Fabio E. Parada MBBS, MSc, MA, FACC

Tener un gran mentor puede cambiarlo todo.

The cholesterol wars are over. LDL won. New guidelines. Four landmark trials. An oral PCSK9 inhibitor that matches injectables. And data proving we should be treating patients we currently aren't. Here's everything clinicians need to know. 🧵

This is a masterclass in why we need RCTs. Observational studies were conflicting. Physiologic rationale made sense. Industry pushed adoption. Reimbursement incentivized use. But when 𝗿𝗶𝗴𝗼𝗿𝗼𝘂𝘀𝗹𝘆 𝘁𝗲𝘀𝘁𝗲𝗱: ❌ How many patients were harmed in the meantime? 🤔

#SPIRIT-HF #ACC26 🧑‍⚕️ HF with preserved or mildly reduced EF (HFpEF/HFmrEF)—a large, underserved group with limited therapies 🧠 Does Spironolactone reduce CV death and HF hospitalizations, building on signals from prior trials like TOPCAT 📊 Trial was underpowered (COVID impact, lower enrollment, high drug discontinuation) → unable to definitively test hypothesis ⚠️ No clear primary outcome benefit; side effects and drug withdrawal were common, potentially blunting efficacy 💡 Takeaway: Signal for benefit may still exist—but tolerability + adherence remain the real barriers in HFpEF therapy Great Discussion by @dranulala 👏👏

Presented at #ACC26: Among patients with atherosclerotic cardiovascular disease, targeting an LDL cholesterol level below 55 mg per deciliter led to a lower 3-year risk of cardiovascular events than targeting a level below 70 mg per deciliter. Full Ez-PAVE trial results: nejm.org/doi/full/10.10… Editorial: Paving the Road toward Targeted Lipid Lowering nejm.org/doi/full/10.10… @ACCinTouch

Aquí esta!!! En Español! El ECG está más vivo que nunca!!! Gracias @distribuna !!! @doctor_roig @ManlioMarquez @sebagz1 @gonzaeperez @mariofitzm @ElaineNunezA @JJuarezLl @DiegoChangomd @LAHRSonline1 @ElectroSIAC1 @DrAndresArteaga @andres_miranda4 @josenalencar @joselmerino

🚨 Fellows. Residents. Early career cardiologists — listen up. #ACC26 is NOT just a conference. It’s a career accelerator 🚀 If you show up right, it can change your trajectory. Here’s how to MAXIMIZE 🎯every minute 👇 @ACCinTouch @JACCJournals @ACCmediacenter

Early surgery in asymptomatic patients with very severe aortic stenosis led to a lower risk of a composite of operative mortality or death from cardiovascular causes at 10 years than conservative care. Full RECOVERY trial results: nejm.org/doi/full/10.10…

I reviewed one of the most practical guides to literature reviews. Here are 10 principles that separate average from publishable ones: ⸻ 1. A literature review is a positioning document Before you write anything, answer this: → What conversation am I entering? → What gap am I clarifying? If you can’t answer that, you’re not ready to write. ⸻ 2. Topic selection is a strategic decision A strong review topic is: → narrow enough to be meaningful → broad enough to matter → active enough to contribute to Most students choose topics that are either too safe… or too vague. ⸻ 3. Searching is not a one-time activity Serious reviewers: → iterate search terms → trace citations forward & backward → revisit the search as their thinking evolves ⸻ 4. Reading without writing is wasted effort If you finish reading 30 papers and have no notes… You’ve retained very little. Strong reviewers: → extract arguments, not just findings → write while reading → begin synthesis early ⸻ 5. Decide your review type intentionally Narrative, systematic, integrative, meta-analysis… Each answers a different kind of question. Confusion here leads to weak methodology and confused writing. ⸻ 6. Synthesis is the core skill Anyone can summarize papers. Very few can answer: → What patterns exist across studies? → Where do findings conflict? → Why do they differ? That is what reviewers are looking for. ⸻ 7. Critical thinking is non-negotiable A strong review: → identifies methodological weaknesses → questions assumptions → highlights gaps ⸻ 8. Structure reflects clarity of thought Disorganized reviews are not writing problems. They are thinking problems. A clear structure means: → logical flow of ideas → intentional grouping of evidence → a reader who never feels lost ⸻ 9. Feedback is part of the process, not the end Good reviews are: → challenged → questioned → reshaped ⸻ 10. The best reviews connect time Weak reviews focus only on recent papers. Strong ones: → anchor in foundational work → integrate recent advances → show how the field is evolving ⸻

Hi Everyone - 🥸Here are all the 27 late breaking clinical trials presented at @ACCinTouch (ACC.26) with session number, day, time, and objective. 😱See you in NOLA: 👇👇👇

Hoping this gets better before departure day for #ACC26 but this is crazy at @iah #airport today No PreTSA open and 240 minute wait in the lines if what is posted is accurate. Please pay the TSA agents now. They need to pay rent, feed their families. Donations at food banks needed throughout Houston.

Paper of the day: Fundamental Anatomy and its Impact on Clinical Practice: Bachmann's Bundle and Interatrial Conduction (Part I-III) González-Casal D, Baranchuk A, Sánchez-Quintana D, Cabrera JA. JACC CR doi: 10.1016/j.jaccas.2026.107414.2026 Mar 16:107414 Working with the best

Number Needed to Treat | New England Journal of Medicine - what a great editorial! nejm.org/doi/full/10.10…

just got invited to peer review a paper I'm one of the authors on

Paper from myself, Dr. Braunwald and others on the use of AI to guide shared decision making. We conduct trials and draw inferences from / about populations. We treat individual patients, however, who have innumerable combinations of subgroups with second and higher order interactions (which can be modeled with ML/AI). We see patients in clinic and iteratively reassess their risk moving forward based upon the presence or absence of events (including multiple events) & their tolerability of a drug / device (eg a patient who has not bled is at a lower risk of bleeding moving forward) We should also take into account individual patient preferences (not population preferences) with respect to ischemic / bleeding outcomes and side effects. We incorporate all of this into a new AI model. jacc.org/doi/10.1016/j.…

Which tense to use in your research papers?

My first 5 grant applications were rejected. Every single one. Here's how I went from £10k to £10m in research funding

La ética es la base de la investigación clínica responsable. Valor social, validez científica, selección justa de participantes y equilibrio entre riesgos y beneficios son pilares para generar conocimiento con impacto en cardiología. Porque la ética no frena la investigación: la fortalece. Más información: siacardio.com #SIAC #InvestigaciónClínica #Cardiología

Dear MSc and PHD students who need help writing a Strong Literature Review, here are some tools you should check out. 📍Elicit: ▪︎ Finds relevant papers and summarises key findings so you don’t waste time digging manually. 📍Consensus: ▪︎ Shows what scientific studies actually agree on, helping you cite evidence-backed conclusions. 📍ResearchRabbit: ▪︎ Visualises paper networks so you can discover related studies quickly. 📍Scite. ai: ▪︎ Tells you whether a paper is supported or contradicted by later research. 📍SciSpace: ▪︎ Breaks down complex research papers into simple explanations and highlights methods/results.

Me alegra que muchos de mis conocidos la estén rompiendo en congresos y demás. Todos unos referentes en sus campos.

Want to be the first to know about the 🔥 science poised to transform cardiovascular care? 🫀 The 7️⃣ Late‑Breaking Clinical Trial sessions taking place during #ACC26 are where practice‑changing science makes its debut. 📊 Be there when the data drops! ➡️ bit.ly/3N7hU5j