Discover and read the best of Twitter Threads about #SCOTHeart

Most recents (5)

⚡️ #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
Now that the #epibookclub is over, my weekends are free for reading #RCTs. So, how about a #tweetorial about #pragmatic trials, causal questions, and #landmark analyses, inspired by the #SCOTHEART trial?

#epimethodsclub #cardiotwitter
If we’re going to talk about #pragmatic trials, then we need to start with a definition. The simplest definition I’ve seen is from a trialist I interviewed for my recent @JClinEpi paper (authors.elsevier.com/a/1XS1b3BcJPuv…)

pRCTs “...attempt to address effectiveness in real world settings”
Sure, it’s a bit vague but it’s useful because, like Tolstoy’s unhappy families, #pragmatic trials are all different.

So, what makes me think #SCOTHEART is pragmatic?

My 2¢: lack of blinding, inclusion criteria based on symptoms not diagnoses, & standard care as comparator.
Read 20 tweets
1| Good #cardiotwitter on #SCOTHeart. Others have tweeted reasons y believable. Here is my reply tweetorial

@khurramn1 @AChoiHeart @MarcDweck @JWeirMcCall @rwyeh @drjohnm @venkmurthy @DavidLBrownMD @RogueRad
#ESCCongress
Linking my original tweetorial:
2| Let's start with MI def. Billing codes less accurate than adjudicated MI outcomes, yes? Could be nondiff misclassification which bias to null. But could also be diff w/ ascertainment bias (look harder, anchoring) knowing CCTA result, since 2/3rds normal or nonobstruct.
3| It is conjecture. But basis of clinical reasoning is to factor in test results. The posterior probability for this theory moves up much higher when we try to figure out by what mechanism did a diagnostic testing strategy lead to better outcomes, since the radiation did zilch
Read 11 tweets
1| follow for my critical appraisal tweetorial of #SCOTHEART trial in @NEJM #ESCCongress

Basics: RCT of upfront CTA vs standard of care for stable CP referred to Scottish cardiology clinics. 1.6% fewer had primary outcome with CTA

nejm.org/doi/full/10.10…
2| more basics: primary outcome is driven by nonfatal MI, not death. Authors did tremendous job at highlighting this

#ESCCongress #SCOTHEART
3| before diving in to methods/findings, how would a CTA first approach meaningfully change outcomes?

#ESCCongress
Read 12 tweets

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