Murat Çap, MD

213 posts

Murat Çap, MD

Murat Çap, MD

@drmcap_mc

Inscrit le Ekim 2020
403 Abonnements103 Abonnés
Murat Çap, MD retweeté
I.H.Tanboga, MD, PhD
I.H.Tanboga, MD, PhD@ihtanboga·
Thank you @realarainmd for posing such a thought-provoking question. I believe that ORBITA-CTO is eagerly awaited by all cardiologists, especially those in the CTO community. Many CTO operators are expecting a result that supports their perspective that CTO opening offers benefits beyond a placebo effect. However, regardless of the outcome, the debate is likely to continue. I would also like to specifically thank @rallamee for introducing the concept of “ORBITA-like” into the medical literature. 2/
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Murat Çap, MD retweeté
Salman Arain
Salman Arain@realarainmd·
The prediction is in! Now we wait for the verdict. Yesterday I posed a challenge to @ihtanboga - aka the ORBITA-CTO Reckoning - and last night he responded with his usual eloquence and brilliance! Is he the Ethan Hunt of biostatistics? Of course! And, will #CTOPCI ‘win’ on Sunday? The answer is nuanced. Read it in full below…
GIF
I.H.Tanboga, MD, PhD@ihtanboga

Thank you @realarainmd for posing such a thought-provoking question. I believe that ORBITA-CTO is eagerly awaited by all cardiologists, especially those in the CTO community. Many CTO operators are expecting a result that supports their perspective that CTO opening offers benefits beyond a placebo effect. However, regardless of the outcome, the debate is likely to continue. I would also like to specifically thank @rallamee for introducing the concept of “ORBITA-like” into the medical literature. 2/

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Murat Çap, MD retweeté
I.H.Tanboga, MD, PhD
I.H.Tanboga, MD, PhD@ihtanboga·
IVI use being associated with such benefit in the very early period (first 3-5 days) is clinically implausible. In addition to your points, I would add the following: - Key claim: IVI-PCI ≈ CABG - But the data come from 3 very different sources, and the mixing creates serious bias concerns. 1/
Salman Arain@realarainmd

PCI vs. PCI - More reflections on the study by Gim et al The sticking point for me (and others like @aymanka, @ihtanboga, @GreggWStone) is the immediate separation of the curves bet. the PCI arms. It is difficult to see how immortal time bias alone accounts for this. doi: 10.1016/j.jcin.2025.11.036

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Murat Çap, MD retweeté
Evandro Martins F. MD
Evandro Martins F. MD@evandrofilhobr·
That’s one concept I tried to understand before but didn’t catch it like this. What a master class! In very few tweets! Clear as water!
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I.H.Tanboga, MD, PhD@ihtanboga

Study conclusion: Angiography guided PCI was associated with significantly higher risk for MACE, However, IVI-guided PCI had comparable risk with CABG in DM patients. But there's a methodological concern hiding in the study design that the authors didn't discuss: Immortal time bias. 1/

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Murat Çap, MD retweeté
Davide Capodanno
Davide Capodanno@DFCapodanno·
#cardioX is more alive than ever. On the same day that @ihtanboga delivers two incredible articles on COBRRA and SELUTION DeNovo, and a masterclass no one interested in biostatistics and trial interpretation should miss, @ehj_ed publishes a debate I joined with @thiele_holger, @cvrints, and others on the significance of the RF-CL model for estimating pre-test probability of coronary artery disease. This article actually originated from the X discussion shown below, where @ihtanboga had also shared a valuable calculator, and I learned a lot from @cvrints as well. These coincidences close the circle. Long live the sparks between scientific literature and social media that keep the debate alive. academic.oup.com/eurheartj/adva…
Davide Capodanno@DFCapodanno

There is one thing that, even as a reviewer and despite having pointed it out during the process, I really haven't understood about the new ESC guidelines for chronic coronary syndromes. Using the new Risk factor-weighted clinical likelihood (RF-CL) model, one can calculate individual risk based on symptoms, sex, and the number of cardiovascular risk factors, and so far so good. In this way, the calculable pre-test probability scores range from 0 to 45%. However, the recommendations for additional diagnostic tests are also applicable to patients with a risk higher than 45%. Now, how does one calculate a pre-test probability higher than 45% based on the RF-CL? With risk enhancers like PAD, resting ECG, etc.? With the calcium score? In fact, the calcium score can be used to determine the new pre-test probability, but I don’t think this is a good reason to perform it on everyone, also because its value lies mainly in recategorizing patients into the very low-risk group when it is zero. However, it seems you cannot determine the new pre-test probability with risk enhancers, unless it is meant that the presence of one of these factors automatically shifts the patient into at least the moderate-risk category. In short, if anyone has figured out how to arrive at the precise number for values above 45%, they’d be doing me a favor, because I can't understand it from the text.

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