Cardiac Trials @CardiacTrials
Simplified landmark cardiology trials app 📱 by cardiologist Justin Sharim MD. Mission: to spread evidence-based medicine worldwide 🌎 apps.apple.com/us/app/cardiac… Joined March 2022-
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HFpEF vs HFmrEF management 🏥 via #esc2023 #EBM 🔑 Clinical Trials: 🔹DELIVER (2022) and EMPEROR-Preserved (2021): SGLT2i in EF>40% 🔹PARAGON-HF (2019): ARNI vs ARB in EF>45% 🔹TOPCAT (2014): MRA in EF>45% 🔹CHARM-Preserved (2003): ARB in EF>40% App 🔗 apps.apple.com/us/app/cardiac…
MitraClip for mitral regurgitation? This landmark trial showed benefit in functional MR. Functional MR = MR not caused by a primary valvular pathology, but from a secondary cause (eg from papillary muscle tethering or annular dilation in HFrEF). COAPT Trial, NEJM 2018 ♥️
Does afib + a bioprosthetic valve equal “valvular afib”, requiring warfarin? A definitive no — thanks to this trial. RIVER Trial, NEJM 2020 ♥️ Pick warfarin (not DOACs) for valvular afib...definition: 1. Mechanical valves (NOT bioprosthetic!) 2. Moderate-severe mitral stenosis
Life update: proud to say that I’ll be returning to my med school alma mater as a faculty member, accepting a position as attending cardiologist at UCLA @UCLAHealth Grateful for my mentors, especially Drs. Matthew Budoff @BudoffMd, Quang Bui, Priya Pillutla, and Sam Daneshvar
Beta blockers for obstructive HCM? Negative inotropes (beta blockers, calcium channel blockers, and disopyramide) have been used for obstructive HCM for decades. This small trial however is the first randomized clinical trial to demonstrate its effect. TEMPO Trial, JACC 2021 ♥️
Cath lab timing in patients with transient STEMI? ~15% of STEMI patients show resolution of ST elevation upon presentation. This trial showed emergent revasc to afford no benefit when compared to medical management with urgent (not emergent) revasc. TRANSIENT Trial, EHJ, 2019 ♥️
General principle 📚 Mitral stenosis? Manage with beta blockade Slower heart rate increases time in diastole —> increased atrial emptying through the narrowed mitral valve, decreasing left atrial pressure and backwards pulmonary venous pressure relieving pulmonary edema 🫀
Myosin inhibitors for obstructive HCM? Negative inotropes are standard of care, but at times fail. This trial showed mavacamten (an actin-myosin binding inhibitor) to reduce outflow tract gradient and further improve symptoms. EXPLORER-HCM Trial, NEJM 2020 ♥️
#meded ECG skills: Can you tell the difference between pericarditis and early repolarization? 🔑 defining features:
Proud to see Cardiac Trials rank in the top 20 (!) downloaded medical apps in North America. apps.apple.com/us/app/cardiac… Here’s to spreading evidence-based medicine worldwide 🌎
🔑 2024 PRACTICE-CHANGING CLINICAL TRIALS this past week #recap ~~ a thread 🧵 ~~ 👇
~~ Fundamentals ~~ Echocardiographic segments and their coronary territories 📚 Spaced repetition – the key to learning 🧠👇#MedEd #BackToBasics
Dr G Rajesh (Gopalan .. @DrRajeshG1
33K Followers 2K Following Professor & Head of Cardiology, Government Medical College Calicut(Kozhikode), Kerala, India. Tweets are not endorsements.Dr Joshua Walinjom @walinjom
92K Followers 10K Following #Cardiology Fellowship @ #Kings #College #London, #Cardiologist @FMSB-UY1, en DIU #cardiologie #Interventionnelle @UPECactus #Christian #Jesus is #LordMamas A. Mamas @mmamas1973
73K Followers 41K Following Professor of Cardiology @KeeleUniversity. Research: CV Epidemiology. Associate Editor @CircIntv. Senior clinical editor @TCTMD. @BCIS_uk audit lead.Matters of the Heart .. @MattersoftheH14
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436K Followers 374K Following Non-Profit Founder/Leader | ❤️ Doc | Artist Scientist Educator | News Anchor https://t.co/7OIKCgMVAT | RT ≠ endorse | Disclaimer: https://t.co/bwmE2O3U5WGiuseppe Biondi-Zocca.. @gbiondizoccai
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3 Followers 9 FollowingIvana M. Seia @ivsearg
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22K Followers 281 Following PhD. Cardiologist 🩺🫀 Heart Failure | Multimodality Cardiovascular Imaging | Pulmonary Hypertension | CardioRenal | Lecturer🫀📚JACC Journals @JACCJournals
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33K Followers 2K Following Professor & Head of Cardiology, Government Medical College Calicut(Kozhikode), Kerala, India. Tweets are not endorsements.Dr Joshua Walinjom @walinjom
92K Followers 10K Following #Cardiology Fellowship @ #Kings #College #London, #Cardiologist @FMSB-UY1, en DIU #cardiologie #Interventionnelle @UPECactus #Christian #Jesus is #LordNephroPOCUS @NephroP
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391 Followers 1K Following Endovascular Interventional Fellow @MountSinaiHeartSripal Bangalore @SripalBangalore
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3K Followers 4K Following MD, PhD, FESC | Cardiovascular Center Aalst, Belgium 🇧🇪 | University Cardiology, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy 🇮🇹Shayan Mohammadmoradi.. @MoradiShayan
1K Followers 3K Following Platelet Function & Vascular Biology @UKYMedicine | @American_Heart Social Media Ambassador | CEO Moradi Enterprise | PDS @LabWhiteHeart | Tweets are mineThe results of this trial were contemporarily corroborated by the ISCHEMIA Trial, published over a decade later
Improving mortality in coronary artery disease with PCI? This landmark trial was one of the first to suggest that in the absence of acute coronary syndrome, PCI improves symptoms alone — WITHOUT mortality benefit. COURAGE Trial, NEJM 2007 ♥️
I am not a dedicated CTO operator but in the last year I have utilized all of the highlighted wires; sometimes in joint cases with CTO colleagues, thanks to them and the companies for the technical progression that advances everybodys’ skill set 🙌
Role of nutrition and healthy lifestyle, for individuals in primary prevention: recent data, gaps in evidence and future directions. Online #FreeAccess #CardioTwitter #Nutrition #Lifestyle #CVP archivesofmedicalscience.com/Role-of-nutrit…
@CardiacTrials Remember.. rigorous lead in period optimizing to GDMT.. only approx 10% made it to clip Matches real world experience... when you optimize to max dose quad rx, early.. a lot of pts w MR improve!
HFpEF vs HFmrEF management 🏥 via #esc2023 #EBM 🔑 Clinical Trials: 🔹DELIVER (2022) and EMPEROR-Preserved (2021): SGLT2i in EF>40% 🔹PARAGON-HF (2019): ARNI vs ARB in EF>45% 🔹TOPCAT (2014): MRA in EF>45% 🔹CHARM-Preserved (2003): ARB in EF>40% App 🔗 apps.apple.com/us/app/cardiac…
.@theallinpod @chamath @DavidSacks Non-competes are very much alive in Healthcare. Directly and negatively effects the doctor-patient relationship. Still remains, a lot of resistance to removal of them. #patientsfirst podcasts.apple.com/us/podcast/all…
crazy how I learned more about basophils than teeth in medical school
MitraClip for mitral regurgitation? This landmark trial showed benefit in functional MR. Functional MR = MR not caused by a primary valvular pathology, but from a secondary cause (eg from papillary muscle tethering or annular dilation in HFrEF). COAPT Trial, NEJM 2018 ♥️
🔑 concept: Vulnerable Plaque Often just a mild stenosis, this thin-capped lipid-rich atheroma is the most prone lesion to rupture —> MI 📚 and can be preemptively detected on cardiac CT by 4 characteristics: 🔹pos remodeling 🔹low density 🔹napkin ring 🔹spotty calcium
Climbing stairs reduces risk for all-cause, cardiovascular death. I try to use stairs when rounding, it’s especially fun with residents/trainees. Hospitals make it difficult to find stairs,that should change!@purviparwani @DrMarthaGulati healio.com/news/cardiolog…
And another BAV. No symptoms. M, 27 y.o.
A starter breakdown for CABG vs PCI 🤜🤛 🔑 points: 1️⃣ PCI in stable CAD relieves symptoms, but does not improve survival or reduce risk of MI 2️⃣ CABG in stable CAD can improve survival and reduce risk of MI, but is dependent on the severity of CAD, EF and presence of diabetes
@ecgandrhythmRoe Atrial. Small negative deflection before QRS.
Huge shout out to @SimonWuMD and @glavaidguy for creating brilliant infographics for our hospital that guided my care this morning. Patient admitted w/ sepsis from CAP but recently hospitalized. When do you cover for MRSA? How about pseudomonas? When do you de-escalate? How…
How to look at a Tricuspid Valve 🫀Use parasternal RV inflow view ⬆️ 2D ‘over gain’ 💡 Correct with 4D gain 🃏 Gamma & Tissue Transparency #echofirst #3Decho #CardioTwitter
Transvers fibrous band identifies the prolapsing cusp (RCC) Ping @LHoyesWouter
What do you think about the cause of the severe aortic valve insufficiency? @lpbadano @almasthela @ASE360 @NMerke @falcardio @ImagenCardiaca @cardiopole @iamritu @DavidWienerMD @mswami001 @ThorEdvardsen @The_Echo_Nerd @fiore_corrado @GARCIAEDINSON95 @StefanoNistri @drzgezdentok1
I got an offer for a training post I love the most; I am going to be a cardiologist! It was not smooth sailing: It took me a travel ban, living in three different countries, eight post-grad exams, and countless sleepless nights to finally get here!