Gurleen Kaur, MD Profile picture
Jul 24, 2021 10 tweets 7 min read Read on X
1/ #ASPC2021 talk for Honorary Fellowship Award by @NMHheartdoc on New Kind of Prevention – Reducing CV Health Disparities at Community and Individual Level

🧵from session

@ASPCardio @CardioNerds
2/ #ASPC2021
Covid-19 deaths by race and ethnicity in the US:
1 in 555 Black Americans has died

Populations w/ highest disease burden➡️ lowest vaccination rates
3/ Any discussion of prevention shouldn’t start at hypertension, dyslipidemia, but at the root cause of those inequities.

Need to address policy. All policy is health policy.

Stolen breaths nejm.org/doi/full/10.10…

#ASPC2021
4/ Physicians must engage with social movements if we want to improve health and address social/structural determinants

⭐️New Prevention⭐️
-Focusing on policy, racism, & changing workforce

#ASPC2021
5/ Racism – belief that all members of each race possess characteristics or abilities specific to race, especially to distinguish it as inferior or superior to other races

jamanetwork.com/journals/jama/…

#ASPC2021
6/ How should we use race in medicine? #ASPC2021

Race is not proxy for biology. Report actual social determinants of health.
jamanetwork.com/journals/jama/…

Thinking fast (with stereotypes) and slow (with cognition) ➡️ inform biases

Need to be aware of our implicit bias.
7/ How do we risk-assess communities? #ASPC2021

Social vulnerability index (SVI) from census
➡️for Chicago SVI map overlays map of areas disproportionately affected by COVID-19.

Also overlays redlining maps.

Policies limit access & there are people that make those policies.
8/ #ASPC2021
⭐️Overcome our bias, check assumptions
⭐️Build antiracist culture
⭐️D&I is about excellence, not representativeness
⭐️Target the pipeline

Poor policy harms community
But people design policy
And people can change policy
bit.ly/3kNGKa9
9/ Pipeline problem began w/ Flexner Report in 1910

Majority of historically black medical schools closed

Underrepresentation persists

Higher URM faculty➡️association with matriculation of URIM students

jamanetwork.com/journals/jama/…

#ASPC2021
10/ More discussion with Dr. Yancy on @cardionerds here:
cardionerds.com/135-narratives…

#ASPC2021

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More from @Gurleen_Kaur96

Jul 23, 2023
1/ Strategies for medical management of obesity, presentation by @BevTchangMD #ASPC2023

Currently 5 meds FDA-approved for long term management of obesity ⤵️ Image
2/ Who is eligible for anti-obesity medication❓

🫀 BMI >= 30, BMI>=27 with weight related comorbidity
🫀For Asians, BMI>=25-27, BMI>=25 with weight-related comorbidity

#ASPC2023 Image
3/ Efficacy‼️

Expectation of response rate: >5% weight loss over 1 year

Phen/top: 10% weight loss, 70% response rate

Semaglutide: 15% weight loss, 86% response rate

Tirzepatide: 20% weight loss, 90% response rate

#ASPC2023 Image
Read 6 tweets
Jan 19, 2023
1/ Cardiac Stress Testing @CardioNerds
🔶Indications
🔶Types - Exercise vs. Pharmacological
🔶Compare & Contrast Modalities

Thanks to @SimratKaurMD, @AmitGoyalMD, @jholtzman3 for feedback on this infographic!

Follow🧵for a breakdown of the graphic⤵️
2/ Indications

Evaluate:
🔺Stable chest pain in pts w/ intermediate-high risk of CAD
🔺New onset symptoms in pt w/ known CAD
🔺Valvular heart disease & provocative testing in HCM
🔺Microvascular disease & CAV in transplant pts
🔺Hibernating myocardium in pts w/ known CAD
3/ Types❓Exercise vs. Pharmacological

🏃‍♀️Exercise
What➡️Treadmill
Who➡️ Anyone who can exercise (achieve 4 METs) and get to 85% of max predicted HR (220-age)

When evaluating report, look for:
🌟Duration of exercise
🌟METs achieved
🌟% max HR
🌟HR/BP response
Read 12 tweets
Nov 16, 2022
1/ In Episode 234, @PaChapterACC & @CardioNerds featured a Narratives in Cardiology discussion on Structural Heart Disease & LatinX Representation in Cardiology w/ @MayraGuerreroMD, @TDonisan, @AdrianaCMares

Follow this #CardsNarratives 🧵 on Valvular Heart Disease in Women Image
2/ We’ll cover these 2 questions:

❓What are the disparities in valvular heart disease in women?
❓What changes need to be implemented to improve the care of women with valvular heart disease?
3/ I feel comfortable openly discussing or asking others about factors that make them different from myself like race, religion, ethnicity, gender, sexual orientation, immigration status, etc
Read 12 tweets
Aug 30, 2021
1/ In the🥉@PaChapterACC & @CardioNerds Narratives in Cardiology episode @mirmerrill, @scfuentesr, and @NatashaCuk talk w/ @KTamirisaMD

Follow this #CardsNarratives🧵on the discussion about gender equity & women in Cardiology/Electrophysiology (EP)
2/ We'll cover these 3 questions:

🔸Why should we promote gender diversity in Cardiology/EP?
🔸How do we address barriers for women in Cardiology/EP?
🔸What are some opportunities for EP in private practice?
3/ I feel comfortable openly discussing or asking others about factors that make them different from myself like race, religion, ethnicity, gender, sexual orientation, immigration status, etc
Read 20 tweets
Jul 25, 2021
1/ Day 3 & last session of #ASPC2021 on special populations

Talk on MI & HF among people with HIV by Dr. Markella Zanni

Follow this🧵on:
🔹MI risk in people w/ HIV
🔹HF in PWH
🔹CVD preventive approaches tailored to people w/ HIV

@ASPCardio @CardioNerds
2/ Patients with HIV are now living longer ➡️increased risk of CVD

Global burden of atherosclerotic CVD in people living with HIV has tripled over past 2 decades

Relative risk of MI is 1.5-2 in high-income countries

pubmed.ncbi.nlm.nih.gov/23459863/

#ASPC2021
3/ From US Partners database study – adjusted relative risk for MI was around 3 for women & 1.5 for men – regionally specific

Type 1 vs. type 2 MI: both ~50%
Women – more type 2 MI

pubmed.ncbi.nlm.nih.gov/17456578/

#ASPC2021
Read 18 tweets
Jul 24, 2021
1/ Great #ASPC2021 session by @RonBlankstein on Chest Pain and Imaging

Follow this🧵for some takeaways on
🟣Stress Testing vs. Anatomical Testing
🟣Coronary CTA
🟣Guidelines

@ASPCardio @CardioNerds Image
2/ ‼️ Imaging tests alone do NOT change pt outcomes but how we act on them might

‼️ No one test is always the best test

‼️ Test selection influenced by multiple factors: local availability, prior training, guidelines, evidence

🔜AHA/ACC New Chest Pain Guidelines

#ASPC2021
3/ Stress testing vs. Anatomical

ETT: exercise capacity, not as great for ischemia

SPECT MPI: reversible perfusion deficits, underestimates extent of disease esp if multi-vessel

PET MPI: measure absolute blood flow, calculate myocardial blood flow reserve

#ASPC2021 ImageImage
Read 10 tweets

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