Dr. Baliga's 'Podkasts for Curious Docs'
๐ข Just read the #AMALFI trial in JAMA ๐ฐ โ a landmark remote RCT of AF screening using 14-day ECG patches mailed to older adults at stroke risk ๐ฆ๐ซ. 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 ๐๐ง . Stroke rates were similar โ๏ธ. ๐ฏ Key takeaway: Remote, mail-based AF screening is feasible and nudges diagnosis rates โ but will it move the needle on outcomes? #AFib #StrokePrevention #RemoteMonitoring #ECG #Cardiology #RCT #JAMA #DigitalHealth #Geriatrics ๐ง๐
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐จ New Trial Alert ๐จ Can we safely stop anticoagulation after AF ablation? The ALONE-AF Trial ๐ซ suggests yesโin selected patients with no AF recurrence, stopping DOACs reduced major bleeding ๐ without increasing stroke risk ๐ง . ๐ 0.3% vs 2.2% for the composite outcome (P = .02) ๐ Carefully monitored, low-risk patients may benefit most. ๐ Editorial: Recommends shared decision-making ๐ค & individualized rhythm monitoring. ๐ A potential shift in post-ablation care. ๐ #AFib #Anticoagulation #EPTrials #CardioTwitter #StrokePrevention #JAMA...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐จ New Findings from the HELP-MI Trial! ๐ธ๐ช๐งช Can routine Helicobacter pylori screening during acute myocardial infarction (MI) hospitalization prevent upper gastrointestinal bleeding (UGIB)? ๐ Over 18,000 patients across 35 Swedish hospitals ๐ Result: No significant reduction in UGIB overall (RR 0.90; P=0.18) ๐ BUT: Clear benefit in patients with anemia (RR 0.44โ0.64) and chronic kidney disease (RR 0.75) ๐ง Key Takeaway: Routine screening isnโt broadly warrantedโbut targeted testing in high-risk AMI patients may be the smarter path forward. ๐...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐ฉบ New Insights on Apixaban for VTE! ๐ข The HI-PRO trial challenges the old 3-month rule for provoked VTE. ๐ Extended low-dose apixaban (2.5 mg BID) reduced recurrent VTE from 10.0% โก๏ธ 1.3% with minimal major bleeding. ๐ฏ Editorial in NEJM urges a shift from binary labels (โprovoked vs unprovokedโ) to a patient-centered, risk-adapted approach. ๐ง Art meets evidence in the decision to extend anticoagulation. ๐ฌ Letโs rethink how we label, risk-stratify, and treat. ๐ #VTE #Apixaban #Anticoagulation #NEJM #HI_PRO #Thrombosis #PrecisionMedicine...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐ Zhu Xi (1130โ1200), 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. ๐โจ #Leadership #Philosophy #History #Confucianism
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
Just read the latest from NEJM? The PIpELINe Trial ๐ฎ๐น changes how we approach cardiac rehab in older adults post-MI! ๐งโค๏ธ ๐ฏ A 12-month, multidomain intervention โ risk factor control, nutrition ๐ฅ, and Otago-based exercise ๐ โ cut CV death/hospitalization from 20.6% โ 12.6% (P=0.01)! ๐ Hospitalizations for heart failure dropped 7.1% โ 1.5%. No serious adverse events. And yes โ better gait speed, handgrip strength, and quality of life too. This is how we shift from survival โก๏ธ functional independence in aging populations. ๐ ๐ Would you apply this model...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐จ New Meta-Analysis Alert! ๐๐ซ Can ฮฒ-blockers benefit patients post-MI with mildly reduced ejection fraction (LVEF 40โ49%)? ๐ 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 ฮฒ-blockers vs. control (HR 0.75; p=0.031) โ even in the absence of clinical heart failure. ๐ Consistent across trials and countries. Most benefit seen in patients <75 years. ๐ This could shift guidelines for a large overlooked population. ๐ Read more in The Lancet (Aug...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐ซ๐ 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%). ๐ก A modern, pragmatic trial across 109 centers (Spain + Italy ๐ช๐ธ๐ฎ๐น) with 8438 patients โ shaking the foundation of our long-held post-MI practices. ๐ฉโโ๏ธ Signals of potential harm in women and STEMI subgroups raise questions, not answers. ๐ Should guidelines change? Or should practice just evolve? #Cardiology...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐จ New NEJM Study Alert! ๐ฉบ๐ Do beta-blockers still help after a heart attack if thereโs no heart failure? ๐ค In the BETAMIโDANBLOCK trial (๐ฉ๐ฐ+๐ณ๐ด, n=5574), beta-blocker therapy in post-MI patients with preserved or mildly reduced LVEF (โฅ40%) modestly reduced the composite outcome of death or major cardiovascular events ๐ง ๐ ๐ Primary endpoint: 14.2% (BB) vs. 16.3% (no BB) โ HR 0.85, p=0.03 ๐ก Especially lowered risk of recurrent MI (HR 0.73) ๐ง Even in the era of PCI, DAPT & statins, beta-blockers may still bring benefit โ...
info_outlineDr. Baliga's 'Podkasts for Curious Docs'
๐ฅ New NEJM Trial Alert! A modest 0.3 mmol/L rise in potassium (via MRA, KCl, or diet) significantly reduced arrhythmias, ICD shocks, and hospitalizations in high-risk ICD patients โก๐ซ ๐ HR 0.76 for the composite endpoint ๐ข NNT = 12.3 over 3.3 years ๐ Safe, scalable, and globally relevant ๐ Time to rethink โnormalโ Kโบ levels in cardiology! #Cardiology #Electrophysiology #NEJM #ICD #Potassium #POTCAST
info_outline๐จ New Insights from HELIOS-B ๐ซโจ
In patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM), the RNA interference therapy vutrisiran not only reduced mortality and cardiovascular events, but also showed measurable benefits in cardiac structure and function over 30 months.
๐ Thinner LV walls & lower LV mass index
๐ช Preserved ejection fraction & stroke volume
โ๏ธ Improved diastolic function โ better E/eโฒ & eโฒ velocity
๐ Benefits seen even with substantial tafamidis use
These findings support early initiation of vutrisiran to protect the heart and slow disease progression.
#Cardiology #HeartFailure #ATTRCM #RNAi #Vutrisiran #HELIOSB #Echocardiography #HeartHealth โค๏ธ