#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
#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! @NEJMnejm.org/doi/full/10.10… @Steph_Achenbach
#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
Sorry, left out the slide of baseline characteristics of study population #ESCCongress#STEPStudy
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@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
#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 🏥!
#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
💥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
#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
#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
#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
#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
#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
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….