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Daniel Mark MD

@danmarkmd.bsky.social

Duke cardiologist, cardiac ICU, DCRI clinical trials and outcomes research, Editor American Heart Journal

Reposted by Daniel Mark MD

American Heart Journal @americanheartj.bsky.social · 11/12/2023

Open Access: Early computed tomography coronary angiography and preventative treatment in patients with suspected acute coronary syndrome: A secondary analysis of the RAPID-CTCA trial. pubmed.ncbi.nlm.nih.gov/37709109/ #CardioSky 🫀 🩺

Background: Computed tomography coronary angiography (CTCA) offers detailed assessment of the presence of coronary atherosclerosis and helps guide patient management. We investigated influences of early CTCA on the subsequent use of preventative treatment in patients with suspected acute coronary syndrome.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323002752?via%3Dihub

Figure 1. Study flowchart.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323002752?via%3Dihub

Figure 2. Prescription of preventative treatment.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323002752?via%3Dihub

Figure 3. Between-subgroup differences in prescription of preventative treatment.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323002752?via%3Dihub

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Reposted by Daniel Mark MD

American Heart Journal @americanheartj.bsky.social · 12/11/2023

Open Access: Transforming blood pressure control in primary care through a novel remote decision support strategy based on wearable blood pressure monitoring: The NEXTGEN-BP randomized trial protocol. pubmed.ncbi.nlm.nih.gov/37479162/ #CardioSky 🫀 🩺

Background: Despite high blood pressure being the leading preventable risk factor for death, only 1 in 3 patients achieve target blood pressure control. Key contributors to this problem are clinical inertia and uncertainties in relying on clinic blood pressure measurements to make treatment decisions.

More here: https://pubmed.ncbi.nlm.nih.gov/37479162/

Study Design.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323001771

Figure 2. Aktiia mobile phone application and blood pressure titration strategy.

More here: https://www.sciencedirect.com/science/article/pii/S0002870323001771#fig0002

Table II. Primary and secondary outcomes for the NEXTGEN-BP trial

More here: https://www.sciencedirect.com/science/article/pii/S0002870323001771#tbl0002

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Reposted by Daniel Mark MD

c0nc0rdance @c0nc0rdance.bsky.social · 30/09/2023

In light of proposed budget-slashing of NIH funding, I want to share: "In fiscal year 2021, every $1 of NIH funding generated approximately $2.60 of economic activity." -UFMR report Slashing research budgets to save money is like sawing the wings off an airplane to make it lighter.

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Reposted by Daniel Mark MD

Mark A. Hanson @hansonmark.bsky.social · 29/09/2023

The strain on scientific publishing 📄: We've got issues. Scientists overwhelmed, editors overworked, constant special issue invites, mass article retractions, journal delistings… JUST WHAT IS GOING ON!? See: arxiv.org/abs/2309.15884 A 🧵1/n #AcademicChatter #PublishOrPerish #PhDAdvice #PhDChat

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Reposted by Daniel Mark MD

American Heart Journal @americanheartj.bsky.social · 25/09/2023

Open Access: Ultrathin-strut vs thin-strut drug-eluting stents for multi and single-stent lesions: A lesion-level subgroup analysis of 2 randomized trials. pubmed.ncbi.nlm.nih.gov/37192697/ #CardioSky #Cardiology

Background: Whether ultrathin-strut stents are particularly beneficial for lesions requiring implantation of more than 1 stent is unknown.

Methods: In a post-hoc lesion-level analysis of 2 randomized trials comparing ultrathin-strut biodegradable polymer Sirolimus-eluting stents (BP-SES) vs thin-strut durable polymer Everolimus-eluting stents (DP-EES), lesions were stratified into multistent lesions (MSL) vs single-stent lesions (SSL). The primary endpoint was target lesion failure (TLF), a composite of lesion-related unclear/cardiac death, myocardial infarction (MI), or revascularization, at 24 months.

More here: https://pubmed.ncbi.nlm.nih.gov/37192697/

Figure 1. Lesion-level event adjudication. Every clinical event was classified as either clearly attributable, possibly attributable, or not attributable to a specific lesion. Diagrams show the proportion of each class of event. Examples are provided below. The primary analysis included all clearly and possibly attributable events, for the sensitivity analysis only clearly attributable events were included.

Figure 2. Time-to-event curves. Time-to-event curves for: A, target lesion failure, B, target lesion-related myocardial infarction (MI) or target lesion revascularization (TLR), C, target lesion-related myocardial infarction, and D) target lesion revascularization (TLR) clearly or possibly attributed to at 2-year follow-up (primary analysis). Red lines, ultrathin-strut biodegradable Sirolimus-eluting stent (BP-SES); blue lines, thin-strut durable polymer Everolimus-eluting stent (DP-EES); solid lines, multistent lesions (MSL); dashed lines, single-stent lesions (SSL). SHR, subdistribution hazard ratios with 95% confidence intervals.

More here: https://pubmed.ncbi.nlm.nih.gov/37192697/

Central Illustration. Lesion stratification and event rates at 2 years. Lesion stratification (left side). Proportion of single-stent lesions (SSL) is indicated by dashed areas, multistent lesions (MSL) by solid areas. Colours indicate stratification by stent type (red for ultrathin-strut biodegradable polymer Sirolimus-eluting stents [BP-SES], blue thin-strut durable polymer Everolimus-eluting stents [DP-EES]). Event rates at 2 years (right side). Event rates (primary analysis including all clearly and possibly attributable events) stratified by lesion and stent type for the primary endpoint of lesion-level-adjudicated target lesion failure (TLF) and the secondary composite endpoint of lesion-related myocardial infarction (MI) or target lesion revascularization (TLR).

More here: https://pubmed.ncbi.nlm.nih.gov/37192697/

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