Michael O'Riordan

What happened today is terrible, but insinuating that journalism was responsible for it is... kinda a perfect encapsulation of the pattern of behavior outlined in that article.

Today in 1970, feuding Houston surgeons Denton Cooley and Michael DeBakey appear on the cover of Life Magazine.

CTO PCI Reduces Symptoms, Improves Quality of Life: Meta-Analysis tctmd.com/news/cto-pci-r…

@jedicath @MohammedAlo It must be near impossible to persuade people convinced by hucksters on social media.

@MohammedAlo @michaelTCTMD Recent patient of south Asian ancestry with high LDL, + Family hx, smoker, oooois trying tumeric and whole milk. Can’t fight TikTok, Facebook, and WhatsApp experts

Does crushed garlic lower your cholesterol? A new study from Cleveland Clinic called the SPORT trial tested garlic, cinnamon, CoQ10, tumeric, fish oil, red yeast rice, and several other supplements against placebo and against rosuvastatin. Cinnamon raised CRP (inflammation).

A Trump insider opened a $51,000,000 oil short position — hours before Trump announced a ceasefire with Iran. This guy is now 16 for 16. $170 million in profit. A perfect streak. This is not a talented trader. "We placed the bet." "The ceasefire dropped." "We cashed out." Sixteen times in a row. That is not skill. That is not instinct. That is not research. That is someone who knows what is coming before it comes. Think about what that actually means. A private individual is placing a $51 million bet that oil prices are about to collapse — hours before a sitting president announces a ceasefire that collapses oil prices. Not once. Sixteen times. Zero losses. There are only two explanations and both should terrify you. Either someone inside the White House — or with direct access to it — is leaking ceasefire negotiations to traders before diplomats, before the press, before the American people hear a single word. That is insider trading. That is corruption. That is a federal crime. Or the timing of the announcement itself is being shaped around the trade. Which is worse. This is not a genius investor who reads the news faster than you do. The news hadn't happened yet. He wasn't reading the news. He was getting a phone call. While Americans were watching the ceasefire announcement and feeling relieved — somebody already knew. Somebody had already bet $51 million on it. And somebody was already counting their winnings. You are not watching a free market. You are watching a White House with a side hustle. Via~ Really American

Doug Ford is mounting a hostile takeover of yet more municipalities across southern Ontario. For Ford, being premier is never enough. Now, enough is enough. Thursday's column thestar.com/politics/polit…

Congratulations to Dr. @DanielJDrucker, a 2026 Governor General's Innovation Award laureate! 🏅 This award celebrates Canadians who improve lives through innovation & Dr. Drucker's GLP-1 & GLP-2 discoveries have done exactly that. Learn more ➡️ bit.ly/4sZZ53N

Some thoughts on Toronto’s proposed airport expansion, written from my perspectives as a harbour user and epidemiologist open.substack.com/pub/davidfisma… @juliedabrusin @MarkJCarney @docdanielle @PurdySerena @globeandmail

@kaulcsmc @SVRaoMD A scientist!

@michaelTCTMD @SVRaoMD What do you call someone who points out the exact level of water?

When spin trumps science! Central hypothesis of STEMI-DTU: LV unloading will reduce infarct size. Key results: Infarct size not ⬇️; AEs ⬆️. Overall, benefit-risk not desirable. JNJ PR: Infarct size not ⬆️ 🤷‍♂️ 👇🏻

“Even when you have a negative randomized trial, you learn a lot from it, and that helps you design future research or improve patient care,” @GreggWStone discussed the results of the STEMI Door-to-Unload (DTU) trial with @michaelTCTMD. Learn more in @TCTMD: bit.ly/47wKJPX

Having trouble keeping up with all of the science coming out of #ACC2026? Be sure to check out @TCTMD’s live coverage from the best team in the biz: @TCTMD_Caitlin @michaelTCTMD @lamckeown1 and @ToddNeale tctmd.com/conference/acc…

A $35k device was approved almost 20 y ago without data proving it results in better clinical outcomes. Now every operator has a miraculous anecdote, and the toothpaste is out of the tube.

Congratulations to @divaka_perera & the team …. Important message to interventionists who have allowed non evidence based intuition to influence their choice of impella in high risk pci!? It does not improve patient outcomes

nejm.org/doi/full/10.10… 1/ CHIP-BCIS3: Another Impella Trial bites the dust History of Impella device: 2008: approved despite pivotal trial PROTECT II (n=448) stopped for futility 2015: Label extended for improving hemodynamic support during high-risk PCI

Years ago, we wrote this paper—very much inspired by @kaulcsmc’s long-standing critique—precisely about trials that make the front page with a “noninferiority” claim while failing their own premises: an arbitrary absolute margin and misplaced assumptions on control event rates. This is only going to become more relevant if we don’t course-correct. More and more trials are ending up with fewer events than expected—good news clinically, but statistically problematic. And once the wave passes, what people remember are the conclusions, not the assumptions. jacc.org/doi/10.1016/j.…

CHAMPION AF is out at ACC - (nejm.org/doi/full/10.10…) and there are gonna be some hurt feelings on both sides! Thanks @TCTMD (tctmd.com/news/chaampion…) for the commentary. My thoughts having read the paper a couple of times: 1. LAAO seems to invoke passions in people – I think this study won’t sway either counter party. If you believe in this approach you will be reassured by no increased risk of stroke, reduction in bleeding and the excellent safety profile of the procedure. If you are an LAAO heretic I think you’ll worry about the low event rate – although the absolute differences in stroke/SE maybe approaching clinical irrelevance (1%over three years, 0.3% a year). The differences either way are so small for a patient/clinician this effect isn't going to factor in my decision making. 2. So who won CHAMPION-AF? – patients. I think this solidifies LAAO as an alternative to DOAC. Patients can now meet with their cardiologist and discuss the trade-offs of each strategy. If patients are procedurally oriented they may be willing to accept a potential very small increased risk of stroke/SE to get off medications. Conversely, patients taking DOAC can be reassured that their risk of major bleeds/ICH are comparable to having a device – although they are much more likely to have bleeding events that need medical attention. Both strategies are acceptable and those discussions will really center around patient preference. 3. How does this fit in existing literature? Procedures are not drugs – and device type and procedural hygiene matter. Making sure we minimize complications from both the procedure and post-procedure care are paramount. This continues to improve with device iterations and studies optimizing post-implant medical regimens. CHAMPION proves this is an incredibly safe procedure in the right hands. 4. What comes next? – this sets the stage for important 5 year data. The primary outcome of that is ischemic stroke and systemic embolization. In theory ischemic risk and bleeding risk could continue to diverge. CATALYST will also be set to present – with a similar design but unfortunately an older generation device. LAAOS4 - adding DOAC to Watchman is a compelling hypothesis and we are recruiting! Either way - LAAO is now mainstream and with all therapies patient preference is going to rule the day.

Easy to say in hindsight, of course, but putting a micro-axial flow pump 30 minutes before PCI in STEMIs without shock always struck me as more risky than beneficial—mostly for the delay it adds. And it quintuples BARC 3 bleeding. For the umpteenth time in a STEMI trial: nothing beats reopening the vessel, quickly. #ACC26 jacc.org/doi/10.1016/j.…

tctmd.com/news/champion-… @ToddNeale well done. Good to have 360 degree perspective! 👇🏻