Discover and read the best of Twitter Threads about #powerofzero
Most recents (6)
@TheBhupiThakur @jaideeppatelmd @MichaelJBlaha hi @TheBhupiThakur
For LDL>190 mg/dl
In MESA nearly 35% have #PowerOfZero
13 yr FU, event rate 3.5% (well below threshold for statin consideration)
atherosclerosis-journal.com/article/S0021-…
For LDL>190 mg/dl
In MESA nearly 35% have #PowerOfZero
13 yr FU, event rate 3.5% (well below threshold for statin consideration)
atherosclerosis-journal.com/article/S0021-…
@TheBhupiThakur @jaideeppatelmd @MichaelJBlaha #2
For genetically confirmed #familialhypercholesteremia
See below, clearly not a homogenous disease, many shades of atherosclerotic disease
Events track with CAC score
With CAC zero, can possibly avoid PCSK9i (statins for all)
@rauldsf_santos @miguelcainzos23 @reed_mszar
For genetically confirmed #familialhypercholesteremia
See below, clearly not a homogenous disease, many shades of atherosclerotic disease
Events track with CAC score
With CAC zero, can possibly avoid PCSK9i (statins for all)
@rauldsf_santos @miguelcainzos23 @reed_mszar
@TheBhupiThakur @jaideeppatelmd @MichaelJBlaha @rauldsf_santos @miguelcainzos23 @reed_mszar #3 Across spectrum of Lipid disorders
Clear doesn't matter how you slice or dice the pie, the risk is related to atherosclerotic disease burden across the spectrum of lipid disorders
Clear doesn't matter how you slice or dice the pie, the risk is related to atherosclerotic disease burden across the spectrum of lipid disorders
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…
@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…
🇸🇪 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…
While there is so much established about CAC..
for @Heart_SCCT Prevention Symposium, I was asked by @RonBlankstein to talk about
"what's next for CAC Testing in 2021 (and beyond)?"
What are the main applications in the future?
@miguelcainzos23 @jaideeppatelmd
for @Heart_SCCT Prevention Symposium, I was asked by @RonBlankstein to talk about
"what's next for CAC Testing in 2021 (and beyond)?"
What are the main applications in the future?
@miguelcainzos23 @jaideeppatelmd
#1 CAC has come a long way
-evolving to the needs of the past decade from screening test to a SDM tool
-best tie breaker, adding the dimension of de-risking
-cost-effective and reassuring ok to avoid treatment
-cautiously approved by ACC/AHA guidelines
@Heart_SCCT
-evolving to the needs of the past decade from screening test to a SDM tool
-best tie breaker, adding the dimension of de-risking
-cost-effective and reassuring ok to avoid treatment
-cautiously approved by ACC/AHA guidelines
@Heart_SCCT
#2
Looking forward, beyond established role as decision tool for statins and possibly ASA
we need to think beyond what the future may hold for CAC testing.
While I have a list of at least 10 applications, I will share today the top 5 immediate future roles for CAC testing
Looking forward, beyond established role as decision tool for statins and possibly ASA
we need to think beyond what the future may hold for CAC testing.
While I have a list of at least 10 applications, I will share today the top 5 immediate future roles for CAC testing
Debate CAC vs CTA in primary prevention?
I will start with a provocative statement
Screening, foundational strategy for decades in prev cardio is a seductive paradigm
Its so 1990’s
We are barking on the wrong tree
In 2020, I will explain why this strategy is a fallacy
#ASPC2020
I will start with a provocative statement
Screening, foundational strategy for decades in prev cardio is a seductive paradigm
Its so 1990’s
We are barking on the wrong tree
In 2020, I will explain why this strategy is a fallacy
#ASPC2020
#1 Both primary and secondary prevention lower disease burden and outcomes
#2 Marginal benefit of extensive screening
#3 Whats left to screen? Majority already treatment candidates
#4 Our stakeholders asking for "derisking" vs "screening"
#APSC2020
#2 Marginal benefit of extensive screening
#3 Whats left to screen? Majority already treatment candidates
#4 Our stakeholders asking for "derisking" vs "screening"
#APSC2020
-Despite being being an avid advocate of CAC screening in past, it was time to move on
-Showed 1 in 2 statin candidates have #PowerOfZero
-Proposed CAC as SDM tool
-Concept confirmed in 3 other cohorts, better than any neg marker, cost-effective, and no statin treatment benefit
-Showed 1 in 2 statin candidates have #PowerOfZero
-Proposed CAC as SDM tool
-Concept confirmed in 3 other cohorts, better than any neg marker, cost-effective, and no statin treatment benefit
Humbly honored for this recognition today
Thank you, @Heart_SCCT and especially my friends @RonBlankstein @Agatston_Center presenting it, made it more special
Truly proud to be among the pantheon of cardiology giants who were previously recognized.
Thank you, @Heart_SCCT and especially my friends @RonBlankstein @Agatston_Center presenting it, made it more special
Truly proud to be among the pantheon of cardiology giants who were previously recognized.
In reality honor for #PowerOfZero is really a tribute to the man with Midas touch
Privilege to work & learn so closely, this relationship blossoming not only with him but entire family
@Agatston_Center is national treasure & even today remains a source of inspiration for me🙏
Privilege to work & learn so closely, this relationship blossoming not only with him but entire family
@Agatston_Center is national treasure & even today remains a source of inspiration for me🙏
Early on I was lucky to run across 3 mentors @Agatston_Center @hmkyale @rblument1 who took immense interest in our mission
I then hit #jackpot with collaboration of most dynami, smartest individuals
#PowerOfFriendship of this group been the biggest gift from this journey
I then hit #jackpot with collaboration of most dynami, smartest individuals
#PowerOfFriendship of this group been the biggest gift from this journey
With 5 days to Chol management guidelines update @AHAMeetings..gentle reminder in @JACCJournals: It’s time to accept the #PowerOfZero.
Hope it’s not too late! @rblument1 @hmkyale @MichaelJBlaha @RonBlankstein @ErinMichos @MBittencourtMD.
Some thoughts👇
onlinejacc.org/content/early/…
Hope it’s not too late! @rblument1 @hmkyale @MichaelJBlaha @RonBlankstein @ErinMichos @MBittencourtMD.
Some thoughts👇
onlinejacc.org/content/early/…
#1 Going back to early 2000’s when many showed RF-based approach fell short for individual patient management decisions... aspirations for CAC ‘screening’ gained momentum, though progress stalled due to lack of RCT & waiting for prospective cohorts to confirm prognostication
#3, while hard to rationalize @NIH aversion to fund much needed RCT, sig progress with MESA & HNR confirmed CAC risk stratification capacity->In 2010 Class IIa rec for ‘screen-detect disease-treat’. At that time many hoped next guidelines update wud strengthen CAC screening recs
