9/19
#Tweetorial #CMD #ACC21
#CMD shares similar RFs w epicardial atherosclerosis (traditional ASCVD RFs) & is associated with several biomarkers of inflammation, oxidative stress & coagulation
🔗futuremedicine.com/doi/10.2217/fc…
🔗sciencedirect.com/science/articl…
🔗atherosclerosis-journal.com/article/S0021-…
10/19
#Tweetorial #CMD #ACC21
There is significant overlap between #CMD & epicardial disease
Large number of patients w/ #CMD also have epicardial atherosclerosis (obstructive or non-obstructive) & epicardial endothelial dysfunction
🔗onlinelibrary.wiley.com/doi/abs/10.100…
11/19
#Tweetorial #CMD #ACC21
In our IVUS study:
✅ Most patients with #CMD had significant plaque burden
✅ Patients with #CMD had higher plaque burden & more diffuse atherosclerosis as compared to patients w/o CMD
🔗jacc.org/doi/full/10.10…
12/19
#Tweetorial #CMD #ACC21
In our IVUS study & a study from @MayoClinicCV, #CMD (endo-dependent/independent) was associated with features of high-risk (vulnerable) plaque
🔗atherosclerosis-journal.com/article/S0021-…
🔗eurointervention.pcronline.com/article/associ…
13/19
#Tweetorial #CMD #ACC21
#CMD Clinical Phenotypes:
1⃣ #CMD w/o obst CAD or myocardial disease
2⃣ #CMD w/ myocardial disease
3⃣ #CMD w/ obs CAD
4⃣ Iatrogenic #CMD
🔗nature.com/articles/nrcar…
14/19
#Tweetorial #CMD #ACC21
#CMD is highly prevalent in patients w/ angina and/or signs of ischemia referred for coronary evaluation (in presence or absence of obstructive CAD)
@VTaqMD
🔗jacc.org/doi/10.1016/j.…
15/19
#Tweetorial #CMD #ACC21
Several clinical studies showed poor prognosis for #CMD (abnl invasive/non-invasive CFR) regardless of sex
@venkmurthy @ahmedalbadrimd
🔗ahajournals.org/doi/full/10.11…
🔗jacc.org/doi/full/10.10…
16/19
#Tweetorial #CMD #ACC21
In meta-analysis of 5K patients
#CMD (abnl invasive/non-invasive CFR) associated with
4x ⬆ in mortality
5x ⬆ in MACE
🔗ahajournals.org/doi/full/10.11…
17/19
#Tweetorial #CMD #ACC21
#CMD is diagnosed by non-invasive & invasive imaging tools
Guidelines + reviews:
@ChrisKramerMD @wfearonmd @DrArgyle
🔗link.springer.com/article/10.100…
🔗jacc.org/doi/abs/10.101…
🔗ahajournals.org/doi/full/10.11…
🔗eurointervention.pcronline.com/article/the-fu…
18/19
#Tweetorial #CMD #ACC21
Based on 👆 strong body of evidence, @escardio recently included recommendations for diagnosis + treatment of #CMD:
IIa – Invasive CFR/IMR
IIb – Invasive endothelial function by Ach
IIb – Non-invasive imaging/testing
🔗academic.oup.com/eurheartj/arti…
19/19
#Tweetorial #CMD #ACC21
What I hope you learned from this #CMD #Tweetorial 👇
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