Discover and read the best of Twitter Threads about #ACC22
Most recents (13)
1) Welcome to Part 2 of a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. DOn't miss Part 1, still available for 🆓CE/#CME, at cardiometabolic-ce.com/hcm5a/.
Now you can learn more, and EARN MORE credit, by following this 🧵!
Now you can learn more, and EARN MORE credit, by following this 🧵!
2) Our expert author is again Sergio Kaiser MD PhD FACC FESC 🇧🇷🇮🇱 @pabeda1, cardiologist 🫀, Professor 🎓 of #InternalMedicine, Rio de Janeiro State University. He brings the general cardiologist's perspective to our #HCM discussions. Read and learn!
#FOAMed #CardioTwitter
#FOAMed #CardioTwitter
3) This program is supported by an unrestricted educational grant from Bristol Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.
1a) Welcome to a new #accredited #tweetorial, “MOA and Clinical Trial Data for Novel & Emerging Therapeutic Strategies for #HCM: Can We Target Our Therapy?"
1b) Our expert (and returning @cardiomet_ce) author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies
2) @GiuseppeGalati_ is in Milan 🇮🇹 This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists.
1) Welcome to a new #accredited #tweetorial on #hypertrophic #cardiomyopathy #HCM. Our expert author is Ahmad Masri MD @MasriAhmadMD of @OHSUCardio where he leads the Hypertrophic Cardiomyopathy Ctr. See a previous program from him, on #Fabry disease, at cardiometabolic-ce.com/cardiorenal-fa….
2a) This program is intended for #healthcare providers and is supported by an educational grant from Bristol-Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. FOLLOW US for the most timely expert education in #cardiometabolic care!
2b) #Physicians #Nurses #PhysicianAssociates #NursePractitioners #Pharmacists earn a full 1⃣ hour of 🆓CE/#CME credit from following this 🧵. For educational purposes, Twitter still works!! 😁
#ACC22 LBTs/ Featured Research one liners:
1. VALOR HCM: MAVACAMTEN at 16 weeks in symptomatic HCM decreased the need of SRT
2. Sodium HF: in HF outpatients low-Na diet of 1500 mg/day was not associated with a reduction in CV events but moderate benefit on QoL by KCCQ
1. VALOR HCM: MAVACAMTEN at 16 weeks in symptomatic HCM decreased the need of SRT
2. Sodium HF: in HF outpatients low-Na diet of 1500 mg/day was not associated with a reduction in CV events but moderate benefit on QoL by KCCQ
3. CHAP: In pregnant women with mild chronic HTN, antihypertensives targeted to a BP <140/90 reduced the incidence of adverse pregnancy outcomes
4. POISE 3: In patients undergoing non cardiac surgery, TRANEXAMIC ACID reduced the risk of bleeding ( non inferiority not met)
4. POISE 3: In patients undergoing non cardiac surgery, TRANEXAMIC ACID reduced the risk of bleeding ( non inferiority not met)
5. PACMAN AMI: ALIROCUMAB in acute AMI along with HI statin resulted in reduction in lipid burden/ coronary plaque regression in non-infarct arteries > 52 weeks
6. SUPER WIN: Personalized serial nutrition education at grocery store increased individual compliance to DASH diet
6. SUPER WIN: Personalized serial nutrition education at grocery store increased individual compliance to DASH diet
Ended #ACC22 with "Chaat Masala" A panel discussing Risk-Enhancing South Asian ancestry.
@AmiBhattMD @KevinShahMD @virani_md @alka_kanaya @AnumSaeedMD @SnayCardsPharmD @pnatarajanmd
Just wanted to share some eye-opening facts I learned.
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@AmiBhattMD @KevinShahMD @virani_md @alka_kanaya @AnumSaeedMD @SnayCardsPharmD @pnatarajanmd
Just wanted to share some eye-opening facts I learned.
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⭐️ ischemic heart disease mortality is rising in SA
⭐️ a NorCal Kaiser study looked at incident CHD - showed 8.93% patients with at least one CV event in the SA group, versus 5.66% in the total population (Pursnani 2020)
⭐️ heterogeneity among diff SA groups - unclear why
(2/4)
⭐️ a NorCal Kaiser study looked at incident CHD - showed 8.93% patients with at least one CV event in the SA group, versus 5.66% in the total population (Pursnani 2020)
⭐️ heterogeneity among diff SA groups - unclear why
(2/4)
⭐️ SA have increased visceral fat in the abdomen, liver & around the heart
⭐️ Current risk algorithms (QRISK3) tend to underestimate ASCVD risk in SA
⭐️ Estimated prevalence of GDM in SA up to 17%
⭐️ Subclinical atherosclerosis & premature CAD more prevelant in SA (3/4)
⭐️ Current risk algorithms (QRISK3) tend to underestimate ASCVD risk in SA
⭐️ Estimated prevalence of GDM in SA up to 17%
⭐️ Subclinical atherosclerosis & premature CAD more prevelant in SA (3/4)
This weekend at #ACC22 it was such an honor to present on nutrition & share our new paper "Practical, Evidence-Based Approaches to Nutritional Modifications to Reduce Atherosclerotic Cardiovascular Disease: An ASPC Clinical Practice Statement" sciencedirect.com/science/articl…
It was an honor to lead a clinical practice statement with world renowned cardiologists @DrMarthaGulati @ErinMichos @rblument1 @kcferdmd @DrOstfeld @RonBlankstein @pnatarajanmd @KoushikReddyMD and world expert nutrition scientists @KevinH_PhD @deirdre_tobias @KCKlatt & Dr Sriram
If you told me I would have this opportunity when I was a cardiology fellow, just 2 yrs ago, I would have said "that's impossible." But thanks to @DrMarthaGulati & every author on this important paper, my knowledge of nutrition science & cardiovascular disease continues to grow.
Some patients with very high LDL-C who have already suffered a heart attack:
*may need both the PCSK9 and the ANGTPL3 pathways inactivated
*can we accomplish this with gene editing -
the switching off of two genes in the liver in the same individual?
#ACC22 @VerveTx $VERV
*may need both the PCSK9 and the ANGTPL3 pathways inactivated
*can we accomplish this with gene editing -
the switching off of two genes in the liver in the same individual?
#ACC22 @VerveTx $VERV
NHPs treated:
*day 0 with VERVE-101 targeting PCSK9 (one-time IV infusion)
*day 30 with ANGPTL3 base editor (one-time IV infusion)
*necropsy at day 90 -->
high level editing of each gene!!
69% editing PCSK9
61% editing ANGTPL3
Each edit designed to switch off respective gene
*day 0 with VERVE-101 targeting PCSK9 (one-time IV infusion)
*day 30 with ANGPTL3 base editor (one-time IV infusion)
*necropsy at day 90 -->
high level editing of each gene!!
69% editing PCSK9
61% editing ANGTPL3
Each edit designed to switch off respective gene
Day 0 - VERVE 101 Rx,
blood PCSK9 level plummets
Day 30 - ANGPTL3 base editor Rx,
blood ANGPTL3 level plummets
This will likely be durable for lifetime animal (person)!
blood PCSK9 level plummets
Day 30 - ANGPTL3 base editor Rx,
blood ANGPTL3 level plummets
This will likely be durable for lifetime animal (person)!
A single IV infusion -->
96% lower plasma ANGPTL3 nearly 2y later in non-human primates!!
Coming era of "molecular surgery":
* one time Rx
* permanent switch off disease-causing gene in liver
* lifelong benefit
#ACC22
@ACCinTouch $VERV @VerveTx
newsfilter.io/a/45db4c967cb4…
96% lower plasma ANGPTL3 nearly 2y later in non-human primates!!
Coming era of "molecular surgery":
* one time Rx
* permanent switch off disease-causing gene in liver
* lifelong benefit
#ACC22
@ACCinTouch $VERV @VerveTx
newsfilter.io/a/45db4c967cb4…
some ASCVD patients start with very-high LDL
and
still do not reach LDL goal
despite oral standard-of-care and PCSK9i
and
still do not reach LDL goal
despite oral standard-of-care and PCSK9i
In these patients,
ANGPTL3 inhibition with mAb (Evkeeza) proven to work,
to lower LDL-C by ~50% on top of oral SOC and PCSK9i
ANGPTL3 inhibition with mAb (Evkeeza) proven to work,
to lower LDL-C by ~50% on top of oral SOC and PCSK9i
Hey #ACC22 presenters, especially late breaking studies of consequence. If you don't have simultaneous peer-reviewed pub, consider #preprint what you presented so it's archived & accessible. Let’s make it normative. @medrxivpreprint @yaleHFdoc #LBCT @EricTopol @CMichaelGibson
@medrxivpreprint @yaleHFdoc @EricTopol @CMichaelGibson For all #ACC22 presenters, preprinting is easy; we accept scientific studies, screen rapidly, post quickly. Non-profit. It is of the community-available throughout the world, understood as pre-peer reviewed, and citable. Almost all reputable journals are fine with it, incl @NEJM.
@medrxivpreprint @yaleHFdoc @EricTopol @CMichaelGibson @NEJM In the pandemic @medrxivpreprint stimulated discussions about research in progress, & many examples of advancing research. Cardiology has not yet fully embraced it, yet is this work any less important? All fields should accelerate public scientific communication & #openscience.
Perhaps the most important and most actionable trial #ACC22 is Chronic Hypertension and Pregnancy (CHAP) Trial. Blood pressure control matters in pregnancy. This needs to be put into action. Next in line of great recent BP trials. nejm.org/doi/pdf/10.105… @ACCinTouch @NEJM
@ACCinTouch @NEJM In this study @atitapatterns and colleagues randomized 2408 women w/chronic htn to target <140/90 or usual care (unless BP ≥160/105). Outcomes improved substantially with strategy of targeting <140/90. 18% reduction in risk for primary outcome. @nih_nhlbi @NICHD_NIH
@ACCinTouch @NEJM @atitapatterns @nih_nhlbi @NICHD_NIH Here is the blood pressure in the trial…at baseline SBP was ~134 mm Hg. About 56% diagnosed and receiving medication. SBP randomization to delivery lower in active-Rx group (129.5 vs 132.6 and 81.5 vs 81.5). That’s not much, but yet, yielded benefit.
Should we put patients w/chronic heart failure on low sodium diets. This international trial indicates it doesn’t decrease risk of CV events or all-cause death. Little reason to promote the approach.
Nice study @JustinEzekowitz and colleagues. #ACC22 thelancet.com/journals/lance…
Nice study @JustinEzekowitz and colleagues. #ACC22 thelancet.com/journals/lance…
@JustinEzekowitz The #SODIUMHF study had an interesting finding…secondary endpoints of health status modestly improved w/low salt diet. People can try it if they want & see if they feel better. If not, they can stop w/o fear they're increasing their risk. We docs should not push it on them.
@JustinEzekowitz Another interesting feature of the study is that while people reported modest improvement in health status w/low salt diet, they did not walk farther in 6 minute walk test. So a split in what you might expect.
🎖 #ACC_AHA_HFSA #HF Guidelines are out
Short Tweetorial
🍀 Congrats to the authors for the huge effort : 108 pgs covering multiple aspects including #CardiacAmyloid
@ShelleyZieroth @hvanspall @carlosguizars @ValleAlfonso @JavedButler1 @gcfmd @JJheart_doc
rb.gy/ocnlb7
Short Tweetorial
🍀 Congrats to the authors for the huge effort : 108 pgs covering multiple aspects including #CardiacAmyloid
@ShelleyZieroth @hvanspall @carlosguizars @ValleAlfonso @JavedButler1 @gcfmd @JJheart_doc
rb.gy/ocnlb7
1️⃣ #HFrEF tx
✅ Pros: Clear 4 pillar 1st line 1 day ( No wait)
❌ Cons: NYHA is not fixed very changeable : Better using Hypotension (SBP<100 mmHg) as choice criteria for ACE/ARB vs ARNI
❌ Cons: After 1 + 1/2 year from #GALACTIC_HF Omecamtiv Mecarbil still not in GD
✅ Pros: Clear 4 pillar 1st line 1 day ( No wait)
❌ Cons: NYHA is not fixed very changeable : Better using Hypotension (SBP<100 mmHg) as choice criteria for ACE/ARB vs ARNI
❌ Cons: After 1 + 1/2 year from #GALACTIC_HF Omecamtiv Mecarbil still not in GD
2️⃣ #HFmrEF
✅ Pros: Concur with HFmrEF recom.
⭕️ Probably a 2a in this class for #ARNI is more EBM
@DrNasrien @dranulala @robmentz @MicheleSenni @DrDEliaEmilia @gbiondizoccai @torresviera @JavierdeJuan1 @global_meded @Filippatos @YuriLopatin1
#ACC22
✅ Pros: Concur with HFmrEF recom.
⭕️ Probably a 2a in this class for #ARNI is more EBM
@DrNasrien @dranulala @robmentz @MicheleSenni @DrDEliaEmilia @gbiondizoccai @torresviera @JavierdeJuan1 @global_meded @Filippatos @YuriLopatin1
#ACC22
Check out Top 10🔑points from the 🆕ACC/@American_Heart/@HFSA Guideline for the Management of #HeartFailure #CardioTwitter #ClinicalGuidelines #ACC22
🧵Key Points👇
🧵Key Points👇
1⃣ Guideline-directed medical therapy for #HeartFailure w/ reduced ejection fraction #HFrEF now incorporates four medication classes that include #SGLT2i. #ClinicalGuidelines
2⃣ #SGLT2i have a Class of Recommendation 2a in #HFmrEF. Weaker recommendations (COR 2b) are made for ARNi, ACEi, ARB, MRA & beta blockers in this population. #ClinicalGuidelines
