Søren Lund Kristensen

@BrettSperryMD @dranulala actually very similar to what we found in HFrEF patients in a Danish registry-based study - but would expect it higher in a trial vs. clinical care pubmed.ncbi.nlm.nih.gov/37355774/ @_JohanLarsson

@BrettSperryMD @dranulala Indeed - very difficult to succeed with those conditions - thanks for sharing again :)

The wait is over! ⏳ At #ACC26, Dr. Edelmann is presenting the highly anticipated SPIRIT-HF trial on the main stage: Spironolactone in the Treatment of Heart Failure. Let’s set the stage as the data drops. 🧵👇 #CardioTwitter #HeartFailure

@BrettSperryMD @dranulala Are you sure about the 75% tx disc?! And thanks for sharing the slides

As summarized by discussant @dranulala, difficult trial to assess given the delays in enrollment, underpowering (much fewer patients and events than expected), and almost 75% drug discontinuation! Despite trial issues, concerning safety/hospitalization data! #ACC26

@dr_benoy_n_shah Very nice and informative paper - thanks for sharing👍

In this trial, LAAO was not non-inferior and was, in fact, inferior But not non-inferior does not always/automatically = Inferior This paper is a good read on NI trials Non-inferiority trials in cardiology: what clinicians need to know | Heart share.google/tvF7ELSUgI60xs…

@VerwerftJan I don´t think it is very useful to have 'complementary' risk scores - we need a somewhat simple one that works! Other than that - very nice study, well done :)

HFpEF scores don’t just diagnose ↔️ they predict outcomes In a multicentre cohort (6 centres, 🇧🇪 X-PRESS O2 consortium ) with unexplained dyspnea the HFpEF scores 👉 reflect remodelling, ↓VO₂ and outcomes 👉 capture complementary HFpEF phenotypes x.com/VerwerftJan/st…

@DrToddLee @john_damianosMD @AnilMakam Doh..

@john_damianosMD Starting almost immediately! @AnilMakam

Low-dose aspirin is associated with a 58% ⬇️ risk of colorectal cancer and a 34% ⬇️ risk of mortality in patients with inflammatory bowel disease. academic.oup.com/ibdjournal/adv…

@bogdienache 🙈

“Revascularized within X days” = immortal time bias until proven otherwise

@matthewmylee Very nice work - super interesting 👍

@ebtapper Both are fine but I would go with Fiskebaren

Copenhagen friends: Sanchez or Fiskebaren?

Many choices for trials to highlight the past week, but I love this one. Again from (where else) Copenhagen If I had a dollar for every time a sent a pt with heart failure for thoracentesis for pleural effusion Boom. No benefit in an RCT

Danish study explores #HeartFailure care disparities: 🔸 55,918 pts, mostly native Danish 🔸 Non-Western immigrant patients: younger, more diabetes & #ischemicheartdisease, less #AFib 🔸 Similar #GDMT uptitration at 12 months 📎: jacc.org/doi/10.1016/j.… #JACCHF #HealthDisparities

@drjohnm Thanks for commenting! Curiously, we mostly focused on the differences in characteristics when patients were diagnosed w HF but agree that it’s very positive we see similar uptake of GDMT and outcomes after, really showcasing one of the strengths of the 🇩🇰Healthcare system

Impressive what a proper health care system can achieve: namely low disparities in care 👇🏻 (Like I’ve been saying lately, US cities can’t be like Copenhagen, but we can at least know what is possible.)

Link to full version of paper sciencedirect.com/science/articl…

Our study underlines that many of the geographic differences observed in HFrEF persists, even if patients are taken care of within the same health care system Thanks to Co-authors from @Rigshospitalet, @RigsHeart @AUHCardio , @HerlevGentofte and @UofGlasgow

Really happy to share that our research paper looking at immigrants vs. native Danish patients treated for HFrEF within the public Danish Health Care system is published in JACC HF - jacc.org/doi/10.1016/j.…

@MusicNegrito It was a pleasure seeing your show at Beta - Come back soon!

I’m on a plane

Pleural Effusion and Invasive Hemodynamic Measurements in Advanced Heart Failure @signeglargaard @BFHcardio @soerenlk #AHAJournals ahajrnls.org/4fgYmnz

@RigsHeart @Jani_MD_ *pediatric patients..

🚨 There is a high and similar rate of appropriate ICD therapies in patients with ICDs for primary and secondary prevention. ⚕️💡 ICD-related complications are significant and comparable between primary and secondary prevention recipients ⚠️ doi.org/10.1093/europa… @Jani_MD_

@ADAlthousePhD Makes sense - thanks for your reply 👍

@SLKristensen …if there is actually NO effect, because the threshold to stop early (whether it’s event-driven or enrollment/completer-driven) is still going to be much higher than the threshold to win in a trial with fixed sample size and one (final) look at the data

As promised last week, here is a thread to explore and explain some beliefs about interim analyses and efficacy stopping in randomized controlled trials.

@ADAlthousePhD How does this fit into stopping a event-driven trial at an interim of two thirds of planned events? In your example you stop at 50% of enrolled and completed patients but I guess this is slightly different?

Generally, the threshold for early stopping is sufficiently high that the evidence supporting a treatment benefit for trials that end up stopping is actually higher than would be required to "win" at the final analysis.