CARDIOLOGY QUESTION
Contradiction:
-Large (n=116K) dose-response study for exercise showing a lowering of all cause & CVD mortality endurance up to 900 m/w
-Smaller (n<600) #ACC23: endurance exercise WORSENS all plaque burden, even at moderate levels.
IMPLICATION Plaque⇏risk?
Antithombotics are no joke. More on board = more bleed risk.
🩸#PAD also is no joke. ⬆️⬆️ events. AntiThrombo help ⬇️events
🩸consider adding anticoag to antiplt (voyager/compass) in both PAD and/or CAD
🩸would love to hear thoughts on p2y12i+Xa rather than ASA+Xa
#ACC23
More on anti-thrombo
🩸Too bad vorapaxar went away
🩸arterial thrombosis: platelet activation + thrombus (dual pathway inhibition)
🩸Read Compass! Not just #PAD, but CAD (90% had it)=24% RRR on rivaroxaban👊🏾
🩸Voyager: early separation (3m), ongoing divergence.
#ACC23
What about antithrombolytics in #PAD?
🩸 Risk for MACE/MALE ⬆️w/presence of polyvasc and/or sx/event.
🩸ASA may help, crosses unity line tho
🩸p2y12 helps, modestly - ticag may not be better than clopido
#PAD - the forgotten #ASCVD component.
🦵🏾MI/CVA events higher in PAD than in prior MI/CVA pts!!!!
🦵🏾Low use of statins/other LLT in PAD 👀😮
🦵🏾#LLT effective in PAD: statinize!
What did I learn from being a panelist at this #PAD session? A lot.
@baileyannRN @JVargheseMD @herbaronowMD @marcreixell @KimGSmolderen #acc23 @MarcBonaca
I love the randomness of life. Or perhaps it is not random.
@DrEugeneYang - saved me from turning around from the #acc23 #tweetup. I get anxiety in groups. He came out of an elevator just as I turned to leave from the Ritz-Carlton.
Result: up the elevator w/him. Thx 🙏🏾
So, there I was just walking past the most amazing group of cardiologists and they invited me to take a picture with them.
All amazing and accomplished experts.
Lucky #PhysicianAssociate. #advocacy #equity #acccvt #ACC23
#VitaminD has had back&forth data w/recent “neutral” clinical trials but “positive” analyses for reduced DM and dementia.
#ACC23 #PhysicianAssociate #HeartPA #PatientsHealthFirst
We are enrolling in the Target D trial (Heidi May, PI), an RCT in ACS pat…https://lnkd.in/g77QsuVP
Coronary calcium is pathognomic for coronary atherosclerosis. We looked at CAC from cardiact PET and stand alone CT. Does the distribution of CAC predict 90-d or 1-yr MACE?
#PA #HeartPA #PhysicianAssociate #ACC23
Over 7500 scans were analyzed and expec…https://lnkd.in/gx-zgMHx
Nassim Nicholas Taleb
Viet Le, MPAS PA-C FACC FAHA
