shortfall.
Expected 2026 net benefit from Medicaid supplementals now a $50–$250 million YoY decline.
Exchange disruption and payer-mix shifts drove ~$150 million Q1 EBITDA hit, with full-year impact still pegged at $600–$900 million.
Same-facility exchange admissions fell ~15%, while uninsured admissions rose ~16% YoY.
Resiliency and AI-driven efficiency program tracking toward $400 million 2026 cost savings target.
Capital deployment remained aggressive: $1.1B capex, $1.57B buybacks, $183M dividends, leverage conservative.
Board declared a $0.78 quarterly dividend following release of first-quarter 2026 financial results.
Main concern: Exchange-related coverage attrition and rising uninsured/bad debt could pressure earnings and cash collections through 2026.
Mixed quarter, driven by temporary volume/weather headwinds offset by stronger Medicaid supplemental payments and cost controls.
https://finviz.com/quote.ashx?t=HCA&p=d

US imposes sanctions on a China-based oil refinery and 40 shippers over Iranian oil

President Donald Trump's administration is placing economic sanctions on a major China-based oil refinery and roughly 40 shipping companies and tankers involved in transporting Iranian oil.


The move, announced Friday and first reported by The Associated Press, makes good on Trump's threat to impose secondary sanctions on companies and countries that do business with Iran. It's also part of his Republican administration's overall ramped-up campaign to cut off Iran's key source of revenue — its oil exports.

Concurrently, the U.S. this month imposed a physical blockade on the Strait of Hormuz, the Persian Gulf waterway that is crucial to global energy supplies.

The sanctions, which cut off the companies from the U.S. financial system and penalize anyone who does business with them, come just a few weeks before President Donald Trump and China's Xi Jinping are due to meet in China.

Included in Friday's sanctions is Hengli Petrochemical's facility in the port city of Dalian, which has a processing capacity of roughly 400,000 barrels of crude oil per day, making it one of the biggest independent refineries in China.

The Treasury Department says Hengli has received Iranian crude oil shipments since 2023 and has generated hundreds of millions of dollars in revenue for the Iranian military.

The advocacy group United Against Nuclear Iran said in February 2025 that Hengli is one of dozens of Chinese purchasers of Iranian oil.

China is the biggest buyer of Iranian oil, importing 80% to 90% of Iranian oil before the U.S.-Israeli war with Iran broke out, though the crude — transported by a shadow fleet of vessels — often has its origin obscured but arrives in China as oil from countries such as Malaysia. Smaller refineries, known as teapot refineries, typically are the buyers of Iranian oil.

Iran has previously said that its demands for ending the war include the lifting of sanctions.

Treasury Secretary Scott Bessent said Friday that his agency "will continue to constrict the network of vessels, intermediaries and buyers Iran relies on to move its oil to global markets."

Earlier this month, Bessent's department sent a letter to financial institutions in China, Hong Kong, the UAE and Oman threatening to levy secondary sanctions for doing business with Iran and accusing those countries of allowing Iranian illicit activities to flow through their financial institutions.

Bessent said during a White House press briefing on April 15 that the administration has told countries "that if you are buying Iranian oil, that if Iranian money is sitting in your banks, we are now willing to apply secondary sanctions, which is a very stern measure."

The sanctions come as the global energy trade is in turmoil as war around the Persian Gulf chokes off oil and natural gas shipments, causing prices to soar.

Treasury has tried to quell the impact of rising oil prices issuing temporary sanctions waivers on Russia oil and a one-time waiver on Iranian oil already at sea.

The AP was making efforts to contact Chinese officials for comment on the sanctions.

China has disagreed with previous U.S. sanctions, but its major companies and banks still comply with U.S. sanctions because they are more exposed to the U.S.-dominated financial system.

After the U.S. earlier this month sanctioned a Chinese refinery accused of buying Iranian oil, Liu Pengyu, a spokesperson for China's embassy in Washington, said the use of the sanctions "undermines international trade order and rules, disrupts normal economic and trade exchanges, and infringes upon the legitimate rights and interests of Chinese companies and individuals."

https://www.wtkr.com/politics/foreign-policy/us-imposes-sanctions-on-a-china-based-oil-refinery-and-40-shippers-over-iranian-oil