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_outline๐ง โจ Just read a thought-provoking article in JAMA on the US POINTER trial!
Structured lifestyle changes (think ๐โโ๏ธ๐ฅ๐งฉ) showed modest but real gains in cognition for older adults at risk of dementia. But hereโs the twist: even light-touch self-guided changes yielded nearly similar benefits. ๐คฏ
Soโฆ ๐ฌ Is intensity always worth the investment? Or can simplicity scale smarter?
๐ Worth pondering as we shape the future of brain health! #DementiaPrevention #CognitiveHealth #LifestyleMedicine #PublicHealth #BrainAging ๐ง ๐