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28 May, 5 tweets, 8 min read
What happened to HF admissions during #COVID in England? our an analysis led by @DrAhmadShoaib ➡️bit.ly/3c0iEng with @hvanspall @foziaahmedMD @cpgale3 @TheresaMcDonag3 #JohnCleland shows 40%⬇️in HF admissions @GiuseppeGalati_ @DrNasrien @JJheart_doc @ShelleyZieroth
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
4. Gaps in post-discharge care due to closure of ambulatory care centres during COVID-19 pandemic may have contributed to suboptimal care and increased risk of death following hospitalization @CardioIAN @HeartOTXHeartMD @JJheart_doc @CarlChiefCard @DrSaritaRao2 @DrRajivsankar
5. Final thoughts- COVID has impacted our CV services significantly. the decline in hospital admissions has caused ⬆️ death in community. changes in OP services during COVID has worsened outcomes of long term conditions. A visual asbtract @DrNasrien @ShelleyZieroth @hvanspall

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More from @mmamas1973

Mamas Mamas Profile picture
26 May
Another day another Hike. This time starting at eigiau dam en.m.wikipedia.org/wiki/Llyn_Eigi… that burst in 1925 and flooded millions of gallons of water - you can see break in 1st pic @DrMarthaGulati @saraceciliamtz @bes502 @DBelardoMD @ShaziaTHussain1 @KTamirisaMD @ncurzen @nolanjimradial
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
3. On the way down, a 15km hike, with a climb of over 100 floors according to my app lolol @Umair2017 @Uqayyum123 @iamritu @willsuh76 @SukhNijjer @atunuguntla1 @jedicath @mirvatalasnag @kollsrini @ovidiogarciav @VictorDayan1 @Argenscore @ecrsfd @DrFerNunez @EkateriniL
Read 5 tweets
Mamas Mamas Profile picture
25 May
1. Hired a cottage in wales For a few days, decided to hike to pen y gaer, An old iron age fort. @DrMarthaGulati @BethFratesMD @bes502 @nolanjimradial @iamritu @CastlDalmunzie @SilCastelletti @mirvatalasnag @djc795 @ErinMichos @RodrigoBagur @ncurzen @DrToniyaSingh @jedicath ImageImageImageImage
Further along the climb becomes quite steep. Unfortunately @komoot has taken me nowhere near any dairy products 😜😜 @wordfinga @Libbyextra @Uqayyum123 @billgogas @drercardio @EkateriniL @JGrapsa @Kfarooqi @DrAmirKaki @netta_doc @nishat76 @JSillerMatula @jedicath @DBelardoMD ImageImageImageImage
3. Climbing up across the stone walls and towards The summit @ShaziaTHussain1 @ShrillaB @ShelleyZieroth @jmahmed @ShelleyWood2 @DocSavageTJU @DavidLBrownMD @fischman_david @YndigegnY @VietHeartPA @onco_cardiology @MihaiTrofenciuc @LynnGreigMiller @drrashid05 @dr_mosama ImageImageImageImage
Read 5 tweets
Mamas Mamas Profile picture
4 Feb
1. Today is #WorldCancerDay our analysis led by @dr_mosama & @hvanspall academic.oup.com/ehjacc/advance… with @AnaBaracCardio @islamelgendy83 @DLBHATTMD @adnanalkhouli @safinmc @dataevan studies disparities in care & outcomes of cancer pts presenting with STEMI @DrMarthaGulati @ShrillaB
2. #WorldCancerDay It builds on our work published last year led by @adityadoc1 showing pts with cancer less likely to be managed invasively, and when they are have better outcomes. academic.oup.com/eurheartj/arti… @MKIttlesonMD @ovidiogarciav @DrPeterOKane @SukhNijjer @CardioIAN
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…
Read 8 tweets
Mamas Mamas Profile picture
1 Nov 20
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
Read 12 tweets
Mamas Mamas Profile picture
11 Oct 20
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 ➡️
Read 11 tweets
Mamas Mamas Profile picture
23 Jul 20
1. Our analysis of 144,000 deaths in UK during #COVID19 1st march-12th May published today mayoclinicproceedings.org/article/S0025-… . First national study of causes of death and underlying medical conditions. led by @dr_mosama with @dataevan @cpgale3 @TomLuscher only 25% of deaths due to COVID.
2. Age standardised mortality rates in UK ⬆️⬆️ for non-covid deaths than covid deaths during pandemic for all age groups @TheBHF @amibanerjee1 @DailyMailUK @guardian @ncurzen @ErinMichos @EricSecemskyMD @venkmurthy @DavidLBrownMD @BBCWorld @KeeleComms @AnastasiaSMihai @jcspratt
3. #COVID19 had the highest ASMR at each age group apart from young women where cancer was the commonest cause of death @SkyNews @Telegraph @Pooh_Velagapudi @poojaotherwise @adityadoc1 @onco_cardiology @mirvatalasnag @DrJenniferCo_Vu @jedicath @RodrigoBagur @VietHeartPA
Read 8 tweets

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