@DavidLBrownMD He’ll be back the next infected pacemaker he has.
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Steven Dunn
2.8K posts
Steven Dunn
@CardiacRX
Cardiology Clinical Pharmacist with @UVA and @uvahealthnews. Associate Editor @JACCJournals #JACCEdge. Tweets represent own views and opinions. Sometimes silly.
Charlottesville, Virginia Katılım Eylül 2013
184 Takip Edilen1.1K Takipçiler
News Flash. Cardiologist no longer trusts infectious disease. Gives prescription for regaining his trust.
Joseph Marine@DrJMarine
A sad realization hit me today: I no longer trust that the field of Infectious Diseases is committed to truth-seeking. It has lost its ethos. It will have to examine, challenge, and purge many false narratives from the covid era in order to recover. Bold leadership needed.
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@Jcuttsy013 Best I can offer is some NIL money with Higher Grounds.
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If anyone is offering $8 million for a transfer, I’d like to formally enter the portal with 7 months of advanced cardiac imaging training eligibility remaining…
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This story goes all the way back to RALES but very good reason behind MRA mortality benefit in HF may be achieving higher K lvls. Very cool study but are results due to higher MRA use or higher K? nejm.org/doi/pdf/10.105…
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@drjohnm @theheartorg Secondarily there probably isn’t any more appetite for a digitoxin NDA in the US than there is with vericiguat so I don’t see why this changes anything for a HF practitioner.
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@drjohnm @theheartorg Mortality is still the most important thing in chronic HF. At best this at least shows the digitalis benefit in the face of background beta blocker therapy. We’d do far better increase our (poor) utilization or mortality lowering therapy than messing with dig.
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Darn it. There’s no editorial. Why? Because the heart failure community is stunned. They are speechless. No worries.
You can read this (slightly biased) editorial for free on @theheartorg
medscape.com/viewarticle/fi…
#esccongress #esc2025
NEJM@NEJM
Presented at #ESCCongress: In patients with heart failure and reduced ejection fraction who were receiving guideline-directed medical therapy, digitoxin lowered the risk of death or hospitalization for heart failure as compared with placebo. Full DIGIT-HF phase 4 trial results: nej.md/3HQHLfj @escardio
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Kudos to @mfiuzat, @batallah08, Robert Page & Orly Vardeny for shedding light on the training, practice, & roles of HF pharmacists. jacc.org/doi/epdf/10.10…
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@a_l_bailey @costplusdrugs Ah the good old days of $4 carvedilol…
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During fellowship I often commented Walmart’s $4 drug list changed my practice more than anything else. During adult life it’s @costplusdrugs …
Gregg Fonarow MD@gcfmd
HFrEF ARNI+BB+MRA+SGLT2i Extend median survival by 7-11 YEARS Self-pay cash price for all 4 💊 $121 per month Available today
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@robdeedo @Cait_Centra Cost will absolutely be an issue with finerenone. Can’t imagine there won’t be a consistent PA or copay tier barring new data. They need to more definitively prove safety advantage especially vs generic eplerenone
Otherwise little wrong with spirono from my POV if we’re smart
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@Cait_Centra Sooo, now with 3 MRAs from which to select, excluding cost as an obvious barrier, which would you choose and why? (Rhetorical ?, not directed specifically to @Cait_Centra)
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For all the TOPCAT haters 😏🙂↔️
Muthu Vaduganathan@mvaduganathan
🚨 Finerenone Approved by US FDA in HF based on #FINEARTSHF Finerenone (Kerendia) is a non-steroidal MRA indicated to reduce the risk of CV death, hospitalization for HF, & urgent HF visits in adult patients with HF with LVEF>= 40% bayer.com/media/en-us/us…
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Steven Dunn retweetledi
A few weeks ago @ACCinTouch, @American_Heart, and others societies released the new ACS guidelines! @CardiacRX and I break them down on the new @MJHLifeSciences @Pharmacy_Times Tell-Heart episode; listen here or where you get your podcast: audioboom.com/channels/51512…
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@MartenHawkins It’s great! Start with the interquel - the Heart of What Was Lost and go from there!
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@CardiacRX Thanks Steven!! Always my hero! I’ve actually read memory, sorrow, thorn, but don’t think I’ve looked at the sequel so that’s perfect 😍
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Going on an extended vacay soon and looking for book recs. Prefer fantasy and completed series (I’m not a good wait-er 😫) but open to all! Help!!
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new ACS guidelines!
here I was thinking REDUCE-AMI would have been sufficient to re-consider beta blocker therapy in every ACS case 🤷🏻♀️
Circulation@CircAHA
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes #AHAJournals ahajournals.org/doi/10.1161/CI…
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@robdeedo @StephDwyer21 I’m just glad someone’s still here to hang out with me on this app.
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@StephDwyer21 Just in time for my lecture on ACS—Wednesday🙄 Surprised they wimped out on commenting about BB duration. Guess we’ll have to wait another 11-12 years…
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Steven Dunn retweetledi
According to the American Heart Association, ‘Not Like Us’ by Kendrick Lamar has the right tempo for Hands-Only CPR at 101 beats per minute.
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@kaulcsmc @drjohnm @AndrewFoy82 My take has always been dz-specific hospitalization first and foremost and all-cause is a more nonspecific marker of benefit. Need to dig into paper but my guess is margin of benefit may influence all-cause and also potential safety signal? Cool study - thanks for doing
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Should Heart Failure Trials routinely report on all-cause hospitalizations?
Should clinicians, guidelines & payers favor interventions that favorably impact cause-specific & all-cause outcomes?
jamanetwork.com/journals/jaman…
jamanetwork.com/journals/jaman…
@AndrewFoy82 @drjohnm
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Interrupting your regular dumpster fire of a feed to bring you the journal article title of the year (and also a cool paper): cjcopen.ca/article/S2589-…
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@MartenHawkins I’ve mostly spent time in central Germany (and got married there) but Munich obv, Rothenburg if you want a cool historical town with a gigantic Christmas store with Kathe Wolfhart. Favorite Christmas markets are Nuremberg, Esslingen + Stuttgart and Mainz at night
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Which cities should I visit while in Germany in a few months?
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@kaulcsmc @AnilMakam @cardiobrief @djc795 @drjohnm @PCORI I think the “change” was permission to stop using digoxin. I’d have to look at a time-based study but my guess is digoxin use has done from a 60+ percent use (early 2000’s) in chronic HF to <10% now. Part of it for sure is introduction of more effective therapies.
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@CardiacRX @AnilMakam @cardiobrief @djc795 @drjohnm @PCORI Yes, but why did it change clinical practice?
Reminds me of this discussion. 👇🏻
Sanjay Kaul@kaulcsmc
@drjohnm @MKIttlesonMD We have 3 interventions for HF, all 3 have no impact on mortality, but reduce HHF. Only 1 has a Class I endorsement by the 2022 HF guidelines. Guess what these interventions are.
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@AnilMakam @cardiobrief @djc795 @drjohnm @PCORI I asked same Q 20 yrs ago!
ALLHAT BP trial showing primacy of diuretic Rx
SPRINT (I have been critical of this trial) in setting intensive BP lowering target
ACCORD, VADT showing harm with intensive glycemic control
FHS, establishing risk factors for ASCVD
Any more to add?
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