Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Profile picture
Cardiologist, ❤️‍🩹Expert in Women & Heart Disease, Prevention, Author 'Saving Women's Hearts’- Heals 💔 President of ASPC #earlyinterventionalist @CedarsSinai
Shanil Keshwani Profile picture 🥕Devesh Rai, MD🥕 Profile picture Sarah Owens Profile picture Jan Lockamy Profile picture 4 subscribed
Nov 16, 2022 5 tweets 5 min read
@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
Mar 14, 2022 5 tweets 6 min read
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
Mar 12, 2022 11 tweets 10 min read
@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
Oct 28, 2021 12 tweets 19 min read
The Chest Pain Guidelines are now released!
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
Sep 1, 2021 7 tweets 12 min read
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:

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
Aug 30, 2021 4 tweets 6 min read
#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
Aug 30, 2021 5 tweets 7 min read
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 ImageImageImageImage #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 ImageImageImageImage
Aug 29, 2021 5 tweets 10 min read
#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 ImageImageImageImage #ESCCongress #HOTLINE #CardioTwitter #CVPrev
🫀Study could impact CVD health of the world
@NEJM Read here: bit.ly/3yuVqxU
Fantastic study!!!!!!! @ASPCardio @CardioSmart ImageImageImageImage
Aug 29, 2021 5 tweets 8 min read
#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
💥 AF 32% ILR vs 12% Control w/ OAC ImageImageImageImage #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 ImageImageImageImage
Aug 29, 2021 4 tweets 7 min read
#ESCCongress #Hotlines
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 ImageImageImageImage #ESCCongress #Hotlines
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 ImageImageImage
Aug 4, 2021 11 tweets 13 min read
1/ From @BeckersHR 10 numbers thank show how gender gaps keep women out of the C-suite

@DBelardoMD @DrNasrien @netta_doc @ShelleyZieroth @mirvatalasnag @BiykemB @dranulala @DrKLindley @DrJenniferCo_Vu Only 2 health systems ranked in the top 20 hospitals by U.S. News & World Report are helmed by a woman, highlighting how few female leaders are showcased at the top in healthcare.
@AnastasiaSMihai @SharonneHayes @HeartDocSharon @MKIttlesonMD @cardioPCImom @gina_lundberg
Jun 21, 2021 11 tweets 13 min read
10 numbers that show gender pay gap in healthcare- a thread from a recent report
#gendergap #genderpaygap #healthcare

#womeninmedicine @WomenAs1 @DrToniyaSingh @Drroxmehran @DrJMieres @cardioPCImom @athenapoppa @mikevalentineMD @DickKovacs @DBelardoMD @JulieSilverMD #1: The pay gap is widening: from 25.2% in 2019 to 28% in 2020: earning ~$116,000 less than men in medicine per year
#gendergap #genderpaygap #healthcare
Nov 16, 2020 6 tweets 9 min read
Wonderful talk at #AHA10 @MarilynCipolla on #preeclampsia and the Brain #neuroobstetrics #cardioobstetrics @uvmvermont @MaryCushmanMD
🧠Preeclampsia is vascular disorder
🧠Preeclampsia defined below @acog
🧠Once you have PE, greater 🫀 events, HTN, DM
🧠 But also BRAIN effects #AHA20 #preeclampsia
🤰Preeclampsia is an exaggerated response of pregnancy induced inflammation, hyperlipidemia and hypercoagulation
⬆️ risk of:
🧠cognitive decline
Nov 16, 2020 4 tweets 4 min read
Dr. Peter Rothwell: Paul Dudley White lecture & reminds us that PDW was ahead of his time, believing lifestyle was key. The Pathway along the Charles River is named after him #AHA20
Best quote " I wish we could do something useful with tobacco- like making fertilizer out of it" Profound effect BP on Risk of Stroke #AHA20
🧠🫀 #BloodPressure... #PDWLecture
16 Fold risk association with mean BP and stroke
Nov 16, 2020 5 tweets 9 min read
#mSToPs Study presented at #AHA20 #LBCT @SteveSteinhubl @EricTopol
💫Lifetime risk of Afib ⬆️ (.40%)
💥Risk of #Afib is stroke but also Heart Failure and CV Mortality is even ⬆️⬆️
🥅 was to assess ECG patch in diagnosis of Afib & improve outcomes Study Design of #mSToPs was direct to participants @Aetna patients with #ziopatch worn for a median time of 24.7 days #AHA20
Nov 14, 2020 4 tweets 4 min read
Dr. David Williams speaking at #AHA20
💸Pay gap for Black Americans is 59 cents vs $1 for White Americans
🛑Same as 1978!
Racial differences haven't changed in all this time
At every level of education, gap persists: income and education matter but race overrides this ImageImageImageImage Racial Segregation is real #AHA20 and was part of racial regulation
💔2/3 of all Black Americans live in very low opportunity neighborhoods
💔This access to opportunity (or lack thereof) is a driver of racial ethnic differences ImageImageImageImage
Nov 13, 2020 8 tweets 9 min read
@AnastasiaSMihai @loriannpeterso1 & I will be presenting Poster #1432 at #AHA20. It will be presented at 9am CT (soon) but before it is, I want to thank you all for filling out my survey on #cardioTwitter because this is what our poster is based on. We wanted to find our how you measure #bloodpressure & how reliable you felt your clinical BPs were. I regret to inform you despite you liking your BP reads & trusting them, most of you don't check it correctly @HeartBobH #AHA20 Thanks to @Heart_SCCT @ASPCardio @HBPRCA for help
Aug 31, 2020 5 tweets 8 min read
#ESCCongress #LoDoCo2 Results #LBCT
Colchicine also a winner of @escardio 2020
This study was building on COLCOT results in secondary prevention in patients w/ chronic CAD
🔺5522 patients enrolled
🔺Randomized to Colchicine 0.5 mg vs Placebo
🔺Excluded advanced CKD, HF, valve ds Characteristics of #LoDoCo2 #ESCCongress
🔺90% of patients tolerated medication
🔺Mostly men (84%)
🔺Most had prior revascularization
🔺 Most well treated
Aug 31, 2020 5 tweets 5 min read
#ESCCongress @MaasAngela presenting on IHD in perimenopause:
So Who is at risk? And why?
♥️Hormones fluctuate over a lifetime in BOTH men &💃♥️There are benefits of estrogen in women protecting them but at menopause it changes and more risk factors ⤴️the risk for ♥️ disease @MaasAngela #ESCCongress
🔺⤴️insulin resistance
🔺⤴️ adverse cardiometabolic risk profile
All seen in menopause, increasing the risk of CVD in 💃
Aug 29, 2020 4 tweets 5 min read
EXPLORER-HCM Efficacy and Safety of #Mavacamten in HCM Presented by Dr. Olivotto
♥️Meds for HCM very limited and don't prevent progression or reverse it
♥️HCM results from too many cross bridging and this drug prevents this
#EXPLORER #ESCCongress EXPLORER-HCM Efficacy and Safety of #Mavacamten:
Study & Characteristics &Results as below:
🔺251 Patients (largest trial in HCM)
🔺97% completed study
🔺Improved functional score and improved NYHA class
🔺⬇️post exercise gradients
🔺⬇️ resting and valsalva gradient
Jul 18, 2020 7 tweets 9 min read
#SCCT2020 Limitations of Stress Testing/Imaging in Women from @Heart_SCCT
♥️Too few 💃 enrolled in studies based on prevelance esp in CAD and HF
♥️NIH/Gov funded the worst enrollees of women! We need to change that #scct2020 Sex Considerations for Stress Testing need to be considered
♥️ Sn/Sp of tests based on doing Cath for Obstructive CAD: these are NOT false positives! so these numbers are outdated IMHO
♥️every imaging modality has + &- to consider when imaging women