Vass Vassiliou Profile picture
Aug 30, 2021 14 tweets 24 min read Read on X
#ESCCongress THREAD on CVD PREVENTION. I need to start with this, seeing someone with an MI or heart failure or AF & treating them appropriately doesn’t make us great doctors. PREVENTING those does. These #ESCGuidelines help a lot to getting us there @ShrillaB @wordfinga …/3
#ESCCongress #ESCGuidelines on CVS PREVENTION. A 🧵. Who to assess? ANYONE AT RISK! Those with FHx, DM, HTN, high lipids AND OBESITY… don’t forget Obesity! I would also have included sedentary lifestyle! @bes502 @papathanasiou_ @MichaelPapadak2 @PMarquesVidal @DrTiberi …/4
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 It’s a lifetime risk… from birth to the end… BUT AGE & COMORBITIDY increase risk- hence the vigilance we should have to identify those at likely risk #epeeps @Abraham_RMI @cor_etc @MihaiTrofenciuc @AskDrShashank @SineadHughes19 …/5
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 The burden of CVD in Europe is high, globally might be even higher. Recommendation to assess using SCORE2 (<70 years) & SCORE-OP (>70yrs). I like these scores but remember age is a continuum risk @purviparwani @DBelardoMD …/6
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 The algorithms specify apparently ‘healthy’, those with known Heart disease and people with diabetes. They are easy & clear to follow! @AsherElad @DrMartensPhD @LoaiAlbarqouni @BudoffMd @olbaPnauJ2 @jairlevogiro @Umair2017 …/7
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 AND an acknowledgement of AIR POPULATION as a risk factor - suggestion to consider avoiding regions of high air population. I would have taken it a step further - Wear a MASK in those regions 😷 @MilenaAste @SeemaDesh2020 …/8
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 this is a specific section on AF … basically if we can assess and manage all risk factors AF will decrease & keep our EP friends less busy @dickytill @martinbahls @roxanacampisi @GeminaDB @chiarabd @cchinHEART @HEARTinMagnet …/9
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 And a table giving specific treatment goals for each category of individuals. @maksuddan @DrMartensPhD @roxanacampisi @FuEdouard @DocStrom @EM_RESUS …/10
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 A crucial recommendation for physical activity @bes502 @ErinMichos @EkateriniL @venkmurthy 150-300 mins moderate intensity or 75-150 aerobic. Clearly the more the better! & guidance on lipid management! @drdiegocosta …/11
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 And of course HYPERTENSION - first look for it and treat it - and seek expert help like that if @AnastasiaSMihai and @DrVikasKapil (and local equivalents!) and treat aggressively. And needles to say STOP SMOKING! …/12
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 and because hypertension is so important , a dedicated info gram on its management! …/13
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 and this is the final comments- worth a read that’s for sure! …/14
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 so my short summary for the guidelines? 1- assess risks, I would say even in ‘apparently’ healthy 2- treat aggressively 3- worth reading the full guideline! It is worth it! Great job from @escardio & the #EAPC @EAPCPresident …THE END

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More from @vass_vassiliou

Nov 28, 2021
A thread 🧵 on #omicron #covid #mask #vaccines Almost 2 years since the initial Covid concerns, what we’ve had is governments across the world being reactive (and slowly) not pro-active. So why is this #omicron different, and what is the concern? @DrMarthaGulati @mmamas1973 /2
Multiple mutations have happened- we didn’t get from #delta to #omicron overnight, the other variant were monitored, but not alarming… and scientists kept observing… but not shouting out- now they are, time to be listened, and here are the concerns @AnastasiaSMihai @iamritu /3
#omicron has 32 mutations in its spike protein. These include E484A, K417N and N440K, which are might the virus to escape detection from antibodies… and herein lies the question… WILL THE VACCINES WORK? WILL NATURAL IMMUNITY WORK? @N_Dietis @LynnGreigMiller /4
Read 14 tweets
Oct 24, 2021
It was so great to give a (virtual) talk to the Hellenic Society of Cardiology on #covid and #whycmr- hopefully next year in person with no more need 4 Covid talks! Short 🧵 on CMR use #epeeps #cardioed #echofirst #tavr #metaanalysis …/2
#covid is bad for many organs- including the heart. The role of ACE2 receptors to facilitate entry to the cells is well known! But for the heart Covid does lead to #infarction #arrhythmias #heartfailure #myopericarditis What can you do to avoid this? GET A #VACCINE
Hospitalized patients with high troponin are the sickest ones. Great study from #london hospitals showing that in this cohort - late gadolinium enhancement indicating scar (an adverse prognostic factor) is present in 1/2 patients. How to avoid it? GET A #VACCINE …4
Read 9 tweets
Aug 28, 2021
Educational Thread (longish) on AORTIC STENOSIS on the new #ESCGuidelines #ESCCongress published at @escardio #EHJ academic.oup.com/eurheartj/adva… Another thread to follow on AR. So truly excited about these guidelines and here’s why @mirvatalasnag @mmamas1973 @DrMarthaGulati @Hragy …/2
First things first #ESCCongress - a patient centered approach recommended. 👏 but I thought we had long moved to a patient centred approach but nonetheless good to highlight #epeeps #cardio #echofirst #whycmr …/3
#ESCCongress valve guidelines - and the role of the Heart Team re- emphasized. This is crucial. But also defining who should be present to constitute a ‘Heart Team’ @milena_mate @MelissaLyleMD @drzgezdentok1 @AScatteia @RositaZakeri @pacman8it @dr_benoy_n_shah @tchaaban1 …/4
Read 11 tweets
Aug 27, 2021
#ESCCongress #ESCGuidelines This is a Long thread on Heart Failure Guidelines published @escardio #EHJ academic.oup.com/eurheartj/adva… LONG BUT EDUCATIONAL! Focus on CHRONIC HF #epeeps #CardioEd @AlexFrogoudaki @mmamas1973 @DrMarthaGulati @purviparwani @Filippatos @EkateriniL @Hragy …/2
#ESCCongress Firstly, no longer Mid Range, replace by MILDLY REDUCED LV EF. Makes a lot of sense - in fact for some time I thought the previous guidelines referred to ‘mildly reduced’ until @merinopoulos corrected me… otherwise no real change in the nomeculture …/3
#ESCCongress nice algorithm - assess risk factors… do BNPs (watch the caveats- AF ⬆️ , obesity ⬇️ value so bear this in mind. The #echofirst and classification into Reduced, mildly Reduced and Preserved. @SineadHughes19 @wordfinga @rahatheart1 @HEARTinMagnet @bp_halliday …/4
Read 12 tweets
Sep 1, 2020
#ESCCongress has ended. A unique conference! An unforgettable conference! These are my highlights!

Firstly, an amazing DIGITAL experience... Brining everyone together, breaking all barriers, diminishing borders.

@Barbara_Casadei @Steph_Achenbach @mmamas1973 @DrMarthaGulati
In an earlier (still ongoing) Poll from today... 77% wished to have a hybrid Digital and In Person conference... That would certainly have lots of attractions especially for those who wouldn't other be able to afford it #ESCCongress



@MarziaRigolli
...& now the science! In random order (depending on which I could find in my twitter thread most easily!)

No 1. #Covid and the HEART

HTN, Lipids, Diabetes, CAD, heart failure, ALL associated with worse prognosis (critical events & deaths)

Women have it less severely

#EPeeps
Read 16 tweets
Aug 30, 2020
An EXCITING NEW guideline from @escardio at #ESCCongress on Atrial Fibrillation. It’s a long read of 126 but enjoyable! Here are my top tips from this guideline…#epeeps Link: bit.ly/2YRdX8S @mmamas1973 @pash22 @Hragy @DrMarthaGulati @ErinMichos @AnastasiaSMihai /THEAD
FOCUS is on CONFIRMING AF (12 lead >30s) and CHARACTERISING it…
The 4S….

Stroke Risk…
Symptom Severity…
Severity Burden of AF
Substrate of AF

@KTamirisaMD @StavrosStavrak1 @StavrosDrakos @JonathanBehar @bogdienache @mencardio
#ESCCongress /3
AF ESC GUIDELINE Tweetorial

Stroke Risk – Simple – CHA2DS2-VASc Score
& HAS-BLED, to stratify bleeding
Symptom severity- Use the EHRA symptom scale
Burden- paroxysmal, persistent, permanent and if paroxysmal how frequently
Substrate of AF- comorbidities #ESCCongress /4
Read 15 tweets

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