Discover and read the best of Twitter Threads about #YesCCT
Most recents (24)
1/ SGLT2 inhibition initiation in the acute hospital setting? This trial showed significant benefit — REGARDLESS of ejection fraction — safe, and with incrementally added benefit when started early. EMPULSE Trial, Nature Medicine, 2022 ♥️ 
2/ SGLT2 inhibition for HFpEF? This trial showed SGLT2 inhibitors to have mortality benefit with EF > 40%, regardless of diabetes status. HFpEF represents a population of patients that beyond diuretic use, has historically been difficult to treat. DELIVER Trial, NEJM 2022 ♥️
🧵TWEETORIAL para ENTENDER LA TOMOGRAFÍA CORONARIA #YesCCT
👨🏫Empecemos:
💡Si necesitas conocer los principios básicos te recomendamos este video:
❤️Cardiac CT: Current Technology & Principles. Faisal Nabi, MD, FACC
👨🏫Empecemos:
💡Si necesitas conocer los principios básicos te recomendamos este video:
❤️Cardiac CT: Current Technology & Principles. Faisal Nabi, MD, FACC
2⃣ Guías muy relevantes para comprender la incorporación de #YesCCT en los algoritmos diagnósticos de dolor💔
📌Guía 2021 ACC/AHA de dolor precordial
jacc.org/doi/10.1016/j.…
📌Guía 2022 para el uso de angioTC coro en dolor tx agudo (SCCT, ACR y NASCI).
linkinghub.elsevier.com/retrieve/pii/S…
📌Guía 2021 ACC/AHA de dolor precordial
jacc.org/doi/10.1016/j.…
📌Guía 2022 para el uso de angioTC coro en dolor tx agudo (SCCT, ACR y NASCI).
linkinghub.elsevier.com/retrieve/pii/S…
📌Repasando. ¿Qué es el Score Cad- Rads #YesCCT?
Tips and Tricks about Calcium and Coronary CT.
First of all: do not be scared about calcium.
- Calcium is par of the disease you are studying
- Calcium is significant information
- Calcium is not just a number (is a pattern, a phenotype, a study of the patient).
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First of all: do not be scared about calcium.
- Calcium is par of the disease you are studying
- Calcium is significant information
- Calcium is not just a number (is a pattern, a phenotype, a study of the patient).
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Coronary calcifications, then, are meaningful information. Describe them and use them to create the map for the CTA both imaging-wise and reporting-wise.
E.g.: a dominant pattern of calcifications is already pointing towards a therapeutic orientation.
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E.g.: a dominant pattern of calcifications is already pointing towards a therapeutic orientation.
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While looking at all these calcifications on the coronary arteries, do not forget to look at all the other structures in the scan. The correct diagnosis might already be there.
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Thank u @Heart_SCCT @jolson106
Was an honor serving on #ASM committee #SCCT2022 & congrats @ghoshhajra for leading this team
My takeaways:
1) #ISCHEMIA captured current landscape of functional testing & put anatomy vs ischemia discussions in the center
ahajournals.org/doi/10.1161/CI…
Was an honor serving on #ASM committee #SCCT2022 & congrats @ghoshhajra for leading this team
My takeaways:
1) #ISCHEMIA captured current landscape of functional testing & put anatomy vs ischemia discussions in the center
ahajournals.org/doi/10.1161/CI…
2) We learned from those excluded from the trial as much as we did from those included #CIAO-ISCHEMIA
#SCCT2022
ahajournals.org/doi/10.1161/CI…
#SCCT2022
ahajournals.org/doi/10.1161/CI…
3) #DISCHARGE trial will make way for cathlabs to focus on complex procedures as #YesCCT assumes most diagnostic evaluations
nejm.org/doi/full/10.10…
#SCCT2022 @NEJM
nejm.org/doi/full/10.10…
#SCCT2022 @NEJM
Dr. Karen Stout - presenting the 7 rules to evaluate #Congenital #HeartDisease by #yesCCT at #SCCT2022
Rule - 1: ALWAYS be prepared. Check cases a day prior & PLAN the imaging
@Heart_SCCT @FiRSTSCCT @SinghVasvi @AChoiHeart
Rule - 1: ALWAYS be prepared. Check cases a day prior & PLAN the imaging
@Heart_SCCT @FiRSTSCCT @SinghVasvi @AChoiHeart
KNOW the anatomy.
If you don’t understand the repair- LOOK up. #Google
@Fentanes_MD @JWeirMcCall @Nidhi_Madan9
If you don’t understand the repair- LOOK up. #Google
@Fentanes_MD @JWeirMcCall @Nidhi_Madan9
The DISCHARGE trial in online on the NEJM and it confirms what we all experience every day using CCT in a proper manner. CCT is safer, reliable and allows better management of stable patients with suspected obstructive CAD as compared to invasive strategy.
The main observation that comes to my mind however is still the very low prevalence of patients with obstructive CAD (25%) in both arms (CT and ICA). This is well known from previous studies and it is related to the selection criteria adopted for referral, partly.
The fact that still we send for an invasive and costly examination (CAG/ICA) this huge number of patients is simply astonishing in 2022. Healthcare cannot be managed like this, especially in universal systems like Italy, Germany, UK, Canada,...
State fo the Art CCT - 4D cineMPR of Thoracic Aorta in para-sagittal view in 4 different conditions from normal to severely diseased/type B dissection.
#WhyCMR #yesCCT #CardioTwitter #MedTwitter
#WhyCMR #yesCCT #CardioTwitter #MedTwitter
#JACCCardioOnc #Tweetorial: Along the spectrum of cancer Tx, #YeSCCT has a lot to offer regarding identifying subclinical #ASCVD, excluding obstructive #cvCAD in cardiotoxicity when appropriate. #CardioOnc, as a field, can gain from incorporating CCT in practice.
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#YeSCCT may identify subclinical #ASCVD in cancer patients & survivors. Reviewing previous non-gated thoracic CT scans for CAC may help identify subclinical #cvCAD and start prompt preventive Tx.
#JACCCardioOnc #CardioOnc #MedTwitter #CardioTwitter
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#JACCCardioOnc #CardioOnc #MedTwitter #CardioTwitter
2/
Several clinical scenarios in the context of cardiotoxicity may require ruling out obstructive #cvCAD. Cancer pts tend to have ⬆️ risk of complications from invasive procedures➡️ thrombocytopenia & hypercoagulable states. #YeSCCT may derive significant benefit. #JACCCardioOnc
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The NEW @AHAScience @ACCinTouch @ASE360 @accpchest @SAEMonline @Heart_SCCT @SCMRorg Guideline for the Evaluation and Diagnosis of Chest Pain has been released. #CPguideline
jacc.org/doi/10.1016/j.…
Here are highlights for #YesCCT: (1/17)
jacc.org/doi/10.1016/j.…
Here are highlights for #YesCCT: (1/17)
(2/17) #CCTA receives the highest level of recommendation (1A) in new US #CPGuideline
Guideline sponsored by: @AHAScience @ACCinTouch @ASE360 @accpchest @SAEMonline @Heart_SCCT @SCMRorg
In this CP Guideline Tweetorial the (Level of Recommendation is in parentheses).
Guideline sponsored by: @AHAScience @ACCinTouch @ASE360 @accpchest @SAEMonline @Heart_SCCT @SCMRorg
In this CP Guideline Tweetorial the (Level of Recommendation is in parentheses).
(3/17) Acute CP | Intermediate Risk & ⛔known CAD: After ruling out ACS, CCTA is useful to exclude plaque & obstructive CAD as a first line approach (1A) ✅ #CPguideline
#SCCT2021 "Chance Favors the Prepared: Exam Prep & Safety" #YesCCT All in due process by Dr. Quynh Truong @cardioQT @WeillCornell
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#SCCT2021 "Chance Favors the Prepared: Exam Prep & Safety" #YesCCT We need to talk by Dr. Jill Jacobs @nyulangone
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#SCCT2021 "Chance Favors the Prepared: Exam Prep & Safety" #YesCCT Why you gotta be so complicated? by Dr. Christopher Maroules @ChrisMaroules
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#SCCT2021 "Chance Favors the Prepared: Exam Prep & Safety" #YesCCT Rad to the 🦴(🫁 🫀) by Dr. Andrew Einstein @AndrewEinstein7 @CU_Cardiology
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#SCCT2021 "Chance Favors the Prepared: Exam Prep & Safety" #YesCCT Pt Prep & Premeds by Dr. Daniel Groves @CUSystem
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#YesCCT : Clinical reporting & understanding finance by @docjuanb at #SCCT2021 . There are reimbursement challenges . #Cardiac CT is in the wrong Ambulatory Payment Classification (APC). Bill also must be supported by clinical symptom & diagnostic ICD10 codes. Not a “rule out”.
Reimbursement tracks with the CPT used so use the right CPT code and make sure language in report supports that code. All CTA assumes 3D, thus need to mention 3D in report. Have your reporting align with @Heart_SCCT guidelines. @docjuanb at #SCCT2021
Unfortunately #cardiacCT often lumped into CT not cardiac. Hospitals should update cost charges to accurately reflect true cost of work, align w/ other cardiac testing. With costs underreported, CMS bases APC & reimbursement on these historically lower costs @docjuanb #SCCT2021
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 1: Learn the current set-up.
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 2: Expand the service. Step 3: Educating the team.
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 4: Quality Assurance; Step 5: feedback; step 6: Management
Will #AI enhance care of patients?
Yes!
How?
-Improved reliability
-Atherosclerosis guided Rx
-Risk prediction
-Requires validation ✅
Proud to share my #SCCT2021 talk (1/5)
AI & ML in #YesCCT: New Frontiers in Atherosclerosis
@mirvatalasnag @HeartOTXHeartMD @DrIanWeissman
Yes!
How?
-Improved reliability
-Atherosclerosis guided Rx
-Risk prediction
-Requires validation ✅
Proud to share my #SCCT2021 talk (1/5)
AI & ML in #YesCCT: New Frontiers in Atherosclerosis
@mirvatalasnag @HeartOTXHeartMD @DrIanWeissman
Great session on Artificial Intelligence and Machine learning with session chairs @imagingmedsci, Dr. Bratt, @michael_t_lu, @ivanaisgum, Dr. Al'Aref and @DeCeccoCN at #SCCT2021!
#ICYMI - Here's a brief tweetorial from the #YesCCT session (1/7)
@mirvatalasnag @HeartOTXHeartMD
#ICYMI - Here's a brief tweetorial from the #YesCCT session (1/7)
@mirvatalasnag @HeartOTXHeartMD
#AI & ML in #YesCCT: #SCCT2021 #Tweetorial (2/7)
1⃣: The big picture & black box by Dr. Michael Lu
-Multiple “black box” definitions
-Explainability
-Predictability
-More accurate than SOC, visualizes output (& modifiable), communicates uncertainty (eg grey-zone FFR-CT)
1⃣: The big picture & black box by Dr. Michael Lu
-Multiple “black box” definitions
-Explainability
-Predictability
-More accurate than SOC, visualizes output (& modifiable), communicates uncertainty (eg grey-zone FFR-CT)
3⃣#AI & ML in #YesCCT #SCCT2021: New frontiers in atherosclerosis @AChoiHeart
-Use of #CNN for whole heart stenosis & atherosclerosis
-Improved reproducibility of stenosis to enhance guideline adherence
-Individualized risk prediction
-New Rx paradigm!
-Use of #CNN for whole heart stenosis & atherosclerosis
-Improved reproducibility of stenosis to enhance guideline adherence
-Individualized risk prediction
-New Rx paradigm!
Women are not smaller men! #Atherosclerosis genesis, progression & sequelae different in women. Plaque erosion causing ACS more common in women. Women have unique #SDOH, are undertreated with #cvPrev therapies & #GDMT, leads to worsening outcomes in women. @lesleejshaw #SCCT2021
Women’s CVD risk can be underestimated. Female specific risk enhancers help. #CAC if risk uncertain. Women have lower #CAC prevalence than men but prevalence increases after menopause. CAC when present confers greater risk of incident CVD in women than men. @lesleejshaw #SCCT2021
Prevalence of non-obstructive #CAD is higher in women but is prognostic of risk. @lesleejshaw #SCCT2021
Top 10 paper in #yesCCT by @ToddVillinesMD
1st paper
📝 Italian COVID 19 registry
N=1625
📝 Increasing #CAC associated with worse covid 19 outcomes of hospital death, MI and CVA
#YesCCT
1st paper
📝 Italian COVID 19 registry
N=1625
📝 Increasing #CAC associated with worse covid 19 outcomes of hospital death, MI and CVA
#YesCCT
2nd paper #Top10 papers #yesCCT
#SCCT2021
danish heart registry
📝 Plaque burden, not stenosis the main predictor of MACE
📝 patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events
jacc.org/doi/abs/10.101…
#SCCT2021
danish heart registry
📝 Plaque burden, not stenosis the main predictor of MACE
📝 patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events
jacc.org/doi/abs/10.101…
3rd paper #Top10 papers #yesCCT
#SCCT2021
CREDENCE trial
📝 Stress MPI vs #yesCCT for diagnosis of coronary physiology
📝 #yesCCT superior to stress MPI in the diagnosis of invasive FFR
jamanetwork.com/journals/jamac…
@lesleejshaw @RonBlankstein @AChoiHeart @ghoshhajra
#SCCT2021
CREDENCE trial
📝 Stress MPI vs #yesCCT for diagnosis of coronary physiology
📝 #yesCCT superior to stress MPI in the diagnosis of invasive FFR
jamanetwork.com/journals/jamac…
@lesleejshaw @RonBlankstein @AChoiHeart @ghoshhajra
🚨How do you get a STEMI without atherosclerotic coronary artery disease?? 📟
✏️ Drawing a blank? 📃
Join me to learn more about the world of non-atherosclerotic coronary artery disease and coronary artery vasculitis!
✏️ Drawing a blank? 📃
Join me to learn more about the world of non-atherosclerotic coronary artery disease and coronary artery vasculitis!
🎣 In this tweetorial, we'll tackle how to -
🚨 Implement an approach to ⬆️ troponin
🚨 Classify non-atherosclerotic coronary artery disease
🚨 Recognize causes of coronary artery vasculitis
🚨 Implement an approach to ⬆️ troponin
🚨 Classify non-atherosclerotic coronary artery disease
🚨 Recognize causes of coronary artery vasculitis
So, how do you feel answering the following question:
"I feel comfortable identifying a patient with coronary artery vasculitis."
"I feel comfortable identifying a patient with coronary artery vasculitis."
What is the most commonly performed imaging test for CAD in the U.K.?
The most common imaging test is #CVnuc, #yesCCT increasing after 2016 NICE CG95 but the treadmill is still the most common test whatever the guidelines say openheart.bmj.com/content/6/2/e0…
Myocardial perfusion #scintigraphy for the diagnosis and management of CAD was first assessed by NICE in 2003 nice.org.uk/guidance/ta73
Tweetorial on Challenges in Quantification of Aortic stenosis before tonight’s #ASEchoJC on @PPibarot & @E_Guzzetti 📝 bit.ly/2NNIJgC
~1/3 pts have DISCORDANT indices: AVA is severe <1 cm2 yet mean gradient is low <40 mmHG bit.ly/3dWmJuy
Low Gradient types👇
~1/3 pts have DISCORDANT indices: AVA is severe <1 cm2 yet mean gradient is low <40 mmHG bit.ly/3dWmJuy
Low Gradient types👇
2/low gradient severe AS
types:
1.Classic:both flow SVI EF⬇️(classical Low flow CLF)
2. Paradoxical: EF nl BUT low flow SVI (Paradoxical Low flow PLF )
3. Both EF and flow are nl (Normal Flow NF)
Low flow⬆️💀mortality
Paradoxical Low flow &
Classical Low flow #ASEchoJC
types:
1.Classic:both flow SVI EF⬇️(classical Low flow CLF)
2. Paradoxical: EF nl BUT low flow SVI (Paradoxical Low flow PLF )
3. Both EF and flow are nl (Normal Flow NF)
Low flow⬆️💀mortality
Paradoxical Low flow &
Classical Low flow #ASEchoJC
3/ low gradient represents more advanced cardiac disease stage
D2: classical low flow low EF low gradient
D3: paradoxical low flow nl EF low gradient
D? normal flow nl EF low gradient
#ASEchoJC
D2: classical low flow low EF low gradient
D3: paradoxical low flow nl EF low gradient
D? normal flow nl EF low gradient
#ASEchoJC
Evaluation and Management of Patients With Stable Angina: Beyond the Ischemia Paradigm
@JACCJournals @ACCinTouch @DLBHATTMD @ESC_Journals @mmamas1973 @ErinMichos @mirvatalasnag @aayshacader @iamritu @AntoniousAttall @Cosyns @ThorEdvardsen @DavidLBrownMD @venkmurthy
#YesCCT
@JACCJournals @ACCinTouch @DLBHATTMD @ESC_Journals @mmamas1973 @ErinMichos @mirvatalasnag @aayshacader @iamritu @AntoniousAttall @Cosyns @ThorEdvardsen @DavidLBrownMD @venkmurthy
#YesCCT
📝 Major Clinical Trials for the Management of Stable CHD in the Past 2 Decades
📌COURAGE (2007)
📌BARI-2D ( 2009)
📌STICH (2011)
📌FAME-2 (2012)
📌FREEDOM (2012)
📌ORBITA (2018)
📌ISCHEMIA (2020)
@mmamas1973 @mirvatalasnag @ErinMichos @DavidLBrownMD @DLBHATTMD @iamritu
📌COURAGE (2007)
📌BARI-2D ( 2009)
📌STICH (2011)
📌FAME-2 (2012)
📌FREEDOM (2012)
📌ORBITA (2018)
📌ISCHEMIA (2020)
@mmamas1973 @mirvatalasnag @ErinMichos @DavidLBrownMD @DLBHATTMD @iamritu
*COURAGE* (n = 2,287)
PCI + OMT vs. OMT in stable CHD
• All had evidence of ischemia
• 31% triple-vessel CHD
• 4.6 years median follow-up
• HR death/MI 1.05 (95% CI: 0.87 to 1.27
PCI + OMT vs. OMT in stable CHD
• All had evidence of ischemia
• 31% triple-vessel CHD
• 4.6 years median follow-up
• HR death/MI 1.05 (95% CI: 0.87 to 1.27
