Discover and read the best of Twitter Threads about #ISCHEMIA
Most recents (21)
Thomas Luscher MD for @escardio on the morning session on the last day of #CardioEgypt2023 on the ever elusive role of inflammation in atherosclerosis 
And now , Mr President of @escardio Franz Weidinger on the exciting topic of application of #ISCHEMIA in our daily practice , in Cairo, #CardioEgypt2023 am co-chairing the session and learning new stuff!
If you haven’t read this yet, please do
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Past programs still eligible for credit can be found at ckd-ce.com. Faculty disclosures & accreditation statement are at ckd-ce.com/disclosures/. FOLLOW US!
Follow this #CardioTwitter #Thread
to get an overview of ALL
🚨#ESCcongress #HotLineSessions🚨
Including:
➡️14 #OnePager #CongressCards
➡️Links to on-demand stream
➡️Jorunal weblinks
➡️Hashtag of the author/presenter
PART 2 ⬇️
to get an overview of ALL
🚨#ESCcongress #HotLineSessions🚨
Including:
➡️14 #OnePager #CongressCards
➡️Links to on-demand stream
➡️Jorunal weblinks
➡️Hashtag of the author/presenter
PART 2 ⬇️
6.1/ #eBRAVE-AF - Smartphone-based #AF screening.
📕🔗: nature.com/articles/s4159…
On-demand ESC 📺: bit.ly/3Qc6SYp
#ESCcongress
📕🔗: nature.com/articles/s4159…
On-demand ESC 📺: bit.ly/3Qc6SYp
#ESCcongress
Thank u @Heart_SCCT @jolson106
Was an honor serving on #ASM committee #SCCT2022 & congrats @ghoshhajra for leading this team
My takeaways:
1) #ISCHEMIA captured current landscape of functional testing & put anatomy vs ischemia discussions in the center
ahajournals.org/doi/10.1161/CI…
Was an honor serving on #ASM committee #SCCT2022 & congrats @ghoshhajra for leading this team
My takeaways:
1) #ISCHEMIA captured current landscape of functional testing & put anatomy vs ischemia discussions in the center
ahajournals.org/doi/10.1161/CI…
2) We learned from those excluded from the trial as much as we did from those included #CIAO-ISCHEMIA
#SCCT2022
ahajournals.org/doi/10.1161/CI…
#SCCT2022
ahajournals.org/doi/10.1161/CI…
3) #DISCHARGE trial will make way for cathlabs to focus on complex procedures as #YesCCT assumes most diagnostic evaluations
nejm.org/doi/full/10.10…
#SCCT2022 @NEJM
nejm.org/doi/full/10.10…
#SCCT2022 @NEJM
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists 🇺🇸🇪🇺🇬🇧🇨🇦. Past programs still eligible for credit are at ckd-ce.com. Faculty disclosures are at ckd-ce.com/disclosures/. FOLLOW US for regular programs by expert faculty!
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
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…
#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
#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
#Tweetorial on #ASNC2020 session
⚡Selecting Between Different Functional Tests⚡
☢ vs 🧲 vs ⏺ ❓
🔘 Strengths/Limits of Lesion Specific vs Myocardial Ischemia
🔘 Comparing Dx Accuracy of Tests
🔘 Ischemia Testing in #INOCA
🔘 How to Select Best Noninvasive Test
1/9
⚡Selecting Between Different Functional Tests⚡
☢ vs 🧲 vs ⏺ ❓
🔘 Strengths/Limits of Lesion Specific vs Myocardial Ischemia
🔘 Comparing Dx Accuracy of Tests
🔘 Ischemia Testing in #INOCA
🔘 How to Select Best Noninvasive Test
1/9
☢ Selecting Between Different Functional Tests in 2020? ☢
This should be most interesting session of virtual #ASNC2020
I am excited to be virtual moderator w/ expert speakers Dan Berman, Keon Nieman, Paul Knaapen, @mdicarli, @VTaqMD
#cvImaging #cvNuc #CardioTwitter
This should be most interesting session of virtual #ASNC2020
I am excited to be virtual moderator w/ expert speakers Dan Berman, Keon Nieman, Paul Knaapen, @mdicarli, @VTaqMD
#cvImaging #cvNuc #CardioTwitter
Are you ready for most exciting #ASNC2020 session?
⚡Selecting Between Different Functional Tests⚡
☢ vs 🧲 vs ⏺ ❓
Let’s hear from #cvImaging giants
Keon Nieman, Paul Knaapen, @mdicarli @VTaqMD @danielbermanmd
📆 Sat, Sept 26
⏰ 2:15 to 3:30PM
🗒 bit.ly/333dRNO
⚡Selecting Between Different Functional Tests⚡
☢ vs 🧲 vs ⏺ ❓
Let’s hear from #cvImaging giants
Keon Nieman, Paul Knaapen, @mdicarli @VTaqMD @danielbermanmd
📆 Sat, Sept 26
⏰ 2:15 to 3:30PM
🗒 bit.ly/333dRNO
The #ISCHEMIA trial has been popular again in recent days on Twitter, but amongst all the controversies & criticisms, it got me thinking about the #STICH trial.
These two trials actually have quite a lot in common and it's worth exploring that in a little detail
A thread...1/
These two trials actually have quite a lot in common and it's worth exploring that in a little detail
A thread...1/
STICH was a government funded trial designed to answer definitively - for once and for all - the role of revascularization in ischaemic cardiomyopathy. Numerous observational and/or retrospective studies suggested benefit on 'hibernating myocardium' but the jury was still out 2/
It was a well-intentioned study with enormous amount of thought put into planning methodology, ensuring only experienced surgeons with proven good outcomes took part, OMT had to be maximized etc etc
Tragically, like other RCTs, STICH suffered from enormous enrollment bias...3/
Tragically, like other RCTs, STICH suffered from enormous enrollment bias...3/
Time for my first Twitter Poll!
I believe we should abandon the terms 'sensitivity' and 'specificity' of non-invasive imaging tests. 20th century language, no longer fit for purpose! I'll explain why after poll closes.
Do you agree?
@BSEcho @ASE360 @BritishCardioSo @escardio
I believe we should abandon the terms 'sensitivity' and 'specificity' of non-invasive imaging tests. 20th century language, no longer fit for purpose! I'll explain why after poll closes.
Do you agree?
@BSEcho @ASE360 @BritishCardioSo @escardio
Let’s do a quick one on #clinicaldecisionmaking and #neuroimaging. See bright spot on MRI T2 Brain just means increased water -could be any insult to the brain - #infection #inflammation #ischemia #neoplasm are the top 4 you gotta have in your brain. Pun intended. #MedTwitter
Then you think - active or inactive process? If it’s actively destroying the BBB, it’ll enhance on contrast enhancement. So get MRI with and without contrast. Why without? T2 shine-through - but that’s for another time. #MedStudentTwitter #neurology #neurologyresident
Now the important question here is what you do - remember that nice poem on #theroadnottaken by #robertfrost? 2 widely diverging choices - to immunosuppress or not to immunosuppress. #tobeornottobe #hamlet #MedTwitter #AcademicTwitter #MedStudentChat
1/
⭐️How do we manage CAD in advanced CKD?
In this #Tweetorial, @BUMedicine classmates/future coresidents @RahulAggarwalMD and I review:
🔷#ISCHEMIA-CKD @NEJM #ACC2020
By @SripalBangalore @nyulangone & et al!
#MedTwitter #CardioTwitter #MedEd #COVID19 @MedTweetorials
⭐️How do we manage CAD in advanced CKD?
In this #Tweetorial, @BUMedicine classmates/future coresidents @RahulAggarwalMD and I review:
🔷#ISCHEMIA-CKD @NEJM #ACC2020
By @SripalBangalore @nyulangone & et al!
#MedTwitter #CardioTwitter #MedEd #COVID19 @MedTweetorials
2/
First off, a refresher pop-quiz on the #ISCHEMIA (Outcomes) trial @NEJM we summarized in last week's #Tweetorial!
Q: Patients with stable CAD and moderate/severe ischemia have better outcomes with which intervention?
First off, a refresher pop-quiz on the #ISCHEMIA (Outcomes) trial @NEJM we summarized in last week's #Tweetorial!
Q: Patients with stable CAD and moderate/severe ischemia have better outcomes with which intervention?
3/
If you missed our #Tweetorial last week, here is the link to review our summary of the #ISCHEMIA Outcomes main trial results:
If you missed our #Tweetorial last week, here is the link to review our summary of the #ISCHEMIA Outcomes main trial results:
@DavidLBrownMD @BobDreyfuss2017 @iamritu @mad_sters @ProfDFrancis @rallamee @DrJHoward @mshunshin @MikeTPhD @drjohnm @rwyeh @imperialcollege Yeah, analysis does not adjust for changes in diagnostic sensitivity over time. We have trials included that span 1992 to 2019 and diagnostic criteria were likely more sensitive for inclusion in recent trials.
@DavidLBrownMD @BobDreyfuss2017 @iamritu @mad_sters @ProfDFrancis @rallamee @DrJHoward @mshunshin @MikeTPhD @drjohnm @rwyeh @imperialcollege Overall, the meta-analysis doesn't change the predominant dogma that we cannot save lives or prevent cardiac events in a stable CAD population. However, there are situations defined by acute or recent myocardial injury/infarction that benefit from revascularization with PCI.
@DavidLBrownMD @BobDreyfuss2017 @iamritu @mad_sters @ProfDFrancis @rallamee @DrJHoward @mshunshin @MikeTPhD @drjohnm @rwyeh @imperialcollege I'll transition to the case report by patient and investigative reporter/editor for the @thenation @BobDreyfuss2017
Reminds me of uncomfortable M&Ms I've attended with the patient/family present to recap how medical decisions were made and managed.
ahajournals.org/doi/10.1161/CI…
Reminds me of uncomfortable M&Ms I've attended with the patient/family present to recap how medical decisions were made and managed.
ahajournals.org/doi/10.1161/CI…
Today sharing my views on #ISCHEMIA trial @bmj_latest; the trial is post-presentation and prepublication. I talk about what we can take away so far. blogs.bmj.com/bmj/2020/01/07…
@bmj_latest One of my points about #ISCHEMIA trial is that, since they presented pre-peer review information publicly to with broad media dissemination, would have been nice to #preprint what they had at the time, to archive it, enable it to be cited in the meantime. @medrxivpreprint
@bmj_latest @medrxivpreprint Another point, #ISCHEMIA trial outcomes results same in 2 arms was expected…but what about quality of life findings. Eager anticipation for the quality of life papers. Secondary endpoint. Unblinded trial. No effect in CKD. But provocative in non-CKD. Lots to discuss/debate.
#ISCHEMIA Thread: I gave a quick hot take during #AHA presentation & haven’t had time to expand on it. Queue some collected thoughts (albeit without gifs & references) on some responses I've seen to the study. Hats off to @alenghat for the great graphic on applying the study
So #ISCHEMIA #AHA19 will take time to digest; lots presented and no peer-review pub or @medrxivpreprint yet. There is often drift from the big presentation to the publication. We should resist a rush to judgment. Yet…
@medrxivpreprint A couple of things occur to me from the presentations…reinforces the prior evidence that patients w/stable ischemic heart disease have little to lose by deferring procedures. The medical therapy strategy seems safe. The procedural strategy is not saving lives or events, to date.
@medrxivpreprint It seems to question value of myocardial perfusion imaging in patients w/stable ischemic heart disease. In aggregate large costs…and not clear, in many cases, what it is adding if the procedures are not saving lives or events. Combine that w/STICH, and the question gets bigger.
Main driver of events MI
Single vessel
Proximal LAD
OMT
No heterogeneity
Proximal LAD
OMT
No heterogeneity
#ISCHEMIA
Red or Green?
Entire cardiology world is enthusiastically waiting to know the answer in 10 mins
#AHA19
Red or Green?
Entire cardiology world is enthusiastically waiting to know the answer in 10 mins
#AHA19
And now results of $100 million #ISCHEMIA trial
1/Lot's of angst about #ISCHEMIA and what it will mean for cardiology practice. For me, a positive trial is likely to mean more for changing my practice than a negative one. I'll try to explain (Thread). #AHA19
2/I was trained by conservative cardiologists in the post-COURAGE era. I don't offer PCI to stable patients with the idea that I am going to make them live longer or reduce hard endpoints. We offer PCI to stable patients for one predominant reason - symptoms despite meds.
3/However, it is VERY common for patients to be surprised that walking around with a blocked artery is safe. Even after a clear conversation about what the benefits of elective PCI are, post-PCI patients will often say, "Now I can walk around without worrying...".
This month I revisit #COURAGE. The ultimate conversation starter among @JAMAInternalMed readers and interventional cardiologists. #CQOSpotlight
Quick someone tweet a concerning angiogram cine and ask if anyone else would refer a specific stable CAD patient to OMT!!
Quick someone tweet a concerning angiogram cine and ask if anyone else would refer a specific stable CAD patient to OMT!!
𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: The #COURAGE investigators provide longer survival follow-up on subset of the original study cohort to evaluate how the number of coronary lesions vs. amount of ischemia is prognostic for patients with stable CAD. ahajournals.org/doi/10.1161/CI…
The subset of patients received both quantitative coronary angiograms (QCA) and stress (SPECT) perfusion imaging.
