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David Winchester

@drdavemd.bsky.social
111 followers 89 following 423 posts

Cardiology & health services research. Posts do not reflect positions of my employers. K index 1.42.

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David Winchester @drdavemd.bsky.social · 6h
Incredible and comprehensive statement on Food and Health from @accintouch.bsky.social @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Food and Health: Nutrition for Prevention and Management of Cardiovascular Disease: 2026 ACC Scientific Statement: A Report of the American College of Cardiology
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David Winchester @drdavemd.bsky.social · 9h
What role do beta blockers play in management of heart disease in 2026? www.jacc.org/doi/epdf/10.... @jaccjournals.bsky.social
jacc.org
Refining the Role of Beta-Blockers in Cardiovascular Medicine:
View all available purchase options and get full access to this article.
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David Winchester @drdavemd.bsky.social · 22/09/2026
Excellent research and QI presented at #accquality26 www.acc.org/Latest-in-Ca... @accintouch.bsky.social
acc.org
ACC Quality Summit Abstract Winners Explore AUC Discrepancies, Sex Differences in LAAO Outcomes, SDOH Screening - American College of Cardiology
Explore award-winning ACC Quality Summit 2026 projects on PCI AUC accuracy, sex differences in LAAO outcomes and SDOH screening for TAVR care.
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David Winchester @drdavemd.bsky.social · 18/09/2026
A real pleasure to join @drroxmehran.bsky.social for this episode of #OnTheRox! www.youtube.com/watch?v=Vdgd... @accintouch.bsky.social
youtube.com
On the Rox | The Real Return on ACC Membership: Perspectives from Past & Present BOG Chairs
YouTube video by American College of Cardiology
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David Winchester @drdavemd.bsky.social · 18/09/2026
So exciting that abstracts from #ACCQuality26 are being published, I'd encourage everyone doing QI work to consider submitting for next year! www.jacc.org/events/confe...
jacc.org
ACC Quality Summit & JACC: Case Reports | Advancing Cardiovascular Care | JACC
Join the ACC Quality Summit, where cardiovascular clinicians, administrators, and quality leaders collaborate to improve patient outcomes through innovation and quality improvement. Explore the JACC: ...
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David Winchester @drdavemd.bsky.social · 14/09/2026
Study finds that strength training does not increase risk of ventricular arrhythmia in patients with arrhythmogenic cardiomyopathy www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
jacc.org
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David Winchester @drdavemd.bsky.social · 10/09/2026
How "p-hacking" works, courtesy of @xkcd.com xkcd.com/882/
xkcd.com
Significant
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David Winchester @drdavemd.bsky.social · 03/09/2026
MFR is a continuous variable, using a single, arbitrary cutoff to define "abnormal" ignores the utility of a more nuanced approach, even using 4 categories us better than 2 www.journalofnuclearcardiology.org/article/S107... #CVNuc @asnc.bsky.social
journalofnuclearcardiology.org
Prognostic value of 15O-water PET global myocardial flow reserve: Proposed risk-based cutoffs
A global myocardial flow reserve (MFR) threshold of 2.5 is clinically used to define normal vasodilatory capacity with 15O-water positron emission tomography (PET) myocardial perfusion imaging but lac...
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David Winchester @drdavemd.bsky.social · 01/09/2026
#YesCCT did not improve outcomes for acute chest pain patients, but some subgroups would be interesting to analyze, almost 20% of subjects had prior revasc and while 22% had obstructive CAD on CCT, only 11% went on to cath www.nejm.org/doi/pdf/10.1... #ESCCongress
nejm.org
Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain | NEJM
Many patients with suspected acute coronary syndrome in whom myocardial infarction has been ruled out in the emergency department remain at risk for cardiovascular events. Whether further investiga...
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David Winchester @drdavemd.bsky.social · 01/09/2026
Add it to the list of things that get better with exercise.... www.healio.com/news/cardiol... #ESCCongress
healio.com
High-intensity exercise can halve time spent in atrial fibrillation
MUNICH — Adults with atrial fibrillation participating in a yearlong high-intensity exercise program spent nearly 50% less time in AF and were less likely to be hospitalized for any cause compar...
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David Winchester @drdavemd.bsky.social · 28/08/2026
Is bivalrudin staging a comeback? www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social #ESCCongress
jacc.org
Bivalirudin Versus Heparin in Low and Non-Low Bleeding Risk Patients Undergoing Primary PCI for STEMI: The BRIGHT-4 Trial
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David Winchester @drdavemd.bsky.social · 20/08/2026
Time spent on prior authorization accounts for more than the entire shortage of doctors in the US health care system www.economicliberties.us/our-work/ban... Source: @econliberties.bsky.social
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David Winchester @drdavemd.bsky.social · 19/08/2026
"The digital transformation of medicine, designed with humanism at its core, need not distance us from our patients" @jaccjournals.bsky.social @hmkyale.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Bedside Manner:
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David Winchester @drdavemd.bsky.social · 13/08/2026
Further proof that cardiology has the best trial names, the MARY-JANE trial evaluated the acute effects of inhaled cannabis on cardiac ectopy www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
jacc.org
Acute Effects of Cannabis Inhalation on Cardiac Ectopy, Physical Activity, Sleep, and Glucose:
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David Winchester @drdavemd.bsky.social · 10/08/2026
@jbcarmody.bsky.social has the goods on the research arms race in the most recent Match data, watch what happens at this bookmark when you shift from reporting mean aggregate research projects to median disaggregated data youtu.be/r3O2fwq5YO0?...
youtu.be
Charting Outcomes in the Match: Winners & Losers Edition
YouTube video by Sheriff of Sodium
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David Winchester @drdavemd.bsky.social · 07/08/2026
Advocacy by @accintouch.bsky.social related to Medicare's final rule for inpatient payment www.acc.org/Latest-in-Ca...
acc.org
CMS Releases 2027 IPPS Final Rule - American College of Cardiology
CMS’ 2027 IPPS final rule increases inpatient hospital payments by 2.3% and finalizes updates to NTAP, interoperability and quality reporting policies.
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David Winchester @drdavemd.bsky.social · 04/08/2026
From 2019 to 2023, the rate of deferred testing for low risk chest pain in the ED rose from 67% to 82% @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Trends in the Evaluation of Acute Chest Pain: An Analysis of the Chest Pain-MI National Cardiovascular Data Registry
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David Winchester @drdavemd.bsky.social · 31/07/2026
It looks like @clarivateag.bsky.social has finally shut down the email address that you could use to automatically track your manuscript reviews, quite a shame because it was a product that actually made life as an academic easier.
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David Winchester @drdavemd.bsky.social · 31/07/2026
"Both ivabradine and propranolol reduce tachycardia and symptoms in POTS, supporting their use, but variability in response suggests that individualized treatment selection is warranted." www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
jacc.org
Ivabradine, Propranolol, and Placebo for Postural Orthostatic Tachycardia Syndrome (POTS): A Randomized Crossover Trial
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David Winchester @drdavemd.bsky.social · 29/07/2026
Excellent advice from @hmkyale.bsky.social on how to write a manuscript discussion @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
The Discussion: Where Every Paragraph Has a Job
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David Winchester @drdavemd.bsky.social · 27/07/2026
New research on the use of cardiac imaging modalities comparing VA to Medicare www.sciencedirect.com/science/arti...
sciencedirect.com
Use of Advanced Coronary Artery Disease Imaging Within Veterans Affairs Facilities Compared to Medicare Beneficiaries
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David Winchester @drdavemd.bsky.social · 20/07/2026
Mechanistic RCT showing how decreased preload and afterload result in lower myocardial work and coronary blood flow @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Effect of Sublingual Nitroglycerin on Absolute Coronary Blood Flow: A Randomized Double-Blind Placebo-Controlled Mechanistic Study
View all available purchase options and get full access to this article.
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David Winchester @drdavemd.bsky.social · 17/07/2026
State of the art review on when to withdraw aspirin in patients with CAD and/or stents www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
jacc.org
Aspirin Withdrawal in Patients With Coronary Artery Disease:
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David Winchester @drdavemd.bsky.social · 14/07/2026
Nearly half of physicians surveyed have considered leaving practice (44%,up from 35% last year), including 25% burnout and 16% early retirement www.medcentral.com/reports/medi...
medcentral.com
The Evolution of Medical Practice 2026: How Physicians Are Navigating Rising Complexity Amid Stagnant Pay
MedCentral’s third annual physician survey reveals how physicians are managing among rising retirements, personal health issues, and complex chronic disease care.
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David Winchester @drdavemd.bsky.social · 07/07/2026
Subanalysis from the ISCHEMIA trial, 25% of nuclear and 15% of echo read by the sites as moderate ischemia was none/mild read by the core lab www.ahajournals.org/doi/epub/10....
ahajournals.org
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David Winchester @drdavemd.bsky.social · 07/07/2026
I appreciate a thorough manuscript review as much as the next author, but have you ever gotten a review with 2/3 the word count and almost the same number of references as the manuscript being reviewed?
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David Winchester @drdavemd.bsky.social · 07/07/2026
@accintouch.bsky.social continues to advocate for changes to Medicare's ambulatory specialty care model for heart failure www.acc.org/Latest-in-Ca...
acc.org
Heart of Health Policy | ACC Urges Changes as Ambulatory Specialty Model Approaches - American College of Cardiology
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David Winchester @drdavemd.bsky.social · 06/07/2026
Over 6 years, an academic center cardiology practice saw 16K new patients, 45% of which were via telemedicine, resulting in broader geographical reach and reduced wait times www.ahajournals.org/doi/10.1161/...
ahajournals.org
Telemedicine Use and Access to Care for New Patients at an Academic Cardiovascular Center: An Analysis of Geographic Reach and Wait Times | Journal of the American Heart Association
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David Winchester @drdavemd.bsky.social · 01/07/2026
Thanks to @minnowwalsh.bsky.social et al for the updated universal definition of heart failure @accintouch.bsky.social @escardio.bsky.social @worldheart.org @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026):
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David Winchester @drdavemd.bsky.social · 30/06/2026
Our summary of the latest @accintouch.bsky.social h guidelines on perioperative management are published in @jama.com jamanetwork.com/journals/jam...
jamanetwork.com
Perioperative Cardiovascular Medication Management for Noncardiac Surgery
This JAMA Clinical Guidelines Synopsis summarizes the 2024 recommendations from the American Heart Association and American College of Cardiology on perioperative cardiovascular medication management ...
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David Winchester @drdavemd.bsky.social · 29/06/2026
Signals have arrived to cardiology fellowship process, almost every applicant and program used them, but did you know that the AVERAGE number of programs applied from a single candidate was 90 (down from 96)? @jaccjournals.bsky.social www.jacc.org/doi/epdf/10....
jacc.org
Insights from the First Year of Program Signaling in Cardiovascular Disease Fellowship Recruitment:
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David Winchester @drdavemd.bsky.social · 26/06/2026
Insightful comments from @hmkyale.bsky.social on the complexity of interpreting population level data and risk adjustment @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
When the Same Patient Is Not the Same Patient: The Will Rogers Phenomenon in Contemporary Cardiovascular Care
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David Winchester @drdavemd.bsky.social · 26/06/2026
Meta-analysis finds that GLP1s improve outcomes for HFpEF but not HFrEF www.ajconline.org/article/S000... #cardiosky
ajconline.org
Divergent Efficacy of GLP-1 Receptor Agonists in HFpEF Versus HFrEF: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
GLP-1 receptor agonists (GLP-1 RAs) are increasingly evaluated for cardiovascular outcomes, including heart failure (HF), due to their weight-reducing and anti-inflammatory effects. Individual trials ...
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David Winchester @drdavemd.bsky.social · 26/06/2026
Federal charges for director of a CV practice in Florida for an $89 million health care fraud scheme involving unnecessary cardiovascular testing such as EKGs and echocardiograms performed on student athletes on college campuses. oig.hhs.gov/fraud/consum... #cardiosky
oig.hhs.gov
Consumer Alert: Cardiovascular Testing Scam
The U.S. Department of Health and Human Services, the Centers for Medicare & Medicaid Services, and the Office of Inspector General (HHS-OIG) is alerting consumers, especially parents, caregivers, ath...
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David Winchester @drdavemd.bsky.social · 25/06/2026
We need to continue to encourage people to engage in aerobic activity to reduce risk of heart disease, but don't forget that resistance training benefits as well! @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Resistance Training, Aerobic Activity, Television Viewing, and Risk of Major Cardiovascular Events in U.S. Women:
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David Winchester @drdavemd.bsky.social · 24/06/2026
Almost 20% of cardiologists identified for new CMMI model payment program for HF should not be on the list @accintouch.bsky.social cardiovascularbusiness.com/topics/healt...
cardiovascularbusiness.com
Hundreds of cardiologists incorrectly added to new mandatory payment model
When CMS shared a list of cardiologists being targeted with a brand new payment model, the American College of Cardiology identified a long list of apparent mistakes.
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David Winchester @drdavemd.bsky.social · 22/06/2026
Stepwise case from @curbsiders.bsky.social and @cpsolvers.bsky.social walks through a patient with loss of consciousness and the relevant differentials audioboom.com/posts/891640...
audioboom.com
#529 A Case of Syncope with the Clinical Problem Solvers
Enjoy the ride as we go through a case of syncope with the Clinical Problem Solvers (https://clinicalproblemsolving.com/) ! Listen in awe as they break down their thought process when evaluating a…
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David Winchester @drdavemd.bsky.social · 22/06/2026
Excellent, practical explanation of what diastolic dysfunction is and how to assess it using the most recent @ase360.bsky.social guidelines #echofirst www.ahajournals.org/doi/10.1161/...
ahajournals.org
Past, Present, and Future of Evaluating Diastolic Function | Circulation: Cardiovascular Imaging
The assessment of left ventricular diastolic function started with invasive pressure measurements and is currently primarily based on echocardiographic imaging. The current approach to the diagnosis o...
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David Winchester @drdavemd.bsky.social · 17/06/2026
Incredible story about how more than a dozen doctors gave one man different opinions on his diagnosis and how he navigated the dilemma omny.fm/shows/revisi...
omny.fm
The Trust Diagnosis - Revisionist History
The episode centers on the dilemma of a man with an advanced, metastatic case of prostate cancer. His name is Dan. Every doctor he spoke to had a different opinion on what he should do — or whether it...
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David Winchester @drdavemd.bsky.social · 12/06/2026
Check out the new podcast from Dr. Manshadi, The Physicians Pulse www.youtube.com/@ThePhysicia...
youtube.com
The Physician's Pulse
Welcome to Physician's Pulse, a podcast hosted by Ramin Manshadi, a seasoned cardiologist and physician advocate who knows exactly what it feels like to navigate the modern healthcare machine. This ...
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David Winchester @drdavemd.bsky.social · 11/06/2026
TIL: there are companies that will manufacture custom supplements that you can label/brand/market however you want www.npr.org/2026/06/05/n...
npr.org
Why is there a supplement craze if they don’t even work? : Planet Money
One reason the $70 billion supplement industry is set to double in the next seven years? Lax regulation.On today's show, we tell the story of a century-long battle between the U.S. government and … yo...
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David Winchester @drdavemd.bsky.social · 04/06/2026
Study will screen patients with abnormal echo (diastolic dysfx, HF, VHD, LVH, etc.) for occult AFib with 7 day ECG screening q3mo for a year www.ajconline.org/article/S000...
ajconline.org
Screening of Atrial Fibrillation/Arrhythmia Events in Patients With Abnormal ECHOcardiographic Parameters: The Randomized, Prospective SAFE-ECHO Study Design and Rationale
Atrial fibrillation (AF) screening is important because AF can be paroxysmal and asymptomatic. Although AF is closely linked to certain abnormal echocardiographic parameters, these parameters have…
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David Winchester @drdavemd.bsky.social · 03/06/2026
Meta-analysis suggests that BB may reduce MACE in patients with HFpEF and HFmrEF www.ajconline.org/article/S000...
ajconline.org
Revisiting Beta-Blockers in Heart Failure With Preserved Ejection Fraction—A Systematic Review and Meta-analysis
Despite advances in device therapy and the emergence of novel treatments, beta-blockers (BBs) remain a commonly prescribed medication in heart failure (HF). However, HF with preserved ejection…
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David Winchester @drdavemd.bsky.social · 03/06/2026
CVD costs the US $500 billion a year with average hospitalizations costing about $20K each www.ajconline.org/article/S000... #cardiosky
ajconline.org
The Economic Burden of Cardiovascular Disease in the United States
Cardiovascular disease (CVD) is the leading cause of death in the United States and a major driver of healthcare spending. Combined direct costs, such as hospitalizations, procedures, and medications,...
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David Winchester @drdavemd.bsky.social · 02/06/2026
Randomized trial of ketones in acute decompensated HF shows a dose/time linkage to increase in cardiac output www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social #cardiosky
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David Winchester @drdavemd.bsky.social · 02/06/2026
A story about how setting standards for products shared between manufacturers and that cross international borders can make things better for consumers and producers. @99pi.org 99percentinvisible.org/episode/100-...
99percentinvisible.org
100 Objects #2: 60-Degree Screw - 99% Invisible
A small metal screw, cut to a precise angle. How did one country quietly decide how the modern world holds together? In this episode, Roman and historian Daniel Immerwahr tell the story of the screw a...
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David Winchester @drdavemd.bsky.social · 01/06/2026
2013-2023, volume of MUGA scans decreased 75%, now ~ 10,000 done annually in Medicare population @JNCjournal @almallahmo www.journalofnuclearcardiology.org/article/S107... #cardiosky
journalofnuclearcardiology.org
National trends in MUGA utilization and reader workload (2013–2023)
Multi-gated acquisition
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David Winchester @drdavemd.bsky.social · 29/05/2026
"Breast artery calcium...on routine mammography identifies women at...cardiovascular risk...supporting its potential role as a scalable, no-added-cost marker to enhance cardiovascular risk assessment in women" www.ajconline.org/article/S000... #cardiosky
ajconline.org
Breast Arterial Calcification on Mammography and Cardiovascular Outcomes in Women: A Meta-analysis
Breast arterial calcification (BAC) is commonly observed on screening mammography and may provide a low-cost opportunistic marker to enhance cardiovascular risk assessment in women, in whom cardiometa...
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David Winchester @drdavemd.bsky.social · 27/05/2026
Antibiotic resistance and what food industries and medical researchers are doing to address it @radiolab.bsky.social radiolab.org/podcast/anti...
radiolab.org
Antibiotic Apocalypse
Can we win in the fight against antibiotic-resistant bacteria?
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David Winchester @drdavemd.bsky.social · 20/05/2026
"The nocebo effect explained the problem [with statins]. It should not be our excuse for accepting it." @hmkyale.bsky.social @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
jacc.org
Time to Move Beyond the Statin Nocebo Effect:
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