Walking up towards the summit of wales 2nd highest mountain Carnedd Llewelyn- didn't make it to top, got to 900m. If you go to Wales come here and don't bother with the Snowden. I literally saw one other couple, rather than hundreds of ppl in snowden @DrRajivsankar@VijayKunadian
2. This was accompanied by a ⬇️in hospital HF deaths, but ⬆️⬆️ in community and residential home deaths. we estimate 280 excess deaths from heart failure, and an excess of 2,165 heart failure related deaths (HF anywhere on death certificate) @doc_ccc@onco_cardiology@ncurzen
3. Despite restructuring of services during #COVID19, standard of care appears maintained for ps hospitalised with heart failure with similar adjusted in-hospital mortality rates, but higher 30-day mortality rates compared to the Pre-COVID-19 period. @mirvatalasnag@ShrillaB
3. #WorldCancerDay The greatest incidence of AMI in cancer pts is within 30d of Ca diagnosis, many treatments can ⬆️risk aswell as shared risk factors. We sought to study whether STEMI pts with cancer are less likley to get PPCI & whether they benefit academic.oup.com/ehjacc/advance…
1. Clickbait title but content worth discussing- my thoughts over the next few tweets
➡️Questions around AMI definition.
Dr Taggart and others were part of the discussions that agreed to AMI definition. I think it was right because- see2. medscape.com/viewarticle/93… via @medscape
2. an endpoint should have same prognostic impact in each trial arm. EXCEL definition does, UDMI doesnt
however:
➡️Should probably only include spontaneous AMI post procedure (>72 hrs), whatever definition you use, CABG better in long term
3. ➡️I personally dont think perceived COI have had any impact on the running / outcomes of the trial. Without industry support this trial would never have happened, nor would have many other fundamental trials. This is a smoke screen
1. My talk today at #SHA2020 surgeon session re what #EXCEL really shows. To begin- need to understand importance of endpoints
➡️clinically relevant
➡️related to intervention
➡️relevant to pt
➡️similar prognostic impact in each arm @SVRaoMD@ajaykirtane@RodrigoBagur@jedicath
2. A significant proportion of LMS wont be suitable for either surgery / CABG. As heart teams we have to do better in stratifying by extent of disease - 1/4 of pts included in #EXCEL didnt meet inclusion criteria (low/ intermediate risk) @ovidiogarciav@aspergian1@cardioPCImom
3. The question of periporcedural AMI definition- depends on how you define re UDMI or protocol definition, will impact whether CABG 2x greater or 1/3 less. Personally i think protocol definition better as prognostic impact of AMI the same then in both arms (see pt 1)- BUT ➡️