Federico Archilletti MD

En las últimas décadas, el número de artículos científicos publicados cada año se ha disparado. Más científicos, más revistas, más métricas, más “impacto”. Sin embargo, un grupo de investigadores de Northwestern University y la Universidad de Chicago plantea una pregunta inquietante: ¿este crecimiento cuantitativo realmente impulsa el progreso científico o lo está frenando? Su análisis de 18 mil millones de citas en más de 90 millones de artículos revela un fenómeno paradójico: en los campos científicos más grandes, donde se publican más papers, las nuevas ideas tienen menos probabilidades de emerger y consolidarse. Los artículos tienden a citar cada vez más a los mismos trabajos consagrados, atrapando la ciencia en sus propios paradigmas. El exceso de publicaciones —argumentan los autores— produce una especie de “atasco cognitivo”: los investigadores están obligados a leer, citar y producir dentro de un sistema que premia la cantidad, no la originalidad. Los nuevos trabajos difícilmente logran la masa crítica de atención para desplazar ideas establecidas. El resultado: menos disrupción, más repetición. Más papers, pero menos progreso. Esto nos obliga a repensar las políticas científicas y académicas. ¿Queremos medir el avance del conocimiento por la cantidad de artículos, o por la capacidad de las ideas para transformar? Quizás debamos pasar de la obsesión por el “publish or perish” al principio de “learn or vanish”: menos publicaciones, pero con mayor significado, apertura y riesgo intelectual. “La verdadera ciencia no es una fábrica de papers; es un laboratorio de ideas vivas” Creo que el mundo editorial clásico ha llegado a un punto de inflexión.

@kirawontmiss But we do.

this is actually heartbreaking💔

@MattiaGalli10 @ehj_ed @ESC_Journals Good job ... Always forgotten and very useful..

Pretreatment with heparin in patients with myocardial infarction is a crucial and often overlooked medical intervention. A randomized controlled trial involving 1000 patients supports the benefit of this approach. @ehj_ed @ESC_Journals academic.oup.com/eurheartj/arti…

@JamalRanaMD @SrihariNaiduMD @adityadoc1 @jgharoldmd @DrMarthaGulati @EugenioCingolan @EugeniaGianos @HanCardiomd @Hragy @AnastasiaSMihai @AnkurKalraMD ❤️‍🩹thank you!

This post is dedicated to all unsung heroes who take #911 calls & #EMT responders. I have cared for thousands of patients with💔 & been in hundreds of life-and-death codes. However, a recent experience almost turned my world upside down when I witnessed my dad having a 💔attack.

Nine uncomfortable facts about Global longitudinal left ventricular strain.

@BURZOTTA_F Looks more CABG in STICHES filled the gap in medical therapy of their times... Shouldn't we put an expiration date on some RCTs?

Can we say that #PCI looks at least promising for ischemic #cardiomyopathy ?

@jedicath Nice! Did you do kissing or Just pot ?

Ah, my old nemesis Ostial Circumlex, I am sure we will meet again 😢 IVUS guided Megatron

Please support this initiative!

@DFCapodanno LV unloading (MCS) also preceded primary PCI

The DanGer Shock trial showed different results compared to the IABP-SHOCK II and ECLS-SHOCK trials. This discrepancy may be due to differences in patient populations, timing of the primary endpoint, and the level of hemodynamic support provided. Fewer patients in DanGer Shock had undergone resuscitation before randomization, and those with severe neurologic impairment were excluded. Additionally, DanGer Shock used a 180-day mortality endpoint, unlike the 30-day endpoint used in the other trials.

Here’s my guide to navigate the #ACC25 trials, coming this weekend and featured in many journals with a (very) high impact factor. 1. WARRIOR = Intensive medical therapy in women with ANOCA/INOCA 2. STRIDE = Semaglutide in type 2 diabetes and peripheral artery disease 3. API-CAT = Reduced-dose versus full-dose apixaban in cancer with VTE 4. FARES-II = Four-factor prothrombin complex in cardiac surgery 5. REVERSE-IT = Bentracimab in uncontrolled bleeding or requiring urgent surgery or invasive procedures 6. RIVAWAR = Rivaroxaban versus warfarin in left ventricular thrombus after MI 7. SOUL = Oral semaglutide in type 2 diabetes with ASCVD and/or CKD 8. ADVANCE-HTN = Lorundrostat in uncontrolled hypertension 9. DapaTAVI = Dapagliflozin in transcatheter heart valve treatment 10. MIGHTy-Heart = Two strategies for improving transition to home after heart failure hospitalization 11. FRESH-UP = Liberal versus restrictive fluid intake in chronic heart failure in outpatient setting 12. FAIR-HF2 = Intravenous iron in heart failure with iron deficiency 13. PROTECT-TAVI = Embolic protection in TAVI 14. ALIGN-AR = Dedicated transcatheter aortic valve in aortic regurgitation 15. Evolut Low Risk = TAVI in low-risk 16. FLAVOUR II = Angiography-derived FFR versus IVUS in PCI 17. TRILUMINATE = Tricuspid transcatheter edge-to-edge repair in tricuspid regurgitation 18. FAME 3 = FFR-guided PCI versus CABG in multivessel disease 19. RACER = Out-of-hospital cardiac arrest during long-distance running events 20. Altshock-2 = Intra-aortic balloon pump in heart failure complicated by cardiogenic shock 21. ECLIPSE = Intravascular imaging to guide PCI of severely calcified lesions in PCI 22. HOST-BR = DAPT duration based on bleeding risk

Thanks for sharing @SrihariNaiduMD this is so true.

“Vulnerable or High-Risk Plaque: A JACC Cardiovascular Imaging Position Statement” just published in @JACCJournals jacc.org/doi/10.1016/j.… #atherosclerosis #vulnerableplaque #highriskplaque #imaging #OCT #IVUS #NIRS #deepOCT #CT #PCCT #MRI #lipid #lipidlowering #PCI #outcome

Here we are!

@ColletCarlos But not all vulnerable plaques have a positive FFR

Nearly all lesions with PPG > 0.65 and FFR < 0.70 are vulnerable plaques!

@agtruesdell Great save! Nice result! Did you have some interaction between Impella and the prostetic valve? Or did you take some precaution?

Cardiac Arrest and Shock ⚡️🫀💥. Emergent EC-Pella. Distal LM subtotal occlusion (with prior LCX stent protruding into LM). “Post-hoc” IVUS 👁️ guided DK 💋 Crush LM-LAD-LCX PCI/DES (with dual-lumen MC to wire LCX). EC-Pella decannulated at 48 hours (with normalized final EF)👍…

Recent European guidelines endorsed QFR to guide revascularization decisions for intermediate coronary stenoses. However, the randomized FAVOR III Europe trial showed that a QFR-guided strategy failed to meet non-inferiority to FFR for major adverse cardiac events. This may result from either false-negative QFR leading to missed stenting or false-positive QFR leading to unnecessary stenting, both theoretically increasing risk. The clinical benefit of physiology-based revascularization largely stems from avoiding unnecessary interventions. While the safety of deferring revascularization with wire-based indices is well established, it remains uncertain for QFR. This key subanalysis of FAVOR III Europe highlights that a routine QFR-guided strategy may not ensure the same safety in deferring revascularization for intermediate stenoses as FFR. eurointervention.pcronline.com/article/corona…

@ncurzen Do you remember the aspirin resistance wave too?

What happened to the days when we worried so much about the prevalence of clopidogrel resistance that we needed stronger agents for our DAPT combination!? Ironic

Geppi Cucciari alla premiazione Festa del Cinema di Roma "gioioso approssimarsi dell'ora del desio...soffio vitale che spira aurora...spirito dell'acqua, ma soprattutto del vino...scusate, per errore mi han dato il discorso di un altro" Geppi ti amo #RoFF19 #GeppiCucciari #Giuli

2/2 👍Links to all 3 e-Books right here👉: #1 🔗 scaipro.scai.org/URL/MCS-EBook, #2 🔗 scaipro.scai.org/URL/VascularAc…, and #3 🔗 sccm.org/Education-Cent…⚡️🫀💥…

Dr. Jason Wollmuth gives a step-by-step guide on his Sideclose Technique! #CardioTwitter #MCS