NSTEMI: 📉 Less Ischemia, Less Reintervention
Dr. Baliga's 'Podkasts for Curious Docs'
🚨 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
info_outline
Real-World Rx 💊, Real Results 📉: GLP-1 Agents Slash HFpEF Risk
Dr. Baliga's 'Podkasts for Curious Docs'
💥 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
info_outline
The AMALFI AF Screening Trial-📈 Atrial Fibrillation Unmasked: A Modest Win for Mailed Monitors
Dr. Baliga's 'Podkasts for Curious Docs'
📢 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 🧓📉
info_outline
🛑 AFib Gone, OAC Gone? ALONE-AF Challenges Lifelong Therapy
Dr. Baliga's 'Podkasts for Curious Docs'
🚨 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...
info_outline
🦠💔Bugged After the Heartbreak? Does H. pylori Screening After MI Prevent GI Bleeds?
Dr. Baliga's 'Podkasts for Curious Docs'
🚨 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. 📊...
info_outline
🧬 Risk, Recurrence, Relief: Apixaban’s Edge in VTE 🌡️ Emphasizes the risk stratification, recurrence data, and therapeutic benefit
Dr. Baliga's 'Podkasts for Curious Docs'
🩺 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...
info_outline
Dr RR Baliga's Philosophical Discourses: Zhu Xi (China, 1130–1200 CE) – Neo-Confucian Philosopher
Dr. Baliga's 'Podkasts for Curious Docs'
🌏 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
info_outline
Gait Speed. Grip Strength. Greater Life. 🦵🤝🌟 A Paradigm Shift in Cardiovascular Recovery for Seniors
Dr. Baliga's 'Podkasts for Curious Docs'
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...
info_outline
💊 Block. Beat. Benefit. The Hidden Strength of β-Blockers Post-MI
Dr. Baliga's 'Podkasts for Curious Docs'
🚨 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 <75 years. 📚 This could shift guidelines for a large overlooked population. 🔗 Read more in The Lancet (Aug...
info_outline
🧠 REBOOTing Beta-Blockers – No Gains ⚖️ After Modern MI 💔
Dr. Baliga's 'Podkasts for Curious Docs'
🚫💊 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...
info_outlineCoronary CT angiography-guided management of patients
with stable chest pain: 10-year outcomes from the SCOT-
HEART randomised controlled trial in Scotland
Michelle C Williams, Ryan Wereski, Christopher Tuck, Philip D Adamson, Anoop S V Shah, Edwin J R van Beek, Giles Roditi, Colin Berry,Nicholas Boon, Marcus Flather, Steff Lewis, John Norrie, Adam D Timmis, Nicholas L Mills, Marc R Dweck, David E Newby, on behalf of theSCOT-HEART Investigators*
Summary
Background The Scottish Computed Tomography of the Heart (SCOT-HEART) trial demonstrated that management
guided by coronary CT angiography (CCTA) improved the diagnosis, management, and outcome of patients with
stable chest pain. We aimed to assess whether CCTA-guided care results in sustained long-term improvements in
management and outcomes.
Methods SCOT-HEART was an open-label, multicentre, parallel group trial for which patients were recruited from
12 outpatient cardiology chest pain clinics across Scotland. Eligible patients were aged 18–75 years with symptoms of
suspected stable angina due to coronary heart disease. Patients were randomly assigned (1:1) to standard of care plus
CCTA or standard of care alone. In this prespecified 10-year analysis, prescribing data, coronary procedural
interventions, and clinical outcomes were obtained through record linkage from national registries. The primary
outcome was coronary heart disease death or non-fatal myocardial infarction on an intention-to-treat basis. This trial
is registered at ClinicalTrials.gov (NCT01149590) and is complete.
Findings Between Nov 18, 2010, and Sept 24, 2014, 4146 patients were recruited (mean age 57 years [SD 10], 2325 [56·1%] male, 1821 [43·9%] female), with 2073 randomly assigned to standard care and CCTA and 2073 to standard care
alone. After a median of 10·0 years (IQR 9·3–11·0), coronary heart disease death or non-fatal myocardial infarction
was less frequent in the CCTA group compared with the standard care group (137 [6·6%] vs 171 [8·2%]; hazard ratio
[HR] 0·79 [95% CI 0·63–0·99], p=0·044). Rates of all-cause, cardiovascular, and coronary heart disease death, and
non-fatal stroke, were similar between the groups (p>0·05 for all), but non-fatal myocardial infarctions (90 [4·3%] vs
124 [6·0%]; HR 0·72 [0·55–0·94], p=0·017) and major adverse cardiovascular events (172 [8·3%] vs 214 [10·3%];
HR 0·80 [0·65–0·97], p=0·026) were less frequent in the CCTA group. Rates of coronary revascularisation procedures
were similar (315 [15·2%] vs 318 [15·3%]; HR 1·00 [0·86–1·17], p=0·99) but preventive therapy prescribing remained
more frequent in the CCTA group (831 [55·9%] of 1486 vs 728 [49·0%] of 1485 patients with available data; odds ratio
1·17 [95% CI 1·01–1·36], p=0·034).
Interpretation After 10 years, CCTA-guided management of patients with stable chest pain was associated with a
sustained reduction in coronary heart disease death or non-fatal myocardial infarction. Identification of coronary
atherosclerosis by CCTA improves long-term cardiovascular disease prevention in patients with stable chest pain.