Discover and read the best of Twitter Threads about #ESCCongress

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🧵of 🔟 #pharmacotherapy take home messages from #ESCCongress 22

1️⃣ Post MI - polypill (asp+ACEi+statin) improves 2º CV prev (SECURE)
2️⃣Antihypertensives can be taken AM or PM - no difference (TIME)
3️⃣Neprilysin inhibition doesn't affect cognitive function in HF (PERSPECTIVE) ImageImageImage
4️⃣ AHF, IV Acetazolamide + loop diuretics ➡️ better decongestion, ⬇️ hospital stay & discharge without residual volume overload. (ADVOR)
5️⃣ Dapagliflozin for patients with HFpEF / HFmrEF, and HFimpEF. (DELIVER)
6️⃣Allopurinol doesn't improve major CV outcomes in IHD. (ALL-HEART) ImageImageImage
7️⃣ Adjusted-dose VKA (not rivaroxaban) should remain the standard of care in patients with RHD & AF. (INVICTUS).
8️⃣The LIFE-HF model, Personalised lifetime predection of treatment benefit in HFrEF.
#ESCCongress ImageImage
Read 4 tweets
💥My top 10 learning points from the #ESCCongress 2022💥

A thread for cardiologists/general physicians

1) Addition of IV acetazolamide to IV furosemide in AHF results in 46% higher incidence of successful decongestion after 3 days

EVIDENCE: ADVOR… ImageImageImageImage
2) Revascularization with PCI does not improve event-free survival in pts with severe LVSD over OMT alone
(HF cohort, not acute ACS pts or significant angina)

Evidence: REVIVED…

#ESCCongress ImageImageImageImage
3) In pts with rheumatic heart disease and AF, RCT evidence supports VKA use over rivaroxaban, with decreased composite of CV events and death with VKA and no increase in bleeding.

Evidence: INVICTUS…

#ESCCongress ImageImageImageImage
Read 11 tweets
Follow this #CardioTwitter #Thread
to get an overview of ALL
🚨#ESCcongress #HotLineSessions🚨

➡️14 #OnePager #CongressCards
➡️Links to on-demand stream
➡️Jorunal weblinks
➡️Hashtag of the author/presenter

PART 2 ⬇️ ImageImage

On-demand ESC 📺:

6.1/ #eBRAVE-AF - Smartphone-based #AF screening.
On-demand ESC 📺:

#ESCcongress Image
Read 25 tweets
Follow this #CardioTwitter #Thread
to get an overview of ALL
🚨#ESCcongress #HotLineSessions🚨

➡️14 #OnePager #CongressCards
➡️Links to on-demand stream
➡️Jorunal weblinks
➡️Hashtag of the author/presenter

PART 1 ⬇️
On-demand ESC 📺:

1.1./ #TIME trial - The Treatment in Morning versus Evening study.

On-demand ESC 📺:

Read 25 tweets
We have GDMT and CRT for HFrEF, we will soon also have BAT (Baroreflex Activation Therapy)?

See 🧵below to learn more about this treatment that has significantly improved QoL, exercised capacity and NTproBNP in a RCT...

The #ESCCongress session started with @FudimMarat discussing how it worked – explaining how pts with HF have poor baroreflex sensitivity, that baroreflex down-regulation is related to worse HF symptoms & barostim provided chronic improvement in muscle sym nerve activity

Next William Abraham talked about what has been learnt from clinical trials, focusing on BeAT-HF which was an RCT that showed BAT significantly improved exercise capacity, QoL, NYHA class and NTproBNP, and was safe



Read 7 tweets

Let's get straight to the point about #INVICTUS

The only people not surprised by the results are imagers that do TOEs (TEEs) on these patients! No way VKA was going to lose to NOACs here!😂

A 🧵...

#medtwitter #cardiotwitter #echofirst #epeeps
Patients with rheumatic MV disease typically have very different atrial appearances on TOE. No matter how well anticoagulated, there is very often spontaneous echo contrast in the LA

These atria are just different...why?

Who is this?
The answer is Ludwig Aschoff (1866 - 1942), German physician & pathologist

He described what are now known as Aschoff bodies - inflammatory infiltrates in the atrial walls that eventually turn to fibrotic tissue, which contributes to the atrial myopathy we see in these patients
Read 18 tweets
📌DELIVER Trial #ESCCongress

🔸RCT - 20 países🌐
🔹6.2K👥IC estable con FEY >40%
🔸💊Dapa 10 mg vs Placebo
🔹🗓️Seguimiento ≈ 2.3 a

✅⬇️Muerte CV o empeoramente IC. HR 0.82
✅⬇️Hospitaliz total🏥 y muerte CV. HR 0.77
⛔️No redujo muerte CV o total

#Cardiotwitter Image
📃Varios hasta gaps en la evidencia con SGLT2:
🤔Ptes con FEY >60% se benefician?
🤔IC en🏥 y post alta inmediata?
🤔FEY mejorada >40%?

💡Hipótesis DELIVER: ¿Dapa⬇️el riesgo d empeoramiento d la IC o muerte CV en ptes con FEY levemente reducida o preservada?


#CVD Image
🔸71 a, 🚺43%
🔹90% NYHA II & III
🔸FEY media 54%
🔹FEY ≤ 49%:👥34%
🔸DBT 44% & HTA 88%👥
🔹GFR 61 mL/min Image
Read 7 tweets
🔝🔝🔝Repasamos #Cardiotwitter los #Highlights de las
dos primeras jornadas
#ESCCongress Barcelona 2022 @escardio @ESCardioNews

✅ DANCAVAS Trial ➡️ No
beneficio uso imagen CV en hombres > 70 años ( 🤔 beneficio en
hombres <70 años )

✅ DANFLU-1 trial ➡️
Beneficio de
la vacunación antigripal a altas dosis
en 👴👵 de
65-79 años

✅ DELIVER ➡️ Dapaglifozina
reduce la mortalidad CV y las hospitalizaciones por IC en ICFEVI FEVI > 40%

✅ ADVOR ➡️ Beneficio
Acetazolamida IV en términos descongestión IC Aguda

✅ REVIVAL-BCIS2 ➡️ No beneficio Intervención percutánea en MCD isquémica
Read 5 tweets
A bit of a deep dive on #REVIVED - not ocean floor deep, but just a little more than below the surface!

A lot has already been discussed today, so I'll try not to be too repetitive
This was NOT a trial of revasc in highly symptomatic patients or ACS patients. It was designed to answer the Q of whether PCI is beneficial in ischaemic myocardial dysfunction / ischaemic cardiomyopathy
These multi-centre RCTs are very hard work for steering committees and PIs, huge congrats to everyone that worked on delivering this trial - well done!
Read 24 tweets
📌ADVOR Trial #ESCCongress

🔸RCT 519👥 ICC aguda🏥🇧🇪
🔹1 signo congestión +proBNP >1000o BNP> 250
🔹FEY ≈ 43%
🔸500 mg Acetozolamida IV/día IV+ Furo IV vs Furo IV

🔸⬇️congestión a 3⃣días. HR 1.46
🔹Sin diferencias re🏥a 3 m seguimiento

#Cardiotwitter #CVD
🚩Farmacología y Población
🔹La acetazolamida es un⛔️inhibidor de la a. carbónica q⬇️la reabsorción d Na en el túbulo proximal y mejora su eficacia con d del asa💦
💡Seguro, efectivo, económico y sin patente

👥≈78a, FEY ≈ 43% (42% FEY <40%), CF III/ IV, 44% isquémicos

🚩Pto final 1ro 👉 descongestión exitosa: ausencia d sobrecarga de volumen (no más que un pequeño edema, sin derrame pleural residual, y sin ascitis residual) x puntuación d congestión dentro d 3⃣días

⬇️de congestión
🔸Sin diferencia EA
🔹Re🏥a 3 m ≈17% (SD)
Read 4 tweets
For those who can't get enough from #ADVOR, below the promised Tweetorial!

Acetazolamide in acute #HeartFailure w volume overload on background high-dose loop diuretics:
👍Increases diuresis & natriuresis
👍More euvolemia after 3 days & discharge
#ESCCongress #Cardiology
First, the unsung hero's of this trial, done with a little bit over 2 million €, bargain for largest diuretic #RCT ever!
@KatrienTartagl2 & her team, with only 3FTE, they ran the most successful trial in #AHF
@PieterMartensMD & @JeroenDauw who did most fieldwork
How did we come up with the idea? Actually, cause we all love #physiology. Credits go to Prof. Em. Paul Steels who teached us all how kidneys work.

65% of sodium is reabsorbed in the proximal tubules, can be up to 85% in #HeartFailure
Read 12 tweets
MIC drop at #ESCCongress
No difference at all with revascularization in patients with ischemic cardiomyopathy.
There is silence in the audience! Woooowwwwww
@mmamas1973 @DrMarthaGulati @mirvatalasnag @iamritu @djc795 @SrihariNaiduMD @adityadoc1 @KemalogluOz @Hragy
Conclusions of #REVIVED trial —
In Patients with ICM — PCI didn’t reduce the all cause mortality or heart failure hospitalization at 3.4 years.
( including left main disease)
@DmitryAbramovMD @VinoyPrasadMD @adityadoc1 @datsunian @DineshKalra @DrSharathS
Excellent discussion at #ESCCongress
💥 GDMT works — 90% on BB &ARNI/ACE/ ARB
💥 LVEF increase with PCI doesn’t help with CHF or MI, but better life quality
💥 does viability matter? For risk stratification
@VDelgadoGarcia @alexsfelixecho @Sarah_Moharem
Read 3 tweets
Sesión Conjunta SIAC / ESC
“Estrategias de prevención en las enfermedades cardiovasculares”
Gran participación SIAC en #ESCCongress
Dres @asosaliprandi @Risantilopezcar @AnaGMuneraE @alexandersoneri @adribaran #SIAC_ESC22
Sesión SIAC en #ESCCongress
Full house
Gracias a todos los colegas que nos acompañaron
Sesión SIAC en #ESCCongress
Polipíldora en prevención cardiovascular
Read 6 tweets
The father of syncope in Europe #ESCCongress
Read 23 tweets
Women present with more/worse HF with same risk factors #ESCCongress #Gender
Swedeheart women vs men
Female patients with HFpEF older, live longer #ESCCongress on gender differences in HF
Read 38 tweets
By the way, a few years ago I was attacked in Barcelona and beaten for my watch! No machete was used! I was saved by 2 kind Spanish young men, my watch bracelet was broken , but i kept it.
Please all #ESCCongress attendees be careful with petty crime in this lovely city 🧵
Read 4 tweets
STEP this way for the last of our tweetorials covering #ESCCongress @escardio Looking at a trial of intensive blood pressure control in older adults with hypertension
First...step aside to a different STEP trial – Semaglutide in Obesity – our last tweetorial on this was very popular – have a look!
Now step forward to this tweetorial on BP lowering…
Read 38 tweets
Welcome to the final set of tweetorials from @GoggleDocs A look at some of the interesting trials on hypertension from #ESCCongress
First up we're giving you some SSaSS!
No, not that, we are talking about salt and salt substitution!
Read 32 tweets
1) Welcome to a new joint-accredited #tweetorial on the highlights of cutting-edge #cardiometabolic research from this years #ESCCongress. We are
@GoggleDocs. Follow this tweetorial to earn FREE 0.75h credit, #physicians #nurses #pharmacists!
#FOAMed #medtwitter
2) This program is intended for healthcare professionals and is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, Chiesi, and NovoNordisk. See archived programs at
3) Over the next 3 days the @GoggleDocs will be #Takeover with @cardiomet_CE account.

We are four 🇬🇧 based doc working across healthcare.

Our interests are "what's new, and meaning full in cardio-renal metabolic medicine"

Check out our YouTube channel
Read 16 tweets
So after #ESCCongress we have a new guideline on cardiac pacing and resynchronisation.Some important points to highlight
@escardio @TKDsosyal @EHRAPresident @Steph_Achenbach @vaytekin @m_degertekin @ERTUGRULOKUYAN @doctormutlu @DursunAras2 @ErsaTatl @ahmetilker1 @taylanakgun
Lets start with Dx:

Bingo for imagers @uygurbegum_ @gamzebaburguler @drzgezdentok1
Echo is must and CMRI/CT/PET is needed for <60 y

Bingo for geneticists
Genetic testing is desired for < 50 y

Sleep apnea
Not only important for AF but also for bradycardia so check it before PM
When do we need EPS in syncope? @mertilkerh
If there is a high pre-test probability which are;
1) sinus bradycardia
2) bundle branch block
3) suspected tachycardia
4) structural heart disease
If it is (-) >>> ILR is warranted
Read 19 tweets
💥My top 10 learning points from the #ESCCongress 2021💥

A thread for cardiologists/general physicians

1) There is a treatment for HFpEF!

Empagliflozin significantly ⬇️composite of HF hospitalisation & CV death by 21%

Evidence: EMPEROR-Preserved…

1/n Image
2) A more aggressive BP target (110 to 130 Vs 130 to 150) in elderly patients resulted in lower rates of cardiovascular events

Evidence: STEP study…

2/n #ESCCongress ImageImageImageImage
3) Using a salt substitute ⬇️risk of stroke, major CV events and total mortality.

Evidence: SSaSS study -…

3/n #ESCCongress ImageImageImageImage
Read 10 tweets

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