The top cardiovascular tweeted terms are the trending industry discussions happening on Twitter by key individuals (influencers) as tracked by the platform.
1. Imaging – 698 mentions
Nanox’s innovation in making x-rays more efficient, tissue doppler imaging (TDI) of the diaphragm, and late breaking trials in cardiovascular imaging, were popularly discussed in Q4 2020. According to an article shared by John Nosta, a technology theorist, Nanox has developed a Star Trek-inspired biobed called the Nanox Arc to make medical x-rays cheaper and faster.
The company’s innovation uses cold cathode technology to spot small lesions and tumours easily. A sextet of tubes enables the machine to scan the whole body. The company claims that the system can offer skeletal X-rays, as well as computerised tomography (CT) scans, at the same time. After a minute of processing, the data creates a scrollable 3D model of a person, allowing health professionals to see both the soft tissue and skeleton.
Imaging was also discussed in a research shared by Greg Martin, a professor and master clinician at the Emory University, wherein the tissue doppler imaging (TDI) technique is applied to the diaphragm to determine the velocity of the diaphragmatic muscle motion during contraction and relaxation. Experts believe that this could help in successful weaning from invasive mechanical ventilation.
Discussions on imaging also included a tweet by Rafael Vidal-Perez, a cardiologist, on late breaking trials in cardiovascular imaging in 2020. The first speaker, E. Galli, spoke on the importance of systemic right ventricular assessment in cardiac resynchronisation therapy candidates. She described a machine learning approach to assess the relative effect of clinical, electrocardiographic and echocardiographic results on left ventricular remodelling and prognosis of cardiac resynchronisation therapy (CRT) candidates.
Disruption at a glance!
CT in a Box–GE.
Imaging Outside of Any Box–Nanox.
— John Nosta (@JohnNosta) December 4, 2020
2. Coronary and heart disease – 876 mentions
The assessment of neutrophil extracellular traps in coronary thrombus of a case series of patients with Covid-19 and myocardial infarction, the ability of deep algorithms in heart disease detection, and top heart disease and stroke research advances, were popular topics of discussion in the fourth quarter of the year. According to a study shared by Pradeep Natarajan, a preventive cardiologist, a case series of patients with Covid-19 and myocardial infarction demonstrated neutrophil extracellular traps (NETs) to play a key role in STEMI pathogenesis in Covid-19.
The findings supported the idea that targeting intravascular NETs could be a relevant aim of therapy and a feasible way to prevent coronary thrombosis in critically-ill Covid-19 patients.
The terms also trended with regards to deep learning algorithms based on facial photos being able to detect heart disease, according to a study retweeted by Dr Anastasia S Mihaildou, a senior hospital scientist at the Northern Sydney Local Health District (NSLHD). The aim of the study was to assess the association of facial features with increased risk of coronary artery disease (CAD). The study found the methodology to be effective in its cohorts and held promise for pre-test CAD probability evaluation in outpatient clinics or CAD screening in communities.
Discussions around coronary and heart disease was also included in an article shared by Roger Blumenthal, director of the Johns Hopkins Ciccarone Centre for the Prevention of Cardiovascular Disease in Baltimore. The article listed some of the top heart disease and stroke research advances of 2020. The article detailed a unique therapy that could transform how hypertrophic cardiomyopathy (HCM) is treated. For instance, a phase 3 EXPLORER-HCM study tested a first-in-class HCM medicine, mavacamten, which targets cells responsible for contractions in the heart muscles, in patients suffering with symptomatic, obstructive HCM.
In a small case series of N=5 patients with COVID-19 and STEMI, coronary thrombi had a higher burden of neutrophil extracellular traps compared to N=50 non-COVID-19 STEMI historical controls https://t.co/UrGQEeHqQO @JAMACardio pic.twitter.com/RY7vm4aV9f
— Pradeep Natarajan (@pnatarajanmd) December 29, 2020
3. Stroke – 311 mentions
Ways to manage acute ischemic stroke, the role of combination drugs in reducing the rate of strokes and death, and digital stroke care solutions that increase the feasibility of consultations and diagnosis, were popularly discussed in Q4 2020. According to an article shared by Greg Martin, managing a stroke requires a multidisciplinary approach that starts and goes beyond hospital admission.
Most importantly, it requires the involvement of the critical care specialist, the study noted. The first groundbreaking innovation in stroke care was Federal Drug Administration’s (FDA) approval of IV tissue plasminogen activator (IV-tPA) in 1995, and the second was endovascular therapy in 2015.
Stroke also trended in discussions around the use of combination drugs such as ticagrelor and aspirin to reduce the risk of stroke and deaths among patients, according to an article shared by John P Erwin, a general cardiologist and the clinical chair of the Department of Medicine at North Shore University Health System. Positive results from a phase 3 THALES trial including more than 11,000 patients found that ticagrelor plus aspirin reduced the rate of stroke and death by 17%, as compared to aspirin alone.
The term was also discussed with regards to a telehealth stroke solution having rolled out of Northern Ireland, according to an article shared by John Nosta. Hospital Services Limited (HSL), a specialist supplier of medical equipment, launched a telehealth solution to enable emergency assessment of patients with suspected stroke via virtual consultations and diagnosis. The solution, which is available at all hospitals and general practice surgeries across the UK and Ireland, allows clinicians to diagnose a stroke patient from a tablet, smartphone or laptop.
Everything you need to know about the current approach to acute ischemic stroke, stroke teams, and stroke centers in right here from @CritCareMed Collaboration is key! @SCCM @neurocritical https://t.co/pP7cSmkpXy
— Greg Martin, MD, MSc, FCCM (@SCCMPresident) October 21, 2020
4. Hypertension – 258 mentions
Blood pressure reduction in frail older adults, best approach for diagnosing hypertension, and understanding the rural and racial disparities in pre-pregnancy hypertension, were popularly discussed in the fourth quarter. According to a study shared by Dr María J. Díaz Candamio, a doctor of medicine and a radiodiagnosis specialist, a randomised controlled trial of predominantly non-frail elderly people reported a cardiovascular and mortality advantage with a systolic (S) BP target more than 120 mmHg.
Primary care patients aged 75 years and above and with blood pressure less than 130/80 were associated with greater mortality. Meanwhile, hypertension was not linked to increased mortality at 85 years or at 75-84 years with moderate or severe fragility.
The term also trended with regards to one week of home blood pressure monitoring being the best approach for diagnosing hypertension, according to a research shared by Mamas Mamas, a professor of interventional cardiology. Compared to office blood pressure (OBP) or 24-hour ambulatory blood pressure (ABP), Home blood pressure (HBP) was found to be more reliable and more closely correlated with the left ventricular mass index.
Hypertension was also discussed in a study shared by Roger Blumenthal on the factors leading to pre-pregnancy hypertension. The study found that pregnancy-related deaths in the US increased from 15.0 to 17.0 per 100,000 live births from 2007 to 2016, and cardiovascular disease (CVD) accounted for one-third of all pregnancy-related deaths. In addition, non-Hispanic Black (NHB) and non-Hispanic American Indian/Alaska native women experienced higher pregnancy-related deaths, compared to their White counterparts.
"#Hypertension was not associated with increased #mortality at ages above 85 or at ages 75–84 with moderate/severe #frailty, perhaps due to complexities of co-existing morbidities
The priority given to aggressive #BP reduction in frail #old people requires further evaluation" https://t.co/lFCef6FF31
— María J. Díaz Candamio (@Vilavaite) December 4, 2020
5. Statin – 256 mentions
Management of hyperlipidaemia among statin-intolerant patients, a polypill comprising statins, multiple blood pressure-lowering drugs, and aspirin for reducing cardiovascular disease risks, and the side effects associated with statins, were popular topics of discussion in Q4. According to a study shared by Christie Ballantyne, a professor of medicine and specialist in cardiology, high-intensity statin therapy is the basis of medical management after acute coronary syndrome (ACS).
The study found that those on statins reported a lower rate of major adverse cardiac events adverse (MACE) such as death, cardiac arrest, myocardial infarction, and hospitalisation for unstable angina, after just 16 weeks.
Statin also trended with regards to a combined treatment of a polypill plus aspirin leading to lower incidence of cardiovascular events, according to a study shared by Ritu Thamman, assistant clinical professor of medicine in the University of Pittsburgh. The study found that a combined polypill treatment consisting of statins, various blood-pressure-reducing medications, and aspirin led to lower coronary events than placebo among non-cardiovascular participants at intermediate cardiovascular risk.
Discussions on statins also included Andrew SP Sharp’s, a consultant cardiologist, tweet on the side effects of statins versus placebo. According to a research, the side effects on statins and placebo were the same and much higher than no pill. In addition, it revealed that patients did experience some side effects from statin tablets, but that they have been caused by the act of taking it than because of what it contains.
Management of hyperlipidaemia among statin-intolerant patients after acute coronary syndrome: where do we stand in 2020? https://t.co/6eIDCYwN83 benefit of #PCSK9i in post hoc analysis, unlikely to ever have RCT @gabrielsteg @BCMHeart What to do now?
— Christie Ballantyne (@CBallantyneMD) September 30, 2020