#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
#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
#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 🏥!
Dr. Steve Nissen #FHSummit24
#CvPrev #CardioTwitter
🚨🚨🚨We are failing patients🚨🚨🚨
🚨🚨🚨After 3 decades our practice pattern is the same
It started in the 1970’s with the Cholesterol Skeptics…& now just stronger despite all the evidence
#CVPrev #CardioTwitter
Despite trials that proved the effectiveness of statins, the next studies didn’t help convince people that lower LDL was better (commercial statin wars drove this!)
So patient remained under-treated… as they are now.
#FHSummit24
Then the REVERSAL trial shows no progression with intensive LDL ⤵️ and lower is better.
PROVE-IT showed also lower is better
And so did all these other trials…
And terms, we still don’t use intensive LDL lowering because our guidelines didn’t keep pace with the evidence
@ASPCardio Statement: Defining Preventive Cardiology
🫀Noted ⤵️ in mortality from CVD over the past several decades driven by progress in prevention
🫀More recently CVD mortality ⬆️ w/ ⬆️ risk factors at younger ages
🫀Our goal was to define the field of preventive cardiology
@ASPCardio proposed a unifying definition of preventive cardiology: proactive, patient-centered approach in which clinician, or team of clinicians and non-clinicians, assesses CV risk & implements a comprehensive strategy of risk mitigation to prevent CVD & its clinical sequelae.
CVD Prevention goes far beyond LDL.
Lifestyle Approaches are key and we have had @ASPCardio statements on this, including the role of nutrition on heart health led by @DBelardoMD and myself, with the collaboration of many others
👉Rate of ⬆️ of #WIC is just 0.3%/year
👉No Federal Mandate for Maternity Leave in🇺🇸
👉Issues related to childbearing affect practicing cardiologists
💃purpose of this study was to examine
the impact of pregnancy & maternity leave &
associated institutional policies/practices WIC
📌323 Respondents: ~35% of #WIC so quite good for a survey
📌Practices: Academic🎓/Hospital🏥/🏠Private
📌37% report extra call/service prior to MatLeave
📌<8% have RVUs prorated for MatLeave
📌41% had salary⬇️ during pregnancy year
📌23%: no paid MatLeave
Recommendations to ⬇️ #ASCVD with Nutrition: 1. Primary and Secondary Prevention of ASCVD: A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein & fatty fish is optimal for the prevention of ASCVD
🥕🥬🥦🫑🥒🍅🧅🧄🥔🐟🍉🍒🍏🍊🍇🍋🍎🌶️🍈🍐🌿🌱
2. Hyperlipidemia: Replacing saturated fat with polyunsaturated and monounsaturated fat, reducing dietary cholesterol intake, and increasing intake of fiber rich foods, can all lead to a ⬇️ in LDL-C and apoB.
The Chest Pain Guidelines are now released! ahajournals.org/doi/10.1161/CI…
Top 10: CHEST PAINS
Thanks to the entire writing group and my co-cahirs: Deb Murkerjee & Phil Levy
💥First Chest Pain Guidelines @AHAScience@ACCinTouch
Top 10 messages:
#1: Chest Pain is MORE than Pain in the chest
➡️History Matters
➡️ Assess probability of chest pain symptoms being ischemic
#2:High sensitivity troponin are useful and preferred biomarker
💥No more CK/CM, no more myoglobin
@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