Discover and read the best of Twitter Threads about #CAC

Most recents (14)

💦 Orinoco Flow 💦

INCREASING SOLUBLE FIBRIN LEVELS ARE AN EARLY WARNING INDICATOR THAT IN VIVO THROMBIN GENERATION HAS BEGUN, well before there is any other laboratory or clinical evidence of hypercoagulability. It thus informs our understanding of the very early steps in the>
sequence of events within the clotting process...Although our SF discussion...revolves primarily around the thrombotic tendency in Covid patients, it in fact is valuable in any situation involving increased thrombotic risk (liver transplant...trauma, SEPSIS... SNAKEBITE, etc.)>
Viscoelastic testing (VET)...has demonstrated hypercoagulability early in Covid Associated Coagulopathy (CAC). Additional VET studies demonstrated fibrinolytic shutdown late in a majority of severely ill Covid patients with associated elevation of D- dimer. Elevated D-dimer>
Read 18 tweets
1/ #Study #MegaThread

A new study dropped with a trove of data I've long waited for around #CCTA/#CAC scans and #LDL #Cholesterol

✅ >23k studied (!)
✅ Largest sample of CCTA w/ ≥190 #LDL to date (!)
✅ Very uniform study population

Let's unpack...
jamanetwork.com/journals/jaman…
2/ First, be sure to check out this short thread from the lead author, @MaBMortensen.

2 quick notes:
a) While there'll be lots of data appreciated by LDL skepticism, @MaBMortensen maintains LDL-C is still "an important causal RF"
b) Usual epi caveats, etc
3/ Okay, so if you've followed me a while, you know just how incredibly thankful I am of studies that seek to avoid common risks of selection bias (Even if entirely unintended).

This study had the distinct advantage of categorically scooping its population directly...
Read 18 tweets
The NEW @AHAScience @ACCinTouch @ASE360 @accpchest @SAEMonline @Heart_SCCT @SCMRorg Guideline for the Evaluation and Diagnosis of Chest Pain has been released. #CPguideline

jacc.org/doi/10.1016/j.…

Here are highlights for #YesCCT: (1/17)
(2/17) #CCTA receives the highest level of recommendation (1A) in new US #CPGuideline

Guideline sponsored by: @AHAScience @ACCinTouch @ASE360 @accpchest @SAEMonline @Heart_SCCT @SCMRorg

In this CP Guideline Tweetorial the (Level of Recommendation is in parentheses).
(3/17) Acute CP | Intermediate Risk & ⛔known CAD: After ruling out ACS, CCTA is useful to exclude plaque & obstructive CAD as a first line approach (1A) ✅ #CPguideline
Read 17 tweets
Prevalence of Subclinical Coronary Atherosclerosis in General Population
@CircAHA

1/x
🇸🇪 25K randomly invited individuals w/o known CAD underwent CCTA
🇸🇪 51% women
🇸🇪 50 to 64 yrs
🇸🇪 #SCAPIS (the Swedish Cardiopulmonary Bioimage Study)

ahajournals.org/doi/10.1161/CI…
2/x
🇸🇪 42.1% any CCTA-detected atherosclerosis

🇸🇪 5.2% any significant stenosis (≥50%)

🇸🇪 1.9% LM, prox LAD or 3VCAD

🇸🇪 8.3% any non-calcified plaque

🇸🇪 plaques most common in prox LAD

🇸🇪 Participants with only non-Ca plaques were rare (2.4%)

ahajournals.org/doi/10.1161/CI…
3/x
🇸🇪 Prevalence of CCTA-detected atherosclerosis ⬆ w/ ⬆ #CAC scores

🇸🇪#CAC-positive participants:
- Most w/ low (11 - 100) or ultralow (1 - 10) scores
- median score 35 (IQR 8 - 126)

🇸🇪 participants w/ #CAC zero & interm 10-yr risk, 9.2% had CCTA-verified atherosclerosis
Read 7 tweets
Great session on Artificial Intelligence and Machine learning with session chairs @imagingmedsci, Dr. Bratt, @michael_t_lu, @ivanaisgum, Dr. Al'Aref and @DeCeccoCN at #SCCT2021!

#ICYMI - Here's a brief tweetorial from the #YesCCT session (1/7)
@mirvatalasnag @HeartOTXHeartMD
#AI & ML in #YesCCT: #SCCT2021 #Tweetorial (2/7)
1⃣: The big picture & black box by Dr. Michael Lu
-Multiple “black box” definitions
-Explainability
-Predictability
-More accurate than SOC, visualizes output (& modifiable), communicates uncertainty (eg grey-zone FFR-CT)
3⃣#AI & ML in #YesCCT #SCCT2021: New frontiers in atherosclerosis @AChoiHeart

-Use of #CNN for whole heart stenosis & atherosclerosis
-Improved reproducibility of stenosis to enhance guideline adherence
-Individualized risk prediction
-New Rx paradigm!
Read 7 tweets
Women are not smaller men! #Atherosclerosis genesis, progression & sequelae different in women. Plaque erosion causing ACS more common in women. Women have unique #SDOH, are undertreated with #cvPrev therapies & #GDMT, leads to worsening outcomes in women. @lesleejshaw #SCCT2021 ImageImageImage
Women’s CVD risk can be underestimated. Female specific risk enhancers help. #CAC if risk uncertain. Women have lower #CAC prevalence than men but prevalence increases after menopause. CAC when present confers greater risk of incident CVD in women than men. @lesleejshaw #SCCT2021 ImageImageImage
Prevalence of non-obstructive #CAD is higher in women but is prognostic of risk. @lesleejshaw #SCCT2021 ImageImageImage
Read 6 tweets
Top 10 paper in #yesCCT by @ToddVillinesMD

1st paper

📝 Italian COVID 19 registry
N=1625
📝 Increasing #CAC associated with worse covid 19 outcomes of hospital death, MI and CVA
#YesCCT
2nd paper #Top10 papers #yesCCT
#SCCT2021
danish heart registry
📝 Plaque burden, not stenosis the main predictor of MACE
📝 patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events
jacc.org/doi/abs/10.101…
3rd paper #Top10 papers #yesCCT
#SCCT2021

CREDENCE trial
📝 Stress MPI vs #yesCCT for diagnosis of coronary physiology
📝 #yesCCT superior to stress MPI in the diagnosis of invasive FFR
jamanetwork.com/journals/jamac…

@lesleejshaw @RonBlankstein @AChoiHeart @ghoshhajra
Read 10 tweets
We are at the point in the Climate Action Committee CAC where departments try to put the put the public to sleep so we won't notice what their recommendations are. Looking at you, @NYSDOT! #CLCPA Image
People, we are in BIG trouble. The @NYSDOT commissioner says this "after" photo perfectly illustrates "smart growth." A huge, useless median simply does not facilitate more walking, biking, transit, all the things we need to reduce VMT in New York State. What is going on?!?! Image
Hairpulling now commencing: Commissioner is calling Uber, Lyft, and Via "micromobility." How is this possible? At this stage in the game and with this much at stake? #ClimateActionCouncil @NYSDOT, you simply MUST do better. @NYGovCuomo
Read 12 tweets
Attending virtual #SCCT2020 today?

Interested in #CAD, #CAC, #coronary plaque?

All you need to do is to tune into channel 1 in morning & channel 2 in afternoon to learn from experts & ask your Qs

Here are morning sessions on Channel 1 👇
tinyurl.com/yccr8t4k ImageImageImage
& here are #SCCT2020 early afternoon sessions on Channel 2 for #coronary enthusiasts 👇
tinyurl.com/yccr8t4k ImageImageImage
& finally #SCCT2020 late afternoon sessions on Channel 2 for #coronary enthusiasts 👇
tinyurl.com/yccr8t4k ImageImageImage
Read 3 tweets
Join us now for this case-based education session from @HMethodistCV by @almallahmo & John Mahmarian
#ASNC2019 #CVnuc Image
What is your approach to a pre-op asx patient with nl perfusion but #CAC 3,400 on SPECT?
@khurramn1 @venkmurthy @RonBlankstein @almallahmo
#ASNC2019
#PET + #CFR a great modality to evaluate patients with high #CAC

nl #CFR & perfusion very reassuring in this case with #CAC > 1000 Image
Read 3 tweets
⚡️ #YesCCT Coronary Plaque Assessment #Tweetorial ⚡️

By @CoronaryDoc + @AChoiHeart

✅ Why Plaque Assessment?
✅ High Risk Plaque Features
✅ Plaque Characterization/Quantification
✅ Supporting Clinical Data

#CardioTwitter #ACCImaging #SCCT2019 @heart_scct @journalCCT
1/14
2/14
As #SCD or #MI is 1st symptom of #atherosclerosis in 2/3 of pts, early ID of #CAD is of paramount importance

#YesCCT allows for
✅ ID of plaque
✅ Quant. of plaque
✅ Characterization of plaque
✅ Arterial remodeling

Lin, @LubbDup & @lesleejshaw: bit.ly/2x1b5Yz
3/14
Serial angiographic studies have demonstrated an accelerated & rapid plaque progression before most cases of ACS

Rapid plaque growth ➡️ plaque rupture ➡️ thrombus formation ➡️ MI

@LubbDup & @JonathonLeipsic et al: bit.ly/2WIt5Bj
Read 14 tweets
✅ Do we have enough evidence to use #CAC zero in pts with stable angina?

✅ What about pts with new Dx of #HF? What’s probability of ischemic cardiomyopathy (obs #CAD) with #CAC zero?

@Heart_SCCT @khurramn1 @MichaelJBlaha @RonBlankstein @lesleejshaw
bit.ly/2IscVbS
Let’s discuss this @Open_HeartBMJ paper
1/3

✅ 1753 pts with suspected stable angina, no known CAD, from a hospital in UK (2009-2016)

✅ CCTA in 751 pts (52%) with #CAC zero showed
▪️89.7% normal coronaries
▪️8.4% stenosis <50%
▪️1.9% stenosis >50%
bit.ly/2IscVbS Image
Read 6 tweets
Intro to #CAC Tweetorial!

For #ACCFIT, @FiRSTSCCT @ACRRFS #ACCImaging,
@heart_scct #YesCCT #AHA18 #SCCT2019 #Cardiotwitter 😀😀

*⃣Case
*⃣Basics on CAC
*⃣CAC & prognosis
*⃣ACC/AHA 2018 vs SCCT 2017 guidelines
*⃣Case follow-up
(1/n)
Here’s a case – similar to patients we see everyday in the primary care and cardiology offices. (2/n)

72 year-old asymptomatic healthy 💃
BP 117/74, BMI 22
Lipids: TC 270, TG 100 HDL 90 LDL 155
ACC/AHA ASCVD Risk: 10%

#AHA2018 #YesCCT #CAC #ACCImaging
POLL:

Based on the clinical information, would you (3/n):

#AHA2018 #YesCCT #CAC #SCCT2019 #ACCImaging #Cardiotwitter
Read 14 tweets
Big win for #CAC in 2018 Cholesterol Guidelines just published @CircAHA

#CAC is now recommended for risk reclassification in low & intermediate risk patients to guide decision making for statin therapy

ahajournals.org/doi/10.1161/CI…
@AHAMeetings @MichaelJBlaha @ASPCardio @AHAScience ImageImageImage
Read 3 tweets

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