• I swam in Tigris River in the '90s. • Then, competitive swimmer • Now, physician-scientist (interventional cardiology) •
@NYUStern
EMBA'23 • Tweets are my own
Right Ventricular Failure:
@NEJM
In-depth review on the right heart:
@Brian_Houston12
@RyanTedfordMD
Will try to hit the highlights, but cannot substitute for the details in the full text!
👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
* I am reading this slowly: let's summarize in threads
Read full document:🥸
Thread
#1
👇👇👇
Great
#AHA23
so far:
@AHA_Research
🥸8 Trials: 8 take aways below
Read the read👇👇
1/ATRESIA:
Patients with subclinical atrial fibrillation can benefit from apixaban to reduce the risk of stroke and systemic thromboembolism.
2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction A Report of the American College of Cardiology Solution Set Oversight Committee:
@JACCJournals
Dense document, but will try to break it down w threads
Starting here👇👇👇
Clopidogrel vs Aspirin Monotherapy Beyond 1 Year After Percutaneous Coronary Intervention:
@JACCJournals
🥸 Sorry been away
😱Here are few summary points about STOPDAPT-2
👇👇
Atrial Fibrillation Occurring During Acute Hospitalization: A Scientific Statement From the American Heart Association:
@CircAHA
AHA Statement from out council:
@AHA_AcuteCVCare
Here is a summary 👇👇👇
Semaglutide and Cardiovascular Outcomes
in Obesity without Diabetes:
@NEJM
The select trial:
#AHA23
🥸Wow!
@AHA_Research
😱Now on the stage in main event
😱Let's get the highlights
👇👇👇
P2Y12 Inhibitor or Aspirin Monotherapy for Secondary Prevention of Coronary Events:
@JACCJournals
*** Great - this is what
@AHAScience
recommended for older higher risk patients:
@MichaelGNanna
25-point summary in am report: (they are short sentences 😱)
👇👇👇
Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses From COMBINE AF:
@CircAHA
Great topic - important in practice, specifically in terms of renal function.
10-points below: 👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
Guidelines are detailed: reading it slowly.
Please, read full doc!
Thread
#10
:
Lipid management and chronic coronary disease?
🥸
Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction: The FIRE Trial
@NEJM
Outstanding work by
@SimoneBiscaglia
and colleagues: advancing care for older adults living with ACS 👏🎩
Let's summarize it here: with our 2 friends 🥸😱
👇👇👇
Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease A Randomized Clinical Trial:
@JAMA_current
High intensity statin rate of MACE at 3 years = 8.7%
LDL target 50-70 mg/dL = 8.1%
Here is 10 point summary 👇👇👇
Impact of Complete Revascularization in the ISCHEMIA Trial:
@JACCJournals
How do you interpret the results of this ischemia sub-study? The devil is in the detail. 😱
Good morning: 🥸
Below 👇👇
Acute Effects of Coffee Consumption
on Health among Ambulatory Adults:
@NEJM
This is fun. Few remarks: small sample (type ii error is a concern), a lot of confounders (still remain) in part related to blinding, mediations, and adherences. Great attempt though!
Summary 👇👇
Evaluation and Management of Pulmonary Hypertension in Noncardiac Surgery: A Scientific Statement From the American Heart Association:
@CircAHA
Here are few points to summarize
👇👇
Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society:
@CircAHA
🥸Great work:
@AHA_Research
@AHA_AcuteCVCare
😱Let's summarize: Happy Sunday :)
👇👇👇
Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events:
@JACCJournals
* So sorry for absent; many deadlines all at once :)
🥸 How Many Daily Steps Are Linked to Reduced Mortality and CVD Risk? 😱😱😱
Let'd do it 👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
* I am reading this slowly: on risk assessment of future MACE
Read full document:🥸
Thread
#2
📷
Management of Cardiogenic Shock Unrelated to Acute Myocardial Infarction
1/7 The primary goals of cardiogenic shock treatment are to restore and maintain adequate cardiac output, normalize cardiac filling pressures, and normalize total body volume
Heart Failure With Preserved Ejection Fraction:
@JACCJournals
Scientific Statement
For those of us who write scientific statements, there is a lot to learn from the level of depth in this work!
Brilliant 👏👏👏
Where do you start?
👇👇👇
Management of Mechanical Prosthetic Heart Valve Thrombosis:
@JACCJournals
Review Topic of the Week
Fabulous review from the Washington Hospital Center Team...It is dense, but will try to break it down:
👇👇👇
Aspirin vs Clopidogrel for Long-term Maintenance After Coronary Stenting in Patients With Diabetes A Post Hoc Analysis of the HOST-EXAM Trial:
@JAMACardio
Here are some data to support Plavix monotherapy over aspirin alone +/- DM
Summary 👇👇
Combination Moderate-Intensity Statin and Ezetimibe Therapy for Elderly Patients With Atherosclerosis:
@JACCJournals
1/ This is great: Primary prevention in older adults >75 years of age
2/ Moderate intensity + ezetimibe is probably better tolerated
Here is 10-point summary
Effects of Elective Coronary Revascularization vs Medical Therapy Alone on Noncardiac Mortality:
@JACCJournals
Chronic coronary disease management and long term non-cardiac mortality:
@ElianoNavarese
Here is a brief summary
👇👇
Thread
#5
2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction:
@JACCJournals
Management of HFpEF: Continued with MRAs
Starting from
#38
: 👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
Guidelines are detailed: reading them slowly.
Please, read full doc!
Thread
#15
: What is need/duration of beta blockers in coronary disease?
🥸📷👇
Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial:
@CircAHA
🥸Let's summarize - good morning
👇👇👇
Management of Stable Angina in the Older Adult Population:
@CircIntv
- This time I get to summarize our work led by my friend
@MichaelGNanna
20-point summary 🧵
👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
* I am reading this slowly; only way to read these thick documents: On goals of treatment and shared decision making!
🥸 Thread
#3
👇👇👇
Today, I received the notice of K23 award from the
@nih_nhlbi
to study frailty and resilience in older adults with AMI...
It took 4.5 years, but here we are.
Thought on how to do it are below [if anyone wants to learn from my mistakes - I made plenty of mistakes]
1/12
Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease:
@JACCJournals
My friend
@MichaelGNanna
is studying the effects of beta blockers and calcium channel blockers in older pts with SIHD:
@PCORI
15-point summary 👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
Guidelines are detailed: reading it slowly.
Please, read full doc!
Thread
#12
: What does the new guidelines say about SGLT2i/GLP-1 agonists for CCD?
🥸 👇👇
Outcomes of Medical Therapy Plus PCI for Multivessel or Left Main CAD Ineligible for Surgery:
@JACCJournals
Agree with the results: this is what we see in practice
4-point Summary below...
👇👇👇
Dual Antiplatelet Therapy De-Escalation in Stabilized Myocardial Infarction With High Ischemic Risk Post Hoc Analysis of the TALOS-AMI Randomized Clinical Trial:
@JAMACardio
🥸This is on de-escalation of DAPT in AMI setting.
😱Summary below and happy holidays
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
* I am reading this slowly & summarizing: Read full doc
Thread
#5
*** Do you know what the recent CCD guidelines recommend on nutrition? 😱😱
Read below👇👇
Sarcopenia and Cardiovascular Diseases:
@CircAHA
From the Geriatric Cardiology Leadership Council:
@ACCinTouch
Main congratulations to
@Dr_Alfaraidy
: a board certified geriatrician and a cardiology fellow - she is amazing AND the best:
@ParagGoyalMD
👏
Summary👇👇👇
Long-Term Outcome of Drug-Coated Balloon vs Drug-Eluting Stent for Small Coronary Vessels: PICCOLETO-II 3-Year Follow-Up:
@JACCJournals
The promise of drug coated balloons for small vessels (2 to 2.75mm)!
Summary 👇👇👇
Thread
#4
2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction:
@JACCJournals
Focusing on Management of HFpEF: breaking dense document into small pieces :)
Starting from
#28
👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
Guidelines are detailed: reading them slowly
Please, read full doc!
Thread
#16
: Renin-Angiotensin-Aldosterone Inhibitors & CCD?
Let's try below:🥸📷👇
Ticagrelor or Clopidogrel Monotherapy vs Dual Antiplatelet Therapy After Percutaneous Coronary InterventionA Systematic Review and Patient-Level Meta-Analysis:
@JAMACardio
🥸 Good morning: more on SAPT monotherapy vs DAPT
😱Summary
👇👇👇
Occupational Safety in the Cardiac Catheterization Laboratory: Time for Better Ergonomics:
@JACCJournals
🥸Do you have back pain? Me too
Read this summary 👇👇
Unmet needs in valvular heart disease:
@ESC_Journals
Summary on gaps in knowledge for VHD
1/ 🏥 Optimize intervention timing & avoid late presentation to significantly impact population-level outcomes.
Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia:
@NEJM
Great advancement in PAD MX and work led by
@shishem
and team
Few highlights below 👇👇👇
Effect of SGLT2 Inhibitors on Cardiovascular Outcomes Across Various Patient Populations:
@JACCJournals
Here is weekend morning report to stay ahead of the published literature :) 🥸🥸🥸
Summary 👇👇👇
New clinical consensus from European Association of Percutaneous Cardiovascular Interventions & ESC Working Group on Cardiovascular Surgery on managing coronary artery disease in patients undergoing transcatheter aortic valve replacement:
@ESC_Journals
10-Point Summary
👇👇👇
In 2002, I arrived to Johns Hopkins. During weekly transplant meetings that I had to attend, he was assertive/intimidating, but shielded me when I was “pimped” by liver attending. 18 yrs later, I read this. Here is a story of a good man
#cardiotwitter
I was told interventional cardiologists cannot be clinician-scientisits or methodologists bec they have no time
I learned that it largely depends on
*Mentorship
*Team
*Environment
Seek out to work with the best: you'll do great things
@EllenJMacKenzie
said I am a doctor :)
A Next-Generation Balloon-Expandable Transcatheter Aortic Valve First-in-Human Experience:
@JACCJournals
On
#Duopoly
: Now, let's wait for a balloon expandable valve from Medtronic!
10-point summary: Let's do it!
👇👇
Reperfusion in Patients With ST-Segment–Elevation Myocardial Infarction With Cardiogenic Shock and Prolonged Interhospital Transport Times:
@CircIntv
🥸Great work by
@seanvandiepen
😱Summary below 👇👇
A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II:
@JACCJournals
@MichaelGNanna
🥸: I meant to summarize this a while back, but here it is below:
🥸At the cross road of Geriatrics and Interventional Cardiology: Happy Sunday
👇👇👇
Microaxial Flow Pump or Standard Care in Infarct Related Cardiogenic Shock:
@NEJM
🥸It was quite busy in ACC to tweet, but will try to summarize few highlights for trials if anyone missed them.
😱Starting with DanGer Shock: funded by Abiomed
Summary 👇👇👇
Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction:
@NEJM
🥸 Trial
#3
: REDUCE-AMI from Sweden, Estonia, and New Zealand.
😱 Long-term beta blockers among patients with AMI + EF>50% did not lead to lower MACE.
🥸 Summary
👇👇👇
Chronological vs Biological Age inInterventional Cardiology - A Comprehensive Approach to Care for Older Adults: JACC Family Series
@JACCJournals
@adnanalkhouli
🥸We study "older" patients undergoing percutaneous procedures. Older is not only "number".
😱Summary
👇👇👇
Angina After Percutaneous Coronary Intervention: Patient and Procedural Predictors:
@CircIntv
1 in 3 patients post FFR guided PCI had symptoms, but delta FFR (pre vs post) may be useful predictor of post PCI angina!
Here is 10 point summary 👇👇👇
Day 3
#AHA23
@AHA_Research
🥸Late breaking clinical trials
😱3 more trials in this short thread:
1. 🥸 SPEECH: In a trial of adults with heart failure, a speech analysis app predicted the need for hospitalization about three weeks in advance of a heart failure.
👇👇👇
Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial:
@ESC_Journals
🥸Nitrate-CIN trial: in-organic nitrate reduced CIN and MACE in ACS pts
😱 Interesting work from Barts
🥸Summary
👇👇👇
Outcomes of Bioprosthetic Valve Fracture in Patients Undergoing Valve-in-Valve TAVR:
@JACCJournals
Many years of collecting these cases: amazing work
@AdnanChatriwala
👏👏
Summary in 15 short bullets
👇👇👇
Management of Guidewire Entrapment and Fracture During Percutaneous Coronary Intervention: When All Bailout Techniques Fail:
@pfeffer_brad
Here is a brief summary in management of wire entrapment AND/OR fracture
👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
* I am reading this slowly and summarizing in threads: read full doc
*** guidelines support team approach to chronic coronary disease
🥸 Thread
#4
👇👇👇
Position Statement on Vascular Access Safety for Percutaneous Devices in AMI Complicated by Cardiogenic Shock:
@JACCJournals
🥸 Few points on vascular access management in the cardiac intensive care unit
😱Full discussion here👇
😱Summary here 👇
Cardiac Catheterization Laboratory Management of the Comatose Adult Patient With an Out-of-Hospital Cardiac Arrest:
@CircAHA
@AHAScience
@AHA_Research
🥸 GM: Dense document - please read full report.
😱I will try to keep it <40 pts: Scroll below for highlights
👇👇👇
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With or Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials:
@CircAHA
🥸wow: more on left main+diabetes: PCI vs CABG!
😱 Summary
👇👇👇
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
Guidelines are detailed: reading it slowly
Please, read full doc!
Thread
#13
: Physical activity and environmental exposures in the context of CCD?
🥸👇👇
Thread
#2
:
2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction:
@JACCJournals
* Easier to digest in small snippets, but not sure how to do this best, but let's experiment.
...continued starting from 13 through 18
Standardized Definitions for Cardiogenic Shock Research and Mechanical Circulatory Support Devices: Scientific Expert Panel From the Shock Academic Research Consortium (SHARC)
-- This is a great effort by
@ronwaksman
SHARC Is out!
👇👇👇
Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction:
@NEJM
🥸 Trial
#3
: REDUCE-AMI from Sweden, Estonia, and New Zealand.
😱 Long-term beta blockers among patients with AMI + EF>50% did not lead to lower MACE.
🥸 Summary
👇👇👇
Assessment and Management of Older Adults Undergoing PCI, Part 1: A
@JACCJournals
Expert Panel
*From the
@ACCinTouch
interventional cardiology and geriatric cardiology leadership councils.
**led by the great Dr
@MichaelGNanna
.
Out today 👇👇
Contraindications to using the arm for right heart catheterization are:
* Obstruction to radial drainage
* Breast surgery
* Trauma
*SVC syndromes
Otherwise, median antecubital vein should be the default access site for RHC
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease:
@JACCJournals
- Tips on SCAD from the guidelines
Let's keep short 🥸🥸👇👇
Critical Care Enrichment During Advanced Heart Failure Training:
@JACCJournals
By the great:
@JasonKatzMD
and team.
- The title should have read advanced heart failure and interventional cardiology training!
Highlights below.
👇👇👇
Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension:
@NEJM
More advancement in the pulmonary hypertension space!
(Funded by Acceleron Pharma, a subsidiary of MSD)
Summary below! 👇👇👇
Incidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves:
@JACCJournals
The rate of PPI:
Acurate neo: 8.8%
Acurate neo2: 7.7%
Evolut PRO: 15.2%
Evolut PRO+: 10.4%
Summary 👇👇