Discover and read the best of Twitter Threads about #CVD

Most recents (24)

Dr. Tuttle discussing diabetic CKD and benefits of relatively new med Finerenone #AACE2022 Image
#diabetes is responsible for half of #CKD. CKD worsens CVD risk. 90% die from other cause before reaching ESRD #AACE2022 #endotwitter ImageImage
#ckd -- screen, treat and refer. #kdigo to help us know when to do it #diabetes #AACE2022 Image
Read 10 tweets
1) Welcome to a new #accredited #tweetorial on Cardiorenal Disease in T2D & the Impact of Blocking the MR in Patients w/DKD, another CE/#CME program by one of the @GoggleDocs, this time our friend @AmarPut, Diabetes & Endocrine Consultant in the West Midlands 🇬🇧. #CaReMe #FOAMed Image
2) This program is supported by an educational grant from Bayer & is intended for #healthcare providers. Author disclosures can be found at ckd-ce.com/disclosures/. Prior programs, still available for CE/#CME credit, are at ckd-ce.com. CE/#CME credit 🇬🇧🇪🇺🇨🇦🇺🇸
3) So first – the ‘triple threat’ . . . We know of the link between the 🫀 and the kidneys and the ‘#cardiorenal’ syndrome, but what about in the setting of #diabetes?
Read 55 tweets
1) Welcome to a new #accredited #tweetorial from our good friends and #diabetes experts @GoggleDocs, specifically @drkevinfernando, @drpatrickholmes, & @AmarPut. They have put their 🗣️s together to provide us with a summary of the first-ever consensus statement from ...
2) ... @AmDiabetesAssn & @goKDIGO, which were discussed at the recently concluded #isnwcn congress in Kuala Lumpur. This joint document nicely summarizes important recent advances and practice-changing data for the management of diabetic #kidneydisease #DKD.
3) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US based healthcare professionals.
Read 29 tweets
You asked, so I'll deliver. This is what I know about responsible disclosure/#CVD/how to report security issues in other people’s software. Call it "10 Commandments of Durson" if you want. 🧵
1. Be verbose - more info is better. Don't assume that anyone will know what you're reporting from context. Include as many details and as much background as possible in your report.
2. Produce - *and provide* - a proof of concept which bears out your assertions. Any decent incident responder will be fine reading a 10 page description of your findings. But if they can't reproduce them, they can't help you.
Read 11 tweets
How #sleep loss may make physical #exercise more challenging for the #heart:

We find that sleep loss ⬆️ the exercise 🚴‍♀️-induced ⬆️ in blood levels of a #cardiac stress biomarker vs. after normal sleep

But note, exercise is essential for your health
🧵->
sciencedirect.com/science/articl… Image
2/ Extensive epidemiological data has found that sleep impacts the risk of cardiovascular disease (CVD).

E.g. @uk_biobank (n~408k):

Vs. 7 h, sleep duration of ≤5 h & ≥9 h were associated with higher risk of CVD mortality & incidence (~+8-30%).

sciencedirect.com/science/articl…
3/ And elegant human experimental studies have shown that curtailed #sleep can adversely impact🫀physiology.

For instance, shortened sleep can ⬆️ #bloodpressure in humans, seen both after overnight wakefulness academic.oup.com/sleep/article/… & shortened sleep ahajournals.org/doi/abs/10.116….
Read 23 tweets
1/ Wow!

Interesting study about HDL-raising & LDL-lowering medications, CETP & PCSK9 inhibitors, w 1 finding that caught me off guard

Will reveal later in thread 2encourage ppl 2read in context, bc study revealed both good and bad

#CVD #Alzheimers

nature.com/articles/s4146…
2/ Study used Mendelian randomization 2assess possible effects of SPECIFIC pharmacological CETP or PCSK9 lowering on risk

Useful for assessing whether the failures of CETP inhibitors are more likely due to off-target or on-target effects and for directing future development...
3/ Some positive things:
👉MR analysis suggests CEPT inhibition could be useful4reducing coronary hard disease risk (OR=0.95) risk & thus further drug development may be warranted

👉CEPTi anacetrapib&evacetrapib most closely
reflected the on-target association of lower CETP...
Read 10 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Cardiologist, #SoMe education advocate, and true #Renaissance man @CMichaelGibson will be discussing a novel #aspirin prep that has PK/PD like plain #ASA . . .
. . . but a different site of absorption--with greater predictability than ECASA. DON'T MISS IT!! @DLBHATTMD @cpcannon @AnnMarieNavar @DrM_ODonoghue @DrMarthaGulati @practicalcardio @GuyattGH @DrMauricioCohen @SVRaoMD @ASPCardio @PlateletDoc @stephanamayer #FOAMed #CardioTwitter
1) Welcome to a #tweetorial where we’ll explore how changing the formulation of #aspirin & where it's absorbed in the GI tract can ⬇️the risk of acute GI injury, but still maintain predictable absorption. This program is accredited for 0.50h CE/#CME. I am @CMichaelGibson. #FOAMed Image
Read 42 tweets
Our #systematicreview and #metaanalysis on the association of #sepsis with long-term #CVD is out now in @yourICM ! Surviving sepsis was associated with ⬆️#cvMI, #heartfailure, and #stroke over 5+ years. Take-home points below. tinyurl.com/p5n634jy
1. Many studies have examined the risk of #CVD after #sepsis, but variable population and outcome selection has complicated generalizability. We estimated the risk of #cvMI, #heartfailure, #stroke, and composite #CVD after sepsis relative to hospital and population controls.
2. 12,649 citations identified, 27 (25 cohort, 2 case-crossover) studies included. Median of 4,289 (IQR 502–68,125) sepsis survivors and 18,399 (IQR 4,028–83,506) controls per study. We assessed cumulative incidence and relative risk of #CVD from 30 days to longest follow-up.
Read 11 tweets
Thrilled to see our paper led by @johsr2 out in @JACCJournals!
jacc.org/doi/10.1016/j.…
➡️A splicing mutation in the KIV-2 #CNV is the most important SNP regulating Lp(a) variance.
➡️38% carriers, -12 mg/dL #LipoproteinA, -9% CAD
➡️Lp(a) genetics is complex

Thread (1/15)⬇️ Image
2/15
▶️Typed 4733G>A in the #GCKD study (n=4673, apo(a) isoform data available for all) using qPCR
(SNP named 4733G>A based on the reference sequence pos as unique ID not possible in the KIV-2).
▶️1788 carriers (38%, MAF 22%)
▶️Occurs in nearly all isoforms (mostly 24-33 KIV) Image
3/15
▶️KIV-2 4733G>A provided the second strongest relative contribution to the model r2 besides the apo(a) isoform, followed by KIV-2 4925G>A (PMID 28444229), rs10455872, rs3798220, and rs41272114
▶️-12.6 mg/dL but, due to its frequency, explains 12% of Lp(a) variance (iso-adj).
Read 15 tweets
Circulating levels of Lipoprotein Lipase inhibiting factor ANGPTL8 are associated with increased all-cause mortality and CVD risk .@DaveKeto Thoughts?
#metabolism #cvd #LEM
P.S. (ANGPTL8 aka "betatrophin" in the literature)
nature.com/articles/s4159…
cell.com/trends/endocri…
2/ Also, it's all very mechanistic, with ANGPTL4 vs. 3/8 being oppositely regualted by feeding and fasting in a tissue specific manner such that fasting decreases fat storage in adopicytes and feeding promotes it.

And, perhaps, unsuprislingly, the lipid metabolism is...
3/ w.r.t ANGPTLs (and specifically 4, which controls local LPL activity) is linked with glucose homeostasis...
Read 5 tweets
1/ Interesting thread via @ck_eternity_

I'll add some thoughts in my own thread to follow, but consider reading his entirely first.

As always, this is in the spirit of discourse. Love keeping it respectful and productive on such challenging topic. :)
2/ Before getting started, note the coming #LMHRstudy will effectively be tackling much of these common considerations quite directly as we study #LMHRs who have considerably high #LDL from being fat-adapted with otherwise #CVD healthy metrics (See CitizenScienceFoundation.org)
3/ While not commonly known, another major carrier protein for chol is Albumin. It's typically considered in light of transporting NEFAs, but its binding sites can (and are) applied to many other lipids, including cholesterol.
ncbi.nlm.nih.gov/pmc/articles/P…
Read 13 tweets
1/ This new MR study by @mendel_random, @mvholmes, et al makes use of UK Biobank data and determines #ApoB increases risk of #AllCauseMortality, and even #T2Diabetes

This is actually relevant timing as we are rapidly approaching the #LMHRstudy. sciencedirect.com/science/articl…
2/ If you didn't already know, "Lean Mass Hyper-responders" (#LMHRs) would be considered hypercholesterolemic, with this resulting from being very low carb (typically #keto), and are often lean and/or athletic.

(You can read more on this phenotype at CholesterolCode.com/lmhr)
3/ Setting aside why this population exhibits this (see #LipidEnergyModel for more), the most important question is whether they are at risk.

This MR study builds on the existing conventional expectation that they are, and no less in a dose-dependent manner...
Read 6 tweets
Cardiovascular disease is responsible for 35% of deaths in women yearly—yet remains:
❣️Understudied
❣️Under-recognised
❣️Underdiagnosed
❣️Undertreated

NEW @TheLancet Commission outlines 10 recommendations to improve health outcomes for millions of women: hubs.li/H0Ns28Y0
275 million women were diagnosed with cardiovascular disease (CVD) in 2019. Acknowledging sex and gender-specific risk factors is the key to understanding #CVD in women and reducing the 🌍 burden.

Read the #LancetWomenCVD Commission: hubs.li/H0Ns28Y0
The global prevalence of cardiovascular disease in women has declined by 4.3% since 1990, but has risen in some of the world's most populated nations—🇨🇳(10%), 🇮🇩(7%), 🇮🇳(3%).

@TheLancet #LancetWomenCVD Commission provides regional recommendations: hubs.li/H0Ns28Y0
Read 5 tweets
2/ I love that Alan Flanagan kicked off with distinction question re bio markers.

“System Biomarkers in the causal pathway. Systemic biomarkers that can report on the overall picture”
vs
“Biomarkers of disease progression”
...
3/ “... It seems to be in the wider conversation a lot of these are often conflated to a degree. Or there is misplaced emphasis placed on a particular marker...”

I couldn’t possibly agree with this more!
Read 12 tweets
🗣️

Does new study mean #vegans have weak bones? No❌
Does study mean you need meat for healthy bones? No❌

A #thread on #new study:
Vegetarian & vegan diets & risks of total & site-specific fractures: results from the prospective EPIC-Oxford study
bmcmedicine.biomedcentral.com/articles/10.11…
Main Finding:
Data showed 15 more cases of hip fracture in vegans vs meat eaters per 1000 ppl over a 10 year period

⚠️Consider: All enrolled in the study between 1993-2001, last diet assessment 2010
Why it matters:
1. Much #lower knowledge about veganism 10-15-20 y ago vs today
2. Less awareness re protein, RT/muscle & bone health
3. #PlantBased protein options uncommon in marketplace

Reasons for increased fractures in vegans, *important statement: "Fractures at some sites, especially at the hip, may also be more related to osteoporosis than fractures
Read 21 tweets
1/ Big shout out to @MictheVegan organizing a respectful debate between @AviBittMD/@DBelardoMD and @DrEsselstyn/@cardio10s regarding #plantbased diet and #CVD reversal this Saturday

I hope you’ll set aside any biases you may be starting with and appreciate this powerful example. Image
2/ if you follow me, you know how much I value respectful debate, and I would be giving the video a thumbs up on that alone.

This shouldn’t just be happening between communities, but within them as well.
3/ I hope you’ll consider watching this (as I will), and evaluating the debate based not on your existing dietary opinion, but the data and reasoning presented (as I will).

Stay engaged, but please be respectful — we need a lot more of these dialogs, especially in 2020 :) :) :)
Read 3 tweets
For those of you who could not attend the #ENDO2020 sessions this am, due to scheduling or technical challenges, a summary thread #Diabetes #COVID19
We enter the #COVID19 era with an unprecedented set of pharmacological tools that can be used wisely to achieve personalized goals for #T2D
How should we think about the complex interactions between ACE2, DPP4, cardiometabolic inflammation, and the management of #T2D Normally, enhanced ACE2 and reduced DPP4 activity are favorable in PPL with #diabetes
Read 18 tweets
1/ Hot-off-the-press 🔥✍🏽🗣

Precision #CardioOncology: Systems-based Perspective on Tyrosine Kinase Inhibitors & Immune Checkpoint Inhibitors

#PrecisionCardioOnc @SpringerNature

Latest manuscript w/ @MayoClinicCV @mayocvonc & edited by @AnaBaracCardio

rdcu.be/b3q0Y
2/ 🔥✍🏽🗣

A broad spectrum of #CVD toxicities can be seen with targeted therapies or #ICIs

Toxicities of one or the other can include cardiomyopathy, HF, myocarditis, venous or arterial thrombosis, progression of atherosclerosis, QTc prolongation, or arrhythmias

#CardioOnc
3/ 🔥✍🏽🗣

An eminent need is optimal risk management, surveillance, detection, and prevention

The heterogeneities of patient populations, risks, and disease spectra have complicated clinical and translation efforts

#cvPrev #PrevCardioOnc #CardioOnc
Read 13 tweets
Lessons from past #coronavirus & #influenza #epidemics suggest that #viral #infections can trigger acute coronary syndromes, arrhythmias, exacerbation of heart failure owing to a combination of a significant systemic inflammatory response plus localized vascular inflammation.
#COVID19 may either induce new cardiac pathologies &/or exacerbate underlying cardiovascular diseases. A large proportion of patients have underlying cardiovascular disease &/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, comorbidities.
Acute cardiac injury determined by elevated high-sensitivity #troponin levels is commonly observed in severe #COVID19 cases & strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality in patients with #SARSCoV2 infection
Read 6 tweets
Features of #COVID19 @ACCinTouch #CCAACC
🔹fever predominant feature
🔹cough (less often productive)
🔹cough presents on discharge (Lancet paper)
🔹 more than pneumonia
🔹 abnormal coagulation: ⬆️ d-dimer so anticoag needed
@TheLancet @Drroxmehran @CMichaelGibson @hmkyale
Rapid deterioration seen quite often. Cases below demonstrate this: #COVID19
Discussion of this dilemma of ACEI and ARBs: question still remains. We don’t have evidence to stop these and shouldn’t yet.
🔹48% have HTN, less with HTN who survive (~20%)
🔹limited data to say stop anti-RAS
🔹 need studies
@ACCinTouch @hmkyale @DrJenniferCo_Vu
Read 17 tweets
@AGA_Gastro highlights #NASH #NAFLD first up @VidalPuig Where do the fatty acids go? sciencedirect.com/science/articl…
#NAFLD #NASH How much does the clock matter for pathophysiology or therapeutics #circadian sciencedirect.com/science/articl…
“Lost in Translation” or Utility at Last? NASH biomarkers #genetics and risk prediction beyond PNPLA3 sciencedirect.com/science/articl…
Read 6 tweets
1/ Hot-off-the-press!

Tweetorial on Role of Angiotensin‐Converting Enzyme Inhibitors & β‐Blockers in Primary Prevention of Cardiac Dysfunction in Breast Cancer Pts

ahajournals.org/doi/10.1161/JA…

#CardioOnc #CardioOncology #PrevCardioOnc

@avolgman @AnaBaracCardio @DrTochiCardiOnc
2/ Approx 4 million American 👩🏽👩‍🦳 are currently living with a hx of invasive breast ca, w/ 270,000 diagnosed within the past year. Among these 👩🏽👩‍🦳, 64% are aged ≥65 years. Among older 👩🏽👩‍🦳 survivors of breast cancer, cardiovascular disease (#CVD) is the leading cause of death
3/ Are ACEIs and β‐blockers indicated and efficacious for everyone with breast cancer? Should we offer these medications prophylactically to all patients planned for chemotherapy, radiation, or targeted therapy? #CardioOnc #CardioOncology
Read 12 tweets
1/ Preventive Cardio-Oncology Tutorial #PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology

“The time has come for cardiovascular disease (CVD) prevention to play a more prominent role in cardio-oncology.”

tinyurl.com/PrevCardioOncT…
2/ “A myriad of novel cardiotoxic chemotherapeutic & immunotherapeutic drugs are continuously being developed in #Oncology, with diverse cardiovascular (CV) effects.”

tinyurl.com/PrevCardioOncT…

#PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology
3/ Chest radiation “can result in accelerated atherosclerosis, pericardial disease, valve disease, conduction abnormalities, & cardiomyopathies.”

tinyurl.com/PrevCardioOncT…

#PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology
Read 12 tweets
Presenting now #ESCCongress#CVD remains leading cause of mortality globally, accounting for 40% of deaths, but in HIC, #cancer is now responsible for twice as many deaths: findings from #PUREStudy

Free to read with reg until Sept 10 #LancetCardiology hubs.ly/H0kyVcg0 Image
Presenting now #ESCCongress—Modifiable risk factors account for 70% of all #CVD cases globally, with wide variation is risk factors between countries: findings from #PUREStudy

Free to read with reg until Sept 10 #LancetCardiology
hubs.ly/H0kyVyD0 Image
Cancer's global epidemiological transition and growth: Comment by Jonathan Kocarnik on #PUREStudy published today for #ESCCongress

Free to read with reg until Sept 10 #LancetCardiology hubs.ly/H0kzcn60 Image
Read 3 tweets

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