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#ESCCongress @MaasAngela presenting on IHD in perimenopause:
So Who is at risk? And why?
♥️Hormones fluctuate over a lifetime in BOTH men &💃♥️There are benefits of estrogen in women protecting them but at menopause it changes and more risk factors ⤴️the risk for ♥️ disease
@MaasAngela #ESCCongress
🔺⤴️insulin resistance
🔺⤴️inflammation
🔺⤴️ adverse cardiometabolic risk profile
All seen in menopause, increasing the risk of CVD in 💃
#ESCCongress @MaasAngela
✅we know a lot about obstructive CAD
❎WE do not know enough about Coronary Vasomotor disorders or Microvascular disorders (INOCA/MINOCA)- these affect 💃
Our knowledge about assessment & treatment of non obstructive CAD remains limited
@Drroxmehran
#ESCCongress @MaasAngela shows that women have different patters of IHD
♥️Women with more diffuse disease
♥️Men with more focal lesions
♥️Prognosis not better for 💃
#ESCCongress @MaasAngela
Understand the sex-specific risk factors in women like preeclampsia; should be part of our history taking
#sexdifferences @ASCVDRiskEnhancers
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#ESCCongress #sexdifferences

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Dr. Martha Gulati “Masks are the New Black”
@DrMarthaGulati
#ESCCongress #LoDoCo2 Results #LBCT
Colchicine also a winner of @escardio 2020
This study was building on COLCOT results in secondary prevention in patients w/ chronic CAD
🔺5522 patients enrolled
🔺Randomized to Colchicine 0.5 mg vs Placebo
🔺Excluded advanced CKD, HF, valve ds
Characteristics of #LoDoCo2 #ESCCongress
🔺90% of patients tolerated medication
🔺Mostly men (84%)
🔺Most had prior revascularization
🔺 Most well treated
Results of #LoDoCo2 show dramatic effect of colchicine in these patients with chronic CAD
♥️30% reduction in treatment arm for Primary Outcome
♥️28% ⤵️ in MACE
♥️subgroup analysis shown
#ESCCongress #residualrisk #colchicine #inflammation
Read 5 tweets
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Dr. Martha Gulati “Masks are the New Black”
@DrMarthaGulati
EXPLORER-HCM Efficacy and Safety of #Mavacamten in HCM Presented by Dr. Olivotto
♥️Meds for HCM very limited and don't prevent progression or reverse it
♥️HCM results from too many cross bridging and this drug prevents this
#EXPLORER #ESCCongress
EXPLORER-HCM Efficacy and Safety of #Mavacamten:
Study & Characteristics &Results as below:
🔺251 Patients (largest trial in HCM)
🔺97% completed study
🔺Improved functional score and improved NYHA class
🔺⬇️post exercise gradients
🔺⬇️ resting and valsalva gradient
EXPLORER-HCM Efficacy and Safety of #Mavacamten
#ESCCongress
🔺Complete response in 27% as what is seen in septal myomectomy
🔺Very safe & well tolerated drug
🔺Question if beta blockers poorly tolerated in HCM & perhaps time to get rid of this as a med in HCM
Read 4 tweets
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Dr. Martha Gulati “Masks are the New Black”
@DrMarthaGulati
#SCCT2020 Limitations of Stress Testing/Imaging in Women from @Heart_SCCT
♥️Too few 💃 enrolled in studies based on prevelance esp in CAD and HF
♥️NIH/Gov funded the worst enrollees of women! We need to change that
#scct2020 Sex Considerations for Stress Testing need to be considered
♥️ Sn/Sp of tests based on doing Cath for Obstructive CAD: these are NOT false positives! so these numbers are outdated IMHO
♥️every imaging modality has + &- to consider when imaging women
#SCCT2020
♥️Prognostic implications of CAC in women vs men well established: CAC >300: 💃 do worse
♥️Nonobstructive disease more prevalent in 💃
♥️ Implications on imaging women ultimately
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