Discover and read the best of Twitter Threads about #troponin
Most recents (9)
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.
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!! 😁
How #sleep loss may make physical #exercise more challenging for the #heart:
We find that sleep loss ⬆️ the exercise 🚴♀️-induced ⬆️ in blood levels of a #cardiac stress biomarker vs. after normal sleep
But note, exercise is essential for your health
🧵->
sciencedirect.com/science/articl…
We find that sleep loss ⬆️ the exercise 🚴♀️-induced ⬆️ in blood levels of a #cardiac stress biomarker vs. after normal sleep
But note, exercise is essential for your health
🧵->
sciencedirect.com/science/articl…
2/ Extensive epidemiological data has found that sleep impacts the risk of cardiovascular disease (CVD).
E.g. @uk_biobank (n~408k):
Vs. 7 h, sleep duration of ≤5 h & ≥9 h were associated with higher risk of CVD mortality & incidence (~+8-30%).
sciencedirect.com/science/articl…
E.g. @uk_biobank (n~408k):
Vs. 7 h, sleep duration of ≤5 h & ≥9 h were associated with higher risk of CVD mortality & incidence (~+8-30%).
sciencedirect.com/science/articl…
3/ And elegant human experimental studies have shown that curtailed #sleep can adversely impact🫀physiology.
For instance, shortened sleep can ⬆️ #bloodpressure in humans, seen both after overnight wakefulness academic.oup.com/sleep/article/… & shortened sleep ahajournals.org/doi/abs/10.116….
For instance, shortened sleep can ⬆️ #bloodpressure in humans, seen both after overnight wakefulness academic.oup.com/sleep/article/… & shortened sleep ahajournals.org/doi/abs/10.116….
1/ See below summary/thread of the background & rationale and other insights from our study and future directions re hs #troponin
2/ Hs #troponin assays have been clinically used outside the US since 2010-11. The 1st of these assays received FDA 510k clearance until 2017 bit.ly/2TUAXEa. Limited US-based data exists on real-life clinical hs #troponin use.
3/ European data from the APACE @CRIBasel group bit.ly/3vL9iTn showed an improved MI rule-out process using hs-assays, and that the implementation of hs assays was associated w/ ⬇️ in ED LOS & stress testing and no adverse impact on downstream resource utilization.
After a 4-day tour of duty here are some pearls:
#COVIDPearl 1: PE and thrombosis are common. Have a low threshold to treat with full dose Lovenox when Ddimers are markedly elevated and you are having difficulty weaning O2, or there is a setback in the patient’s O2 requirement
#COVIDPearl 1: PE and thrombosis are common. Have a low threshold to treat with full dose Lovenox when Ddimers are markedly elevated and you are having difficulty weaning O2, or there is a setback in the patient’s O2 requirement
#COVIDPearl 2. Be prepared to see sky high inflammatory markers including #CRP and #Ferritin. Their magnitude is not as important as their trends.
#COVIDPearl 3: If the #ProCalcitonin and #WBC go up in the setting of worsening oxygenation, think superimposed bacterial pneumonia
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts
Will add as we go along
Feel free to add your own observations/experiences
#covidclinicalpearls /1
Will add as we go along
Feel free to add your own observations/experiences
#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients
#covidclinicalpearls /3
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients
#covidclinicalpearls /3
Lessons from past #coronavirus & #influenza #epidemics suggest that #viral #infections can trigger acute coronary syndromes, arrhythmias, exacerbation of heart failure owing to a combination of a significant systemic inflammatory response plus localized vascular inflammation.
#COVID19 may either induce new cardiac pathologies &/or exacerbate underlying cardiovascular diseases. A large proportion of patients have underlying cardiovascular disease &/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, comorbidities.
After a lot of work, so proud to finally share this work on #troponin, LV function (#echofirst) and inc HF in the general pop (#ARIC)
1. ⬆️trop is assoc with LV hypertrophy and diastolic (but not systolic!) dysfx
@JAMA_current @JAMACardio @scottdsolomon
ja.ma/2MVFXns
1. ⬆️trop is assoc with LV hypertrophy and diastolic (but not systolic!) dysfx
@JAMA_current @JAMACardio @scottdsolomon
ja.ma/2MVFXns
👉🏻Subjects with ⬆️trop AND diast dysfx are at particularly high risk of HF
(1/10) #JACC #Tweetorial: T2MI is #cvMI due to alterations in either myocardial oxygen supply and/or demand in the absence of acute atherothrombosis. It can occur in pts w/ normal coronaries and in obstructive/non-obstructive stable #cvCAD. fal.cn/AGvR
(2/10) #JACC #Tweetorial: Frequency of T2MI varies widely due to differences in populations, comorbidities, adjudication processes, & cTN assays, w/ a major challenge being the absence of uniform definitions that can be useful w/ high reproducibility. fal.cn/AGvR
(3/10) #JACC #Tweetorial: How T2MI manifests depends on the pathobiology & clinical context, w/ T2MIs less likely to have chest pain, imaging/#ECG abnormalities & ⬇ cardiac troponin concentrations compared to T1MI. Many T2MIs are driven by other illness. fal.cn/AGvR
