📌STREAM-2 #ACC23
🔹TNK media dosis (estrategia farmacoinvasiva -EFI-) 🆚PCI 1⃣ria en adultos mayores c/IAMST sin PCI dentro de 1 h
🔸RCT 2:1.👥604. Edad ≈71 a. ♀️32%.
🔸4- pto final 1⃣rio a 30 días.

🏁Rtdos: EFI con 1/2 dosis TNK🧓c/IAMST es segura y eficaz
#CardioTwitter

📌C. inclusión: > 60 años, IAMST < 3hs, ⛔️imposibilidad de PCI < 3hs.

📌Tto coadyuvante:
🔸EFI: AAS 150-325 + clopidogrel carga y mantenimiento + Enoxa sin bolo
🔹PCI 1⃣ria: DAP

🏁👥
🔸≈71 a
🔹KK I 92%
🔸PAS 134 mmHg, FC76 lpm
🔹IAM anterior 43%, inf. 56%
🔸PCIrescate EFI 34%

✅Pto final 1⃣rio combinado (☠️, IC, IAM & shock a 30 días): EFI 12,8%🆚13,3% PCI 1⃣ria (RR 0.96-IC 95% 0.62-1.48)
🔸Pto 2⃣rio:☠️x todas las causas 7.3 vs 8.4 (p>0.05)
🔹☠️CV 7.3🆚8.4 (p>0.05)
🔸ACV 2.3🆚0.5 (p >0.05)
🔹Hemorragia intracraneana IC 1.5 vs 0 (pNS)

Read 4 tweets

Riya Sam, MD

@RiyaSam12

#ACC23 #WCCardio LBCT one-liners:

1. CLEAR Outcomes: Bempedoic acid improves long-term CV outcomes and effectively reduces LDL-C compared with placebo among patients with either established ASCVD or those who have a high risk and w/ intolerance to statin therapy

2. TRILUMINATE Pivotal: Tricuspid TEER was safe for patients with severe TR, reduced the severity and was associated w/ an improvement in QOL

3. HALO: Baxdrostat at the doses studied did not significantly reduce SBP/DBP compared with placebo among patients with uncontrolled HTN

4. STOP CA: Those receiving chemo w/ anthracyclines for lymphoma were significantly less likely to show e/o cardiac dysfunction after taking atorvastatin for 12 mo

Read 35 tweets

Alaa Diab, MD

@DrAlaaDiab

⚠️Wrist-worn transdermal Troponin-I sensor⁉️

#LBCT #ACC23 #CardioNerds
🫀🫀🫀🫀

🫀 How does the Wrist-Worn Transdermal Troponin-I-Sensor work❓

#ACC23 #CardioNerds

#LBCT at #ACC23 this morning ☀️🫀

⚠️PULSED AF Pivotal Trial⚠️

#CardioNerds 🫀🫀🫀

Using Pulsed field ablation rather than thermal modes through irreversible electroporation (IRE).
#ACC23 #CardioNerds

🔺 Pulsed field ablation resulted in 79.7% (paroxysmal) and 80.8% (persistent) clinical success. 🫀

#ACC23 #CardioNerds

Read 5 tweets

Jay Giri

@jaygirimd

🧵 @InariMedical FLAME trial (largest ever high risk PE study) presented today @ACCinTouch #ACC23 by Mitch Silver!

Details in this thread below

2/ The FLAME trial was 2 parallel prospective registries of high risk PE patients at 11 US hospitals. All patients had hypotension or arrest.

One arm (n=53) included pts treated with Flowtriever large bore embolectomy.

Pts in “context” arm (n=61) treated with other therapies

@MyJSCAI

3/ There were few exclusion criteria so the aim was to enroll a very sick population.

Each arm was compared to historical benchmark of the primary endpoints that was derived through an observational SRMA that was recently published @MyJSCAI :

jscai.org/article/S2772-…

Read 9 tweets

Consejo de Cardiología Clínica y Terapéutica SAC

@clinicasac

📌#REVIVED_BCIS2 #ACC23
⛔️PCI vs OMT💊no mejoró el pronóstico o recuperación FSVI en CAD crónica incluso con miocardio viable.
⛔️Viabilidad no se asoció a mejoría pronóstica.
✅La cicatriz (scar) predijo pronóstico y recuperación del VI independiente de FSVI y extensión CAD.

📄PCI vs OMT💊en👥ptes con CAD. Mas información relevante en enfermedad coronaria crónica de la mano de REVIVED.
✅La carga (% de volumen) de cicatriz predijo pronóstico (HR 1.18).
⛔️Ningún monto de miocardio viable predijo pronóstico o recuperación del VI.
#Cardiotwitter

@divaka_perera

🗣️La explicación desde el autor principal: @divaka_perera 📽️

https://twitter.com/escardio/status/1632087112362217473?s=20

Read 3 tweets

Alaa Diab, MD

@DrAlaaDiab

@CardioNerds

🆘“Nephrology Stopped the Diuretics: Renal Considerations in the Management of Heart Failure” 🫘 🫀
#ACC23 #CardioNerds @CardioNerds

Dr. Alison Grazioli discussed the response to diuretics in HF:

What happens after you start loop diuretics?
🔸Net Na loss
🔸Short term Anti-Natruresis: ↗️Na retention
🔸Nephron remodeling
‼️Na loss may be equivalent to Na retention‼️

@CardioNerds

Patients with decompensated HF will need higher doses of diuretics due to decreased renal blood flow:
#ACC23 #CardioNerds @CardioNerds

Read 4 tweets

John P Erwin III MD FACC

@HeartOTXHeartMD

@USNavy

Former @USNavy Rear Admiral and previous @WhiteHouse physician?!

Dr Mariano for our @KelleyBizMed keynote tonight is a GREAT excuse for having to miss #ACC23

Amazing story and an amazing role model. 1/

@KelleyBizMed

😮 @KelleyBizMed 2/

@KelleyBizMed

😮 @KelleyBizMed 3/

Read 8 tweets

Dr. Purvi Parwani

@purviparwani

@mmartinezheart

#Imaging In #Athletes from @mmartinezheart’s phenomenal talk at @LLUHealth

➡️ physiological adaption in athletes common

➡️ not every “abnormal” finding is a pathology #Echofirst #whyCMR must to evaluate

➡️ ekg interpretation jacc.org/doi/abs/10.101…

➡️ type of cardiac remodeling depend on the sports and activity
Eccentric
Nondilated concentric
LV concentric

➡️ increased LV size and lower EF not uncommon- Stroke volume

#WhYCMR all the way.
Every professional athlete with concern of CVD get a CMR!
#whyCMR in athletes

➡️ accurate biventricular size and function

➡️ LVH assessment - accurate measurement of the septum

➡️ myocardial fibrosis indicates pathology

➡️ risk stratification

Read 6 tweets

Abhishek Chaturvedi MD

@IAmDoctorAbhi