🚨 New Evidence in NSTEMI Care! 🫀

The SLIM Trial shows that FFR-guided complete revascularization during the index procedure in patients with NSTEMI and multivessel disease significantly reduces death, MI, stroke, and repeat PCI compared to culprit-only PCI.

🎯 Key win? Fewer revascularizations, better outcomes — physiology beats anatomy again.

📚 Published in JAMA, presented at #ESC2025

🔗 Read more: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2025.16189

#Cardiology #NSTEMI #FFR #InterventionalCardiology #EvidenceBasedMedicine #SLIMTrial

💥 Practice-Changing Evidence in HFpEF! 💥

In a real-world cohort of 97,000+ patients with obesity & type 2 diabetes, semaglutide and tirzepatide reduced risk of heart failure hospitalization or death by over 40% 📉

⚖️ No meaningful difference between the two agents.

🧠 Findings reinforce STEP-HFpEF & SUMMIT trials and highlight GLP-1 therapies’ expanding role in cardiometabolic HFpEF 🫀

#Cardiology #HFpEF #GLP1 #Semaglutide #Tirzepatide #T2DM #RealWorldEvidence #JAMA #HeartFailure

📢 Just read the #AMALFI trial in JAMA 📰 — a landmark remote RCT of AF screening using 14-day ECG patches mailed to older adults at stroke risk 📦🫀. At 2.5 years, the patch group had a modestly higher AF detection rate (6.8% vs 5.4%, p=0.03) and increased anticoagulation use 💊🧠. Stroke rates were similar ⚖️.

🎯 Key takeaway: Remote, mail-based AF screening is feasible and nudges diagnosis rates — but will it move the needle on outcomes?

#AFib #StrokePrevention #RemoteMonitoring #ECG #Cardiology #RCT #JAMA #DigitalHealth #Geriatrics 🧓📉

🚨 New Trial Alert 🚨

Can we safely stop anticoagulation after AF ablation? The ALONE-AF Trial 🫀 suggests yes—in selected patients with no AF recurrence, stopping DOACs reduced major bleeding 🌟 without increasing stroke risk 🧠.

📉 0.3% vs 2.2% for the composite outcome (P = .02)

📍 Carefully monitored, low-risk patients may benefit most.

📝 Editorial: Recommends shared decision-making 🤝 & individualized rhythm monitoring.

📚 A potential shift in post-ablation care.

🔗 #AFib #Anticoagulation #EPTrials #CardioTwitter #StrokePrevention #JAMA #ALONEAF #Electrophysiology #SharedDecisionMaking #ClinicalTrials

🚨 New Findings from the HELP-MI Trial! 🇸🇪🧪

Can routine Helicobacter pylori screening during acute myocardial infarction (MI) hospitalization prevent upper gastrointestinal bleeding (UGIB)?

💉 Over 18,000 patients across 35 Swedish hospitals

📉 Result: No significant reduction in UGIB overall (RR 0.90; P=0.18)

🔍 BUT: Clear benefit in patients with anemia (RR 0.44–0.64) and chronic kidney disease (RR 0.75)

🧠 Key Takeaway: Routine screening isn’t broadly warranted—but targeted testing in high-risk AMI patients may be the smarter path forward.

📊 #Cardiology #Gastroenterology #HPylori #HELPMI #EvidenceBasedMedicine #SWEDEHEART #MI #GIbleeding #RCT #PrecisionMedicine

🩺 New Insights on Apixaban for VTE!

📢 The HI-PRO trial challenges the old 3-month rule for provoked VTE.

📉 Extended low-dose apixaban (2.5 mg BID) reduced recurrent VTE from 10.0% ➡️ 1.3% with minimal major bleeding.

🎯 Editorial in NEJM urges a shift from binary labels (“provoked vs unprovoked”) to a patient-centered, risk-adapted approach.

🧠 Art meets evidence in the decision to extend anticoagulation.

💬 Let’s rethink how we label, risk-stratify, and treat.

📚 #VTE #Apixaban #Anticoagulation #NEJM #HI_PRO #Thrombosis #PrecisionMedicine #SharedDecisionMaking #EvidenceBasedMedicine #Cardiology

🌏 Zhu Xi (1130–1200), a master of Neo-Confucianism, reshaped Chinese philosophy with his focus on rationality, self-cultivation & education. His commentaries on the Four Books guided civil service exams for centuries across East Asia. 📚✨

#Leadership #Philosophy #History #Confucianism

Just read the latest from NEJM? The PIpELINe Trial 🇮🇹 changes how we approach cardiac rehab in older adults post-MI! 🧓❤️

🎯 A 12-month, multidomain intervention — risk factor control, nutrition 🥗, and Otago-based exercise 👟 — cut CV death/hospitalization from 20.6% → 12.6% (P=0.01)!

📉 Hospitalizations for heart failure dropped 7.1% → 1.5%. No serious adverse events. And yes — better gait speed, handgrip strength, and quality of life too.

This is how we shift from survival ➡️ functional independence in aging populations. 🙌

👇 Would you apply this model to your older patients post-MI? #CardioRehab #AgingWell #NEJM

🚨 New Meta-Analysis Alert! 💊🫀

Can β-blockers benefit patients post-MI with mildly reduced ejection fraction (LVEF 40–49%)?

📊 An individual patient data meta-analysis (REBOOT, BETAMI, DANBLOCK, CAPITAL-RCT) shows a 25% reduction in the composite outcome of death, MI, or HF with β-blockers vs. control (HR 0.75; p=0.031) — even in the absence of clinical heart failure.

🌍 Consistent across trials and countries. Most benefit seen in patients

🚫💊 Should We Rethink Beta-Blockers Post-MI?

In the landmark REBOOT trial (NEJM, 2025), beta-blockers failed to reduce mortality, reinfarction, or heart failure hospitalizations in post-MI patients with preserved ejection fraction (>40%).

💡 A modern, pragmatic trial across 109 centers (Spain + Italy 🇪🇸🇮🇹) with 8438 patients — shaking the foundation of our long-held post-MI practices.

👩‍⚕️ Signals of potential harm in women and STEMI subgroups raise questions, not answers.

📉 Should guidelines change? Or should practice just evolve?

#Cardiology #REBOOTTrial #BetaBlockers #NEJM #PrecisionMedicine #MedicalEducation #HeartAttack #LVEF #Guidelines #ClinicalTrials #InternalMedicine #EvidenceBasedMedicine #Revascularization