Viet Le DMSc PA-C FACC FAHA HF-Cert Profile picture
May 17, 2021 35 tweets 31 min read Read on X
#ACC21

Join us now - Prevention and Health Promotion and the year in review. Dr. Donna Polk presenting.

acc21.virtual-acc.org/topic-essentia…
#ACC21

The "Covid 19" weight gain?
#ACC21

Yes, the "covid 19" weight gain did occur. How do we combat it though? why did it occur?
#ACC21

Covid restrictions to reduce cases via large group gatherings impacted our usual #exercise routines.
#ACC21

Like any disruptive event, covid impacted/accelerated other parts of healthcare. #cardiacrehab #telehealth @iamritu
#ACC21

What changed in lipid therapy, more specifically, our knowledge in statin use in 2020? #Statinwise #Sampson - Those with statin myalgias, can be reinitiated on statins long-term. #Nocebo like statin myalgias, is just as real.
#ACC21

We know weight loss can be difficult, it carries many many stigmas, and also can contribute to amplification of other chronic disease states. Semaglutide was shown to help reduce weight. #GLP1Ra
#ACC21

Intensive BP management to <120 vs <140, how did this impact cognition and dementia development?
- No difference in probable dementia.
But,
- Mild cog impairment and mild cog+probable dementia did have protection.
#ACC21
Dr. Polk summarizes that the lessons learned and provides opportunities for us to improve on prevention.
#ACC21

Next up Dr. @mchonig - CV and Renal outcomes across glycemic spectrum.

acc21.virtual-acc.org/topic-essentia…
#ACC21

1st, remember that there is a well-established association of CVD and Renal disease with Type 2 DM.

What is the risk of cardiorenal outcomes though across the glycemic continuum/spectrum (beyond T2DM)?
#ACC21

Great visuals and tables on the HR for incident outcomes . N=46,911 and 14% developed incident T2DM.
#ACC21

For the full results, characteristics, please watch Dr. @mchonig full presentation. Below are the summary and implications.
#ACC21

Are there sex differences in genetic risk for HTN?
Dr. Aittokallio up now.
acc21.virtual-acc.org/topic-essentia…
Thoughts? @AnastasiaSMihai @jbrianbyrd @Hragy @hswapnil @DrMarthaGulati
#ACC21

Finland population. Polygenic risk scores for blood pressure.

@skathire @pnatarajanmd
#ACC21

Results and Conclusions.

PRS may help communicate risk to our patients, prioritize pharmacotherapy vs lifestyle interventions alone.
#ACC21

Next up @DrKene. Don't miss this very interesting evaluation of Alcohol on CVD! Is ETOH protective or Harmful?

I will try to come back to this as my talk is next.

acc21.virtual-acc.org/topic-essentia…
#ACC21

History of EtOH use. It's been used throughout our human history. A J-shaped curve - a little is good, but a lot....
#ACC21

Love the approach and hypothesis here. Is the benefit of EtOH mediated by its anxiolytic properties?
#ACC21

Methods. MGH Biobank, surveys, and ICD mining
#ACC21

Methods, continued. ICD Dx mined and imaging
#ACC21

Results - Moderate alcohol associated with lower MACE, lower stress.
#ACC21

As noted in previous post, moderate EtOH associated with lower MACE and lower stress associated neural activity. This provides nuance on why/how EtOH associates with decrease MACE.

Important question - can we parse weekend drinkers vs daily drinkers in this data?
#ACC21

Next up: Dr. @paragchevli - Metabolomics in atherosclerosis from the diabetes heart study.
#ACC21

Well, you heard the sub-study results of #STRENGTHtrial. We hope to provide nuance to the Omega 3 CVOT trials. Recognizing that there appears to be a difference from EPA-only vs EPA/DHA mixed preparation trials.
#ACC21

Lots of controversy in OM3. We looked at circulating serum levels of EPA and DHA, unadjusted/adjusted for one another and adjusted for comorbidities.
#aCC21

A reminder of the EPA and DHA doses in contemporary CVOT in OM3 and outcomes.
#ACC21

N = 987 from the INSPIRE Registry. All undergoing coronary angiography.
#ACC21

Results - 1
#ACC21

Results - 2
#ACC21
Happening now - our @intermountain data on EPA and DHA impacts on one another and MACE.
acc21.virtual-acc.org/topic-essentia…
#ACC21

Dr. Audry Chacin-Suarez up next!
acc21.virtual-acc.org/topic-essentia…
#ACC21

Does an increase in peak Vo2 in #CardiacRehab associate with lower MACE?
#ACC21

Great presentation by @audrychacin
#CardiacRehab resulting in an increase in peak %Vo2 from pre to post rehab resulted in a decrease in MACE. Not surprising, those with the greatest change had the greatest reduction in risk.
#ACC21

My apologies, here is the conclusion slide. @audrychacin

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More from @VietHeartPA

Nov 7, 2022
#aha22 - SPORT trial

💊nutraceuticals ubiquitous and “assumed” by many pts to be heart healthy.
💊💰💸industry
💊 SPORT ➡️ compared to rosuva and placebo, do they impact biomarkers?
jacc.org/doi/abs/10.101…
@kewatson @ErinMichos @ljlaffin 1/ ImageImageImage
N=199, randomized single blind
💊 lipid, hsCRP, CMP. Baseline and at 28 days.
💊 1° risk, age 40-75, LDL-C 70-189, borderline to upper intermediate risk (5-20%, estimated 10 yr event)
💊 1° endpt: %LDL-C change vs rosuva
💊2° endpt: biomarkers vs rosuva; vs placebo
#aha22 2/ ImageImage
💊 most were at least 7.5% 10 year risk
💊 nice representation of 💃🏽
💊 LDL-C >100 (~125); hsCRP <2.0

#aha22 3/ Image
Read 6 tweets
Nov 7, 2022
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape EPA effect on ASCVD in Japanese pts w/chronic CAD and EPA/AA ratios <0.4, on statins.

🐟EPA 1.8 gm (like JELIS)
🐟EPA baseline 46 ug/mL (JELIS, 96)
🐟All on statins, randomized to control or EPA, no blinding (like JELIS)

#aha22 1/ @AHAScience
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience N=2506

🐟interesting drop out rate/protocol deviation, covid era?
🐟LDL-C baseline, similar to reduce it
🐟EPA median 46 ug/mL, higher than reduce it (26), lower than Jelis (96).
🐟hsCRP ~0.40
2/ #aha22
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience 1,800 mg EPA
🐟46 ➡️ 145 ug/mL (26➡️150 ug/mL, reduce it)
🐟LDL-C, Trigs, HDL-C no change
🐟hsCRP went down in both
3/ #aha22
Read 5 tweets
Nov 5, 2022
Dr @DrCaliff_FDA providing the opportunities we have to improve health in the US #AHA22
#AHA22 What the @US_FDA hopes and seeks to do
Throwing dollars at “health”doesn’t = improved health. This is staggering. We need to change what and how we deliver #Healthcare and where the $$ are spent #aha22
Read 4 tweets
Nov 5, 2022
I have never claimed to be fashionable and rarely do I ever match ☺️

I am wearing my heart shoes and my red dress tie from @HeartNews @AHAScience @GoRedForWomen

#AHA22 Day 1 Image
My shoe buddy and frankly the genesis for why I purchased these shoes @KnightSNPs

Stop by S3156. Dr Knights poster on #disparities in #research. #aha22

We need to fix it. ImageImage
Also, don’t miss Dr Horne’s poster on #statin and #etoh. S3063

If transaminases are elevated and statins are indicated: keep the statin, abstain from etoh
@Intermountain @KirkKnowlton
#aha22 ImageImageImageImage
Read 4 tweets
Nov 4, 2022
TRANSFORM-HF

What do we really know about efficacy of furosemide vs torsemide?

I am sure @robmentz and team have something to say about this 👊🏾

pubmed.ncbi.nlm.nih.gov/33714745/

#AHA #LBCT @AHAScience @noshreza
Chlorthalidone versus HCTZ - pragmatic emr study by @Areefishani et al. After #SPRINTTrial I use chlorthalidone. What’s the evidence?

pubmed.ncbi.nlm.nih.gov/35390512/

#AHA #LBCT @AHAScience @noshreza
PPAR-alpha (e.g., fenofibrate, permafibrate) - Are triglycerides as a target out for CV event reduction, or just this mechanism?

pubmed.ncbi.nlm.nih.gov/30342298/ @APradhanBrigham to present 👊🏾

#AHA #LBCT @AHAScience @noshreza
Read 8 tweets
May 16, 2021
#ACC21

Ensuring diversity - acc21.virtual-acc.org/engage-channel/

Come listen to these wonderful talks in how we strengthen diversity -
#ACC21

I love the advice to have cross professional recruiting, e.g. include other #ACCCVT in recruiting physicians and vice-versa.
#ACC21

Make interprofessional practice a baseline. Implement this early and foundational to curricula.

Make it "a thing" to utilize the strengths of team members in care.

Respect the title! All have earned theirs. Introduce by title in front of the patient

#CardioTwitter
Read 24 tweets

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