Glad to be part of an in-depth analysis of aortic valve replacement in US elderly, led by remarkable @mori_md & @aakriti_15 w/interdisciplinary team of cardiologists & cardiac surgeons. Findings highlight key trends in the TAVR era. jacc.org/doi/10.1016/j.… @JACCJournals @YaleMed Image
@mori_md @aakriti_15 @JACCJournals @YaleMed First, the Medicare beneficiaries receiving a new aortic value increased 60% from 2012, with increasing TAVR (percutaneous procedure) and decreasing SAVR (aortic valve surgery). TAVR up 680%; SAVR down 40%. Marked practice change. @YaleCardiology @ArnarGeirssonMD @ajaykirtane Image
@mori_md @aakriti_15 @JACCJournals @YaleMed @YaleCardiology @ArnarGeirssonMD @ajaykirtane This study took an approach to investigate total aortic valve replacement; often we are looking at the two procedures and comparing them, but missing overall growth of the total procedures and trends in outcomes. More people getting them…and mortality and readmission dropping.
@mori_md @aakriti_15 @JACCJournals @YaleMed @YaleCardiology @ArnarGeirssonMD @ajaykirtane Interestingly, readmission and 1-year mortality trended lower over time for TAVR and SAVR; more people survived both procedures. In this period, patient age remained stead and there was a slightly increasing comorbidity profile.
@mori_md @aakriti_15 @JACCJournals @YaleMed @YaleCardiology @ArnarGeirssonMD @ajaykirtane Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. Here is a link to the paper outside the firewall, which is much appreciated. authors.elsevier.com/a/1e7Th2d9GHow…
@ElsevierConnect @JACCJournals

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More from @hmkyale

22 Nov
Since I drink a lot of tea I really liked this @uk_biobank paper… I am usually skeptical of these types of studies, but this is a good one. “...drinking coffee and tea separately or in combination were associated with lower risk of stroke and dementia.” journals.plos.org/plosmedicine/a… Image
@uk_biobank I was just a little uncertain why people at the top end of coffee and tea consumption tended to have a higher risk… looked a bit like a j-curve. Image
@uk_biobank In the table the authors side-stepped it by considering the group with 4 or more cups a day as high coffee and tea consumption and lumped everyone together. For stroke, more dose response for tea than coffee with this approach, and ischemic stroke. Lots of comparisons... Image
Read 5 tweets
18 Nov
Lots of discussion about science journals…here’s the thing, they do not make it easy on authors. Each journal has their own format, they do not accept each others peer reviewers, they often ask authors to pay for privilege of publishing, and ask authors to donate time to review.
There are so many ways to make this easier… be flexible on format until you decide you want the paper… then you can ask authors to format according to your particular preferences.
Come to agreement about peer reviewers; with each journal starting over with peer reviewers it creates so much more work and delays. There are ways to share among the journals if author so elects.
Read 6 tweets
12 Nov
Great news… @califf001 nomination for @US_FDA seems imminent. And this is a wise choice for someone with the experience, skills and vision to lead at this critical juncture. Sooner we get confirmation, the better. politico.com/news/2021/11/1… Image
@califf001 @US_FDA It is rare to have a Commissioner who has the experience to hit the ground running, and the expertise on the far-reaching responsibilities of the agency, and deeply understands the science. He also knows the potential gamechanging nature of the digital revolution for regulation.
@califf001 @US_FDA To move forward we need a Commissioner who can bring people together and fight on behalf of patients for a system that better servess them. I believe that is what @califf001 can do. I have known him a long time, and can judge by actions, not just words.
Read 5 tweets
8 Nov
We published today a study on acute hypertension hospitalization trends, led by @yuan_lu1 and news is not good. Over last 20 yrs rates markedly increased even though this can be prevented w/simple & inexpensive strategies. ahajournals.org/doi/10.1161/CI… @YaleMed @YaleCardiology @CircAHA
@yuan_lu1 @YaleMed @YaleCardiology @CircAHA And disappointingly but not surprisingly, the highest rates of acute hypertension hospitalizations were among Black patients, who also experienced the steepest increase over last 20 years. The hypertension crisis is also a health equity crisis. @AHAScience
@yuan_lu1 @YaleMed @YaleCardiology @CircAHA @AHAScience The increase in acute hypertension hospitalizations occurred in all subgroups. Makes sense since hypertension control is worse over time; hypertension deaths are rising. This must be recognized as a national crisis. @JeromeAdamsMD saw this as Surgeon General. This work is so imp.
Read 6 tweets
8 Nov
Resistant #hypertension is elevated BP despite the use of 3 antihypertensive drugs. We now introduce persistent hypertension, a broader concept of persistently elevated blood pressure. @amjmed amjmed.com/article/S0002-… @YaleMed @YaleCardiology #BloodPressure
@amjmed @YaleMed @YaleCardiology Resistant hypertension focuses attention on those already treated with maximum doses; persistent hypertension is broader, those with persistently elevated blood pressure, for a wide range of reasons - and this is the vast majority who languish at high risk. @yuan_lu1 @amjmed
@amjmed @YaleMed @YaleCardiology @yuan_lu1 To make progress against hypertension we need to focus intently on those with persistent hypertension; high bp readings over time, without progress. There are so many reasons; and many are social in nature. And this burden falls hard on Black patients in particular.
Read 7 tweets
7 Nov
So privileged to work with the brilliant @VirusesImmunity … she said @washingtonpost: “We have a big dream,” Iwasaki said, describing a sweeping goal of understanding the development of long covid and other post-acute-infection syndromes. washingtonpost.com/health/2021/11… @YaleMed
@VirusesImmunity @washingtonpost @YaleMed The dream is to bring together life science, data science, clinical epidemiology, & digital technologies/software to solve previously intractable conditions that cause much suffering. And to do so in true partnership w/those facing the condition, being worthy of trust every day.
@VirusesImmunity @washingtonpost @YaleMed We will enlist learning community, participating together, sharing wisdom, & being co-producers of research, in traditional & non-traditional ways- setting new standard for quality & speed & utility of the knowledge generated. Researchers working for & on behalf of the community.
Read 9 tweets

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