Fernando Bernardi

@GamewithDave So many bro

For anyone who used a computer between 1990 & 2005… what’s the one game you still think about?

@purviparwani @adityadoc1 @DrMarthaGulati @iamritu @GreggWStone @Drroxmehran @DLBHATTMD @ErsozluSara @ACCinTouch One of the dumbest trials ever

#STEMI DTU # ACC26 Mechanical Circulatory Support Doesn’t Reduce Infarct Size in STEMI ❤️“Time is myocardium” - this trial challenged that ⏱️ Deliberately delaying PCI to unload the LV first 🩸 Impella support— ~6x more bleeding/vascular complications 🤯 Delaying PCI by ~45 min didn’t worsen infarct size—but also didn’t meaningfully help it either 💫Impella is good for cardiogenic shock—not for routine STEMI strategy based on #STEMIDTU @mmamas1973 @mirvatalasnag @SrihariNaiduMD

@SamaHoole When earn more money they get access to health care, to clean water, to better sanitary, to antibiotics, to more food in general, to more security, etc. This univariate correlation in such ultra complex equation is one of the dumbest things to say. The result is multivariable

Let me tell you what every population does when it gets money. Not every population. Every. Single. One. Japan, 1950s. South Korea, 1970s. China, 1980s. Brazil, 1990s. Vietnam, 2000s. Every developing economy that has industrialised in the last century. The first thing they buy with their disposable income is animal protein. Meat. Dairy. Eggs. Not quinoa. Not oat milk. Not the plant-based burger made in a laboratory by a Californian startup. Steak. Pork. Chicken. Milk. And in every single case, within a generation, their children grow taller. Their chronic disease burden shifts from deficiency-based illness to the diseases of abundance: which are primarily diseases of seed oils and inactivity, not of meat. The people arguing that we should eat like the poor populations they used to be are almost never the people who grew up in those populations. The people who actually grew up in those populations are eating steak. They can taste the difference between ideology and dinner.

@MAnisHaider A significant limitation is that the comparison was not against the S3 Ultra Resilia (which had not been released by the time of the trial).

ViV-TAVR in failed small surgical valves (≤23 mm): what matters at 3 years? The randomized LYTEN trial 3-year follow-up shows a clear hemodynamic signal: supra-annular SEV (Evolut R/PRO/PRO+) outperform BEV (SAPIEN 3/ULTRA) with significantly lower gradients and larger EOAs—yet clinical outcomes remain similar (death, stroke, HF hospitalization). So what should drive ViV strategy in small valves? Not a single metric. Hemodynamics, operator experience with BVF, future coronary access, and lifetime management all matter—and demand case-by-case individualization. Key limitations • Not powered for clinical endpoints • ~20% missing 3-year echo follow-up • Events not independently adjudicated; ascertainment not blinded • BVF at operator discretion; heterogeneous surgical valve types Notably, BVF technique has matured substantially—with major contributions from the St. Luke’s Mid America Structural Heart Team,#StLukesMidAmerica redefining what’s achievable in small-valve ViV. #ViVTAVR #StructuralHeart #AorticStenosis #SmallValve #PPM #BVF #LifetimeManagement #CoronaryAccess #HeartTeam #StLukesMidAmerica #europcr lnkd.in/gCPUXE9R

@davidasinclair Time to run a properly sized randomized clinical trial with long follow-up, such as the ones that showed iSGLT2 can safely and effectively protect the kidneys.

8. There is at 1 randomized controlled trial giving oral β-NMN (MIB-626) in hospitalized patients with COVID-19 and AKI, primarily reporting safety and NAD+ boosting

Acute kidney injury (AKI) occurs in 10–20% of hospitalized patients. A new paper shows that NMN protects the kidneys, reduces cell injury, and suppresses inflammation, immune cell infiltration, and reactive oxygen species in mice receiving chemotherapy. It is about the 8th paper demonstrating kidney protection by NMN 💪

@DFCapodanno I quit using ticagrelor when ISAR-REACT 5 was out. Way back there. I really don't understand why people kept pushing on ticagrelor. The data was not good plus patients had to take it twice a day and a good part of them complained of shortness of breath.

TUXEDO-2, in plain terms. The trial was designed to test non-inferiority of ticagrelor vs prasugrel in patients with diabetes and multivessel disease, using a composite endpoint mixing ischemic and bleeding events. The NI margin was 5%, but the 95% CI of the difference ranged from −2.07% to +6.74%. To me, this is an inconclusive result: it cannot confidently rule out benefit or harm. Still, I’m comfortable with the authors’ and the journal’s conclusion—ticagrelor did not meet non-inferiority, seemingly due to numerical increases in both ischemic and bleeding events. This is now the second trial suggesting that the two drugs are not exactly on the same level. Ticagrelor was not superior to prasugrel in ISAR-REACT 5, and it was not non-inferior in TUXEDO-2. This may sound like nuance, but it’s actually the key point. In both trials, ticagrelor was the one being tested against prasugrel, not the other way around. The burden of proof was on ticagrelor—and it didn’t quite carry it. With the comparison reversed, and given these statistical designs and endpoints, results might have been the same, or maybe not. Add to this that one trial was in ACS and the other not strictly so, and the picture becomes even more blurred. Bottom line: we really need a patient-level meta-analysis. A study-level one would probably just add another layer of confusion. jamanetwork.com/journals/jamac…

@VascodaGama Mais um brasileirão patético do Vasco.

⏱ 34' | 1T 🔄 Alteração no Vasco: ⬆️: Leandrinho ⬇️: Vegetti #CAMxVAS 2️⃣-0️⃣ #Brasileirão2025 #VascoDaGama

@elonmuskADO 56

@janvankeer @drjohnm What is the point of small studies if the results shown are simply not true and biased. In this case, it would be much better to just publish the treatment arm. Why comparing things that can't be compared?

@drjohnm Dear dr Mandrola, I'm a huge fan of your podcast but I respectfully disagree; it is important to educate colleagues not to draw overreaching conclusions, but if only mega trials are allowed to be published, small research will have a hard time flourishing

The main reason to read this paper is as an example of observational study run amok “Among 253 pts at a single center…” With all due respect, please, resist the urge to do (and publish) such folly. Look at the early curve separation jacc.org/doi/10.1016/j.…

@TWilsonMD @Umair2017 @BifurcationClub @ShariqShamimMD @JingLiu_MD @evandrofilhobr @Pooh_Velagapudi @HadyLichaaMD @djc795 @minhaskh @BaoGTran @nyalborgesmd @jedicath Same here

@Umair2017 @BifurcationClub @ShariqShamimMD @JingLiu_MD @evandrofilhobr @Pooh_Velagapudi @HadyLichaaMD @djc795 @minhaskh @BaoGTran @nyalborgesmd @jedicath Cut, DCB

🔹How would you manage this ostial LCx stenosis? #FFR = 0.70 after IC adenosine. Large dominant LCx. No other significant disease. Severe angina despite OMT. #CardioTwitter #ACCIC @BifurcationClub #ACCFIT #Cardiology

@VascodaGama Olha ele dando soco na bola de novo!!! Pqp. Bola alta, só pular e segurar com as mãos

@VascodaGama Por que o Léo Jardim não segura a bola quando sai do gol?? Pq tem que sempre dar um soco no bola. Que falta de skill é essa?

#flaxVAS 1️⃣-0️⃣ | ⏱ 11' | 1T #Brasileirão2025 #VascoDaGama 📺 Globo e Premiere

@VascodaGama Mais um ano zicado. Time pode jogar bem que alguma coisa acontece pra perder ou empatar. Ninguém nos salva da série B em 2026 infelizmente

🔁 ɐpɐɹıʌ de chave e início da preparação para enfrentar o Sport em jogo válido pelo Brasileirão 💢 📸 Matheus Lima | #VascoDaGama

@douglewinenergy @grok put that into context for me please

The United States is about to walk off the field, ceding a major economic lever for the 21st century to China. Thank you for your attention to this matter.

@MananPareekMD @AmiBhattMD Exactly

@AmiBhattMD Great post, but no TAVI story is complete without mentioning Dr. Henning Rud Andersen, the actual inventor: cardiovascularnews.com/henning-rud-an…

Imagine heart surgery without cracking open the chest. Sounds impossible, right? But in 2002, Dr. Alain Cribier made it a reality with transcatheter aortic valve implantation (TAVI). This procedure has saved the lives of patients previously deemed too weak to survive.🧵

@SVRaoMD Still a lot. Unacceptable

Very interesting study - seeing a lot more radial grafts for CABG but their long term patency in clinical practice remains unclear. This RCT shows that vasodilators help keep these grafts open. #RadialFirst (but for grafts...)

@drjohnm @baileymd Is it an abomination to scare a patient with a LDL-c > 190mg/dL?

@baileymd I agree w Steve Nissen who once gave a talk where he said it was an abomination to use an image to scare a pt into healthy living.

Highly recommended 👇🏻 I don’t think a CAC scan is ever very useful but this well written paper on when NOT to do a scan is quite good b/c I see errors like these every week. If you do CAC when PCE is > 20% you fail Medicine 101

@ecgandrhythmRoe I see a patient needing emergency coronary angiography

this ECG from a 70 yo person with chest pain was sent to me. What do you see?

@JackStr42679640 That's the price of being THE POLICE of the World. The US has military bases in nearly every Western country. I really don't know what is right or wrong but with that the US no longer will be the major military ruler of the planet

BANG The US is cutting off funding for NATO. All subsidies to the general fund and payments will be stopped as of February 28 of this year. All financial transactions not related to the defense capability of the US Army will also be cancelled. The US can no longer subsidize NATO allies that do not spend enough on defense, Secretary of State Rubio said Victor

@Manic_Doge @elonmusk Quit crying. There was no disrespect. Have Americans became so soft??

@elonmusk After Ukraine’s blatant disrespect toward the President and Vice President of the United States, as well as the American people, it’s time to cut their access to Starlink. They’ve shown they’re not worthy of our support, and it’s time to stand firm. Please act accordingly.

🇺🇸🇺🇸🇺🇸