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Dr. Martha Gulati “Get Vaccinated Please” Profile picture
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29 Aug, 5 tweets, 8 min read
#ESCCongress #HOTLINE #LOOP study #CVprev
Screening for #Afib with loop recorder to prevent stroke
🫀 Incl:age >/=70& 1+ RF; Excl:known Afib
🫀 ILR (Linq) vs Control: afib: tx with OAC
🫀1o: Time to stroke or systemic embolism: 64m F/U
🫀42%💃
💥 AF 32% ILR vs 12% Control w/ OAC ImageImageImageImage
#ESCCongress #HOTLINE #LOOP study #CVprev
Screening for #Afib with loop recorder to prevent stroke
🫀1o outcome:NS
🫀2o outcome NS
🫀 death from any cause NS
🩸 NS dif in Bleed
[Baseline SBP>157: benefit from ILR but hope they tx BP!]
💥Afib diagnosed but NS diff in any outcomes ImageImageImageImage
read results now in @TheLancet #LOOP study
#ESCCongress
thelancet.com/journals/lance…
Interesting #STOPSTROKE was positive, LOOP was negative
🫀But the studies are very different in the screening, length of follow up an definition of #AFib
🫀12% early d/c of ILR
#ESCCongress @escardio @TheLancet @Steph_Achenbach ImageImageImage
#ESCCongress @escardio summary results that are always so well@done by the ESC
@Steph_Achenbach #LOOP STUDY Image

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More from @DrMarthaGulati

Dr. Martha Gulati “Get Vaccinated Please” Profile picture
1 Sep
Great discussion last night with the #EMPEROR in the room
Thanks @JavedButler1 @DrNasrien @hswapnil & Dr. Bayes
If you want to view the recording the link is here:
drive.google.com/file/d/10iTYIN…

We started with @hswapnil disclosing his #flozinator status & how we all need to be as well
@hswapnil showed that until now for CKD, every trial of other drugs has essentially failed.
Although renal function was not a 10 (or 2o or even 3o) endpoint of EMPA trials, the benefits were seen
Work by @ChristosArgyrop (🥬Lover & #Flozinator) showed Renal & CVD benefits #SGLT2i
@hswapnil @uOttawa mentioned that mechanism of how renal protection with #SGLT2i occurs unknown. But asked the proactive question: "Does it Matter?"...and now he is a cardiologists according to @JavedButler1

Group Hug Endo/Cards/Nehpro

@DBelardoMD @DLBHATTMD @ChristosArgyrop
Read 7 tweets
Dr. Martha Gulati “Get Vaccinated Please” Profile picture
30 Aug
#ESCCongress #HOTLINE #cvPrev #STEPStudy
Can intensive tx ⬇️ CVD risk risk HTN, older 👴🧓
🫀Optimum BP remains uncertain in older pt: differing rec's worldwide
🫀🇨🇳 age 60-80y, 9624 pts RCT, >50% Home BP cuff provided
🫀Intensive 110-130 SBP vs 130-150: 26% benefit with int tx ImageImageImage
#ESCCongress #STEPStudy
🫀 No diff in afib, coronary revasc, Mortality but all other endpoints significant
🫀 Safe: Hypotension more common in Intensive arm but no great syncope
🫀 No subgroup diff
How low should we go? Lower!
@NEJM nejm.org/doi/full/10.10…
@Steph_Achenbach ImageImageImageImage
#ESCCongress #STEPStudy
➡️Mean age 66 (75% below age of 70)
➡️ Most with well controlled BP at entry
Context of patient heterogenity
🫀Signif impact on CV events
🫀 Tx well tolerated & achieved! (SBP 126 Intensive)
🫀Is this SPRINT? BP achieved similar to STEP ImageImageImageImage
Read 4 tweets
Dr. Martha Gulati “Get Vaccinated Please” Profile picture
30 Aug
#ESCCongress #HOTLINE #IAMI
Does influenza vaccination improves outcomes in patients with recent MI?
💉 Flu assoc 🫀 death
💉 Vaccine=Class 1 ESC/AHA/ACC
💉8 countries, 4 Flu seasons RCT- double blind of AMI pt, 2571 pts: mostly male (>80%)
💉28% ⬇️ events with vaccine 🆚placebo ImageImageImageImage
#ESCCongress #HOTLINE #IAMI
💉Safe, well tolerated
💉In patients with MI/high risk CAD benefit from influenza vaccination
💉Flu & CVD: 2 of the most common causes of 🏥
Vaccine ⬇️ risk of flu, all cause death and CV events now
High risk pt benefit from flu vaccine
#CVprev ImageImageImageImage
#ESCCongress #IAMI
💉Flu vaccine does ⬇️CV deaths but does not seem to ⬇️ acute CV events in post-AMI patients
💉Data clearly shows influenza vaccine is useful in high risk patients with CVD. Mechanism isn't clear but does that matter?
💉Vaccinate people after #AMI in 🏥! ImageImageImage
Read 5 tweets
Dr. Martha Gulati “Get Vaccinated Please” Profile picture
29 Aug
#ESCCongress #HOTLINE #CardioTwitter #CVPrev
#SSaSS Salt Substitute and Stroke Study @georgeinstitute
🫀Included w/ prior stroke or poorly controlled BP
🫀Interventional: Salt subs
🫀 65y 50%💃 73% hx stroke
🫀3.3 SPB⬇️
🫀⬇️ stroke&CV events
🫀Salt subs is effective to ⬇️ stroke ImageImageImageImage
#ESCCongress #HOTLINE #CardioTwitter #CVPrev
#SSaSS
🫀Study could impact CVD health of the world
@NEJM Read here: bit.ly/3yuVqxU
Fantastic study!!!!!!! @ASPCardio @CardioSmart ImageImageImageImage
💥Very Important study
💥High risk group- mean age 65, 3/4 with stroke, high salt intake (but typical in the world for many)
💥5000 MACE: Power enormous
💥3mmHg SBP ⬇️
⬇️ in stroke & mortality HUGE! Simple intervention
#ESCCongress @Steph_Achenbach
#CVPrev #cardiotwitter ImageImageImageImage
Read 5 tweets
Dr. Martha Gulati “Get Vaccinated Please” Profile picture
29 Aug
#ESCCongress #Hotlines
#RIPCORD2
Does routine #FFR measurements in assessment of CAD impact Chest pain eval?
🫀 open RCT: angio vs FFR
🫀 1o 🏥costs, QOL- 12m
🫀75% male enrolled, longer with FFR, more additional test with just cath
🫀 NS diff in 1o endpoint or clinical endpoints ImageImageImageImage
#ESCCongress #Hotlines
#RIPCORD2
Does routine pressure wire measurements in assessment of CAD for diagnosis of Chest pain?
🫀 No advantage of performing routine FFR
🫀 Not necessary, not beneficial, more complications
🫀FFR better used on specific patients rather than routine ImageImageImage
#ESCCongress #Hotlines
#RIPCORD2
FFR in Chest Pain evaluation
🫀 Patients had low complexity of disease
🫀 Assessment of 30-50% lesion based on protocol may have contributed to the NS findings
🫀 Less selective use: more complications with #FFR
@Steph_Achenbach @mirvatalasnag ImageImageImageImage
Read 4 tweets
Dr. Martha Gulati “Get Vaccinated Please” Profile picture
4 Aug
1/ From @BeckersHR 10 numbers thank show how gender gaps keep women out of the C-suite

@DBelardoMD @DrNasrien @netta_doc @ShelleyZieroth @mirvatalasnag @BiykemB @dranulala @DrKLindley @DrJenniferCo_Vu
Only 2 health systems ranked in the top 20 hospitals by U.S. News & World Report are helmed by a woman, highlighting how few female leaders are showcased at the top in healthcare.
@AnastasiaSMihai @SharonneHayes @HeartDocSharon @MKIttlesonMD @cardioPCImom @gina_lundberg
3/ Even though female executives are sparse among healthcare ranks, 26 percent of its executives are women. It's among the highest of any industry, alongside finance and retail….

@DrHeatherJohn @JoyHenningsenMD @heartofthemater @BethFratesMD @iamritu @DrToniyaSingh
Read 11 tweets

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