Our paper in @JACCJournals today:
Childbearing Among Women Cardiologists
The Interface of Experience, Impact, and the Law
with my coauthors @pamelasdouglas @drmalissawood @sarma_amy @DrToniyaSingh @Drroxmehran Dr. Bairey Merz & legal experts Joan Williams,Rachel Korn,Jessica Lee Image
👉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 ImageImageImageImage
📌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 Image
🚨~37% with pregnancy complications!
This is higher than reported in any surgical specialty or any medical specialty!

@HeartOTXHeartMD @mirvatalasnag @bjcohenmd @JoshuaBeckmanMD @HFnursemaghee @WomenAs1 @SharonneHayes @HeartDocSharon Image
🚨 Salary 💰⬇️ in 41% of #WIC: particularly highest in private practice but not protected in academic settings or hospital settings Image

• • •

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More from @DrMarthaGulati

Sep 23
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


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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
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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


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Read 7 tweets
Nov 16, 2022
@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 Image
@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. Image
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

@KevinH_PhD @KCKlatt @kcferdmd @deirdre_tobias Image
Read 5 tweets
Mar 12, 2022
@ASPCardio Statement led by @DBelardoMD & myself w/ @ErinMichos @RonBlankstein @rblument1 @kcferdmd @KCKlatt @pnatarajanmd @DrOstfeld @KoushikReddyMD @deirdre_tobias @KevinH_PhD Practical Evidence-Based Approaches to Nutritional Modifications to ⬇️ #ASCVD
bit.ly/3tRD0XP Image
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.
Read 11 tweets
Oct 28, 2021
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

@HighSTEACS @MaasAngela @mmamas1973 @KTamirisaMD @iamritu @mswami001 @cardiojaydoc02 @onco_cardiology @ShelleyZieroth @fitmslax @DrToniyaSingh
Read 12 tweets
Sep 1, 2021
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
Aug 30, 2021
#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

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