Wonderful talk at #AHA10 @MarilynCipolla on #preeclampsia and the Brain #neuroobstetrics #cardioobstetrics @uvmvermont @MaryCushmanMD
🧠Preeclampsia is vascular disorder
🧠Preeclampsia defined below @acog
🧠Once you have PE, greater 🫀 events, HTN, DM
🧠 But also BRAIN effects
#AHA20 #preeclampsia
🤰Preeclampsia is an exaggerated response of pregnancy induced inflammation, hyperlipidemia and hypercoagulation
⬆️ risk of:
🧠seizures
🧠stroke
🧠cognitive decline
🤰⬇️seizure threshold
🧠#preeclampsia ⬆️ this susceptibility

#AHA20 @AHAMeetings @nataliebello9
Stroke Risk with #Preeclampsia also increase #AHA20
💥1/3 of pregnancy-related strokes have #preeclampsia
🧠intracerebral hemmorrhage occurs frequently
🤰not included in stroke trials so we know little about what to do with them
Preeclampsia also associated with cognitive impairment: 🧠seen within 5 years of incident preeclampsia (so these are still young women!)
🧠changes seen in cognition and brain atrophy
⬆️ vascular dementia but not Alziehmer's Disease
@MarilynCipolla @AHAMeetings @MitchElkind

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More from @DrMarthaGulati

16 Nov
Dr. Peter Rothwell: Paul Dudley White lecture & reminds us that PDW was ahead of his time, believing lifestyle was key. The Pathway along the Charles River is named after him #AHA20
Best quote " I wish we could do something useful with tobacco- like making fertilizer out of it"
Profound effect BP on Risk of Stroke #AHA20
🧠🫀 #BloodPressure... #PDWLecture
16 Fold risk association with mean BP and stroke
Treatment of HTN decreased risk of recurrent stroke: Important work from Dr. Rothwell @UniofOxford #AHA20 @AHAMeetings #PDWLecture
Read 4 tweets
16 Nov
#mSToPs Study presented at #AHA20 #LBCT @SteveSteinhubl @EricTopol
💫Lifetime risk of Afib ⬆️ (.40%)
💥Risk of #Afib is stroke but also Heart Failure and CV Mortality is even ⬆️⬆️
🥅 was to assess ECG patch in diagnosis of Afib & improve outcomes
Study Design of #mSToPs was direct to participants @Aetna patients with #ziopatch worn for a median time of 24.7 days #AHA20
🔺3 year clinical outcomes
🔺Control arm (standard of care)
🔺Pre-specified Primary Outcome time to 1st event
💥Time to diagnosis af #Afib greater in intervention arm
w/ 32% by patch/68% clinically
🔺OAC in ~40%
💃40% female
#aha20 #LBCT
Read 5 tweets
14 Nov
Dr. David Williams speaking at #AHA20
💸Pay gap for Black Americans is 59 cents vs $1 for White Americans
🛑Same as 1978!
Racial differences haven't changed in all this time
At every level of education, gap persists: income and education matter but race overrides this ImageImageImageImage
Racial Segregation is real #AHA20 and was part of racial regulation
💔2/3 of all Black Americans live in very low opportunity neighborhoods
💔This access to opportunity (or lack thereof) is a driver of racial ethnic differences ImageImageImageImage
The consequences of lack of opportunities increases all level of stressors and the consequences are real:
▶️Accelerated aging
▶️Premature aging
▶️Earlier onset of chronic diseases
#AHA20 @AHAMeetings #racism #racisminmedicine Image
Read 4 tweets
13 Nov
@AnastasiaSMihai @loriannpeterso1 & I will be presenting Poster #1432 at #AHA20. It will be presented at 9am CT (soon) but before it is, I want to thank you all for filling out my survey on #cardioTwitter because this is what our poster is based on.
We wanted to find our how you measure #bloodpressure & how reliable you felt your clinical BPs were. I regret to inform you despite you liking your BP reads & trusting them, most of you don't check it correctly @HeartBobH #AHA20 Thanks to @Heart_SCCT @ASPCardio @HBPRCA for help
When you measure #BP this is how we need to do in clinic @HeartNews but most people don't #AHA20
Read 8 tweets
31 Aug
#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
31 Aug
#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
Read 5 tweets

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