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June 20, 2022

Top tweets: Coronary revascularisation guidelines and more

Clinical Trials Arena lists five of the most popular tweets on cardiology in Q1 2022 based on data from GlobalData’s Pharmaceutical Influencer Platform.

The top tweets are based on total engagements (likes and retweets) received on tweets from more than 253 cardiology experts tracked by GlobalData’s Pharmaceutical Influencer platform during the first quarter (Q1) of 2022.

1. Gregg W. Stone’s tweet on coronary revascularisation guidelines

Gregg W. Stone, a cardiologist, shared an infographic on some guidelines and recommendations for patients undergoing coronary revascularisation. If the optimal treatment method of a patient is unclear, a specialised heart team must be approached, which implies health experts from related departments, such as cardiology, cardiac surgery, and clinical cardiology, who will help in correct decision-making and improved patient outcomes, the infographic elucidated.

Likewise, in patients undergoing coronary revascularisation, decisions taken by the medical professionals and experts should be patient centric and taken in collaboration with the patient’s support system. For example, it is important for patients to understand the patient’s preferences and goals, health literacy, cultural beliefs, and social determinants of health.

Additionally, for patients undergoing revascularisation or coronary angiography, adequate information should be provided to the patients about the benefits, dangers, therapeutic outcomes, and potential alternatives in the performance of percutaneous and surgical myocardial revascularisation, when feasible, thereby providing enough time for informed decision-making to achieve better clinical outcomes.

Username: Gregg W. Stone

Twitter handle: @GreggWStone

Likes: 118

Retweets: 30

2. Dr. Purvi Parwani’s tweet on defining severe aortic stenosis (AS) in asymptomatic patients

Dr. Purvi Parwani, a cardiologist and assistant professor of medicine at the Loma Linda University, California, shared a study on defining severe AS in asymptomatic patients. Approximately one-third of the patients suffering with severe AS and considered asymptomatic at the time of diagnosis experienced symptoms on exercise testing, the research highlighted. Therefore, exercise testing was a precursor to identifying patients who are not actually asymptomatic, and who should undergo aortic valve area (AVR) in case of acceptable operative risk.

The projected annualised rate of sudden deaths for asymptomatic patients with severe AS is 1%, the paper detailed. AS is a lesion that grows persistently, and its progression is more rapid when the aortic valve is severely calcified and stenotic. Therefore, the risk of conservative treatment must be assessed against the risk of operative death related with AVR.

A study of 116 asymptomatic patients with severe AS found Vmax >5.5 m/s to be related to a three‐year risk of surgery or death of 89%. Furthermore, Vmax ≥5 m/s was the only indicator of death in patients with severe AS with preserved ejection fraction (LVEF), and is also linked to an 80% increase in the relative risk of death during asymptomatic patients’ follow‐up, the study noted.

Username: Dr. Purvi Parwani

Twitter handle: @purviparwani

Likes: 117

Retweets: 19

3. Philippe Pibarot’s tweet on cardiac surgery not improving survival against antibiotics in TAVI-IE patients

Philippe Pibarot, director of cardiology research at the University Institute of Cardiology and Pulmonology of Quebec, Laval University, shared a study on cardiac surgery not improving survival versus medical therapy when a majority of the patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) were treated with antibiotics.

A study of 584 patients was conducted, with 111 patients being treated with cardiac surgery and antibiotics (IE-CS) and 473 patients being treated with antibiotics alone (IE-AB). The aim of the study was to understand patient outcomes and clinical characteristics of TAVI-IE patients being treated with cardiac surgery and antibiotics, and with antibiotics alone.

The findings of the study where a majority of the patients were treated with antibiotics revealed that cardiac surgery did not improve all-cause in-hospital or 1-year mortality. In fact, the high mortality of TAVI-IE were linked to the patients’ characteristics, IE-related issues, and pathogen, the study noted.

Username: Philippe Pibarot

Twitter handle: @PPibarot

Likes: 94

Retweets: 33

4. Dr Vijay Kunadian’s tweet on increased cardiovascular disease (CVD) deaths in women

Dr Vijay Kunadian, personal chair, and professor of Interventional Cardiology at Newcastle University, shared an article on heart disease being a leading cause of death among women globally, with around 35% CVD deaths being reported from across the world in 2019, according to the Global Burden of Disease study. She further tweeted that there was a lack of evidence in the best care provided to women suffering with heart attacks.  The study highlighted that there were an estimated 275.2 million instances of CVD in women globally. Additionally, there were an estimated 6.10 million deaths caused from CVD in women in 1990, which rose to 8.94 million in 2019.

The study also found that hospital admissions of young women with acute myocardial infarction (AMI) climbed from 27% between 1995 and1999 to 32% between 2010 and 2014. It was also revealed that women with AMI are less likely to receive guideline-indicated pharmacological and revascularisation treatments, percutaneous coronary intervention, compared to men.

Women represented less than 39% of the clinical cardiovascular trials between 2010 and 2017, the study detailed. Some of the major factors responsible for under-representation in studies were found to be related to the burden of participation on health and time, as women cited caring responsibilities to be a major reason for not participating in a clinical trial. As a result, women face worse outcomes for acute coronary syndrome (ACS), have a dissimilar risk profile, and a much higher incidence of myocardial infarction with non-obstructive coronary artery disease (MINOCA). Researchers therefore believe that a different management method is required for women than men.

Username: Dr. Vijay Kunadian

Twitter handle: @VijayKunadian

Likes: 79

Retweets: 35

5. Dr. Deepak L. Bhatt’s tweet on Cangrelor reducing ischemic events versus oral Clopidogrel

Dr. Deepak L. Bhatt, a professor of medicine at the Harvard Medical School, shared an article on the IV P2Y12 inhibitor Cangrelor minimising the number of early ischemic events compared to oral Clopidogrel, after percutaneous coronary intervention (PCI), mainly myocardial infarction (MI) or heart attack and stent thrombosis. Researchers found Cangrelor to reduce early ischemic events that took place two hours after PCI by about 25% compared with Clopidogrel.

The double-blind CHAMPION PHOENIX trial enrolled 11,145 patients undergoing PCI, where the main results showed that Cangrelor outdid Clopidogrel for the primary efficacy endpoint of death, MI, ischemia-driven revascularisation or stent thrombosis at 48 hours, and the primary safety endpoint of severe bleeding, the study highlighted.

Researchers further noted that the trial showed benefits for ACS, as well as non-ACS patients, particularly when the latter had high risk angiographic features.

Username: Dr. Deepak L. Bhatt

Twitter handle: @DLBHATTMD

Likes: 54 Retweets: 8

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