Luke Joseph, MD

Summary of all Late-Breaking Trials at #ACC2026 – take home points @ACCinTouch @ACCmediacenter @JACCJournals 1. HI-PEITHO: Ultrasound-facilitated catheter-directed thrombolysis led to a lower risk of PE-related death, cardiopulmonary decompensation or collapse, or recurrence of PE. vs anticoagulation alone in intermediate-high risk PE.

@AlabamaACC FIT jeopardy team! Advancing to semifinals tomorrow.

Advancing to the semifinal of FIT jeopardy!! Glad to represent Alabama and @UABCardiology alongside my UAB co-resident, Ben, and South Alabama colleague, Sanchitha! 🫀🎉😎 @UABCVI @ACCinTouch @AlabamaACC

Great start to being in NOLA for #ACC26 by attending Cardio-Onc pre-session! 🎉🫀🦀 @UABCardiology @ICOSociety

Diastolic vibration of the anterior leaflet of the mitral valve as a result of aortic regurgitation (Austin Flint).

@SeeFisch Decaf trial would say no!

Does COFFEE increase the risk of atrial fibrillation?

Oral anticoagulation after publication of the CLOSURE-AF trial and LAAC deemed “not non-inferior”. 😐

Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…

This state-of-the-art review outlines current evidence on the mechanisms, prevalence, clinical relevance, and management of TAVI thrombosis and highlights ongoing clinical trials investigating this condition. eurointervention.pcronline.com/article/transc…

🚨 The 2026 ACC/AHA Dyslipidemia Guidelines are here, and CAC scoring just got a Class 1 recommendation for guiding statin therapy decisions in intermediate-risk patients. Key updates: ➡️ CAC = 0 may allow withholding statins ➡️ CAC ≥100 AU or ≥75th percentile → statin therapy recommended ➡️ CAC ≥1,000 AU → intensive LDL-C targets ➡️ PREVENT-ASCVD equations now guide primary prevention ➡️ Lp(a) testing at least once in a lifetime Big shift in how we risk-stratify and treat. Worth reading the full guideline. 👇

Want to know my most important takeaways from the new 2026 Cholesterol Guidelines? Set to music, of course. @AHAScience @ACCinTouch @ASPCardio Clip here- Full song at the link- youtube.com/watch?v=DRO5kH…

Do we need full-dose anticoagulation after 6 months in cancer-associated VTE? API-CAT trial compared: • Apixaban 2.5 mg BID vs • Apixaban 5 mg BID Result: • Similar VTE recurrence • Less bleeding with 2.5 mg 👉 Reduced dose may be ideal for extended therapy. #MVOnco #Oncology

Patients with greater spontaneous echo contrast (SEC) grade displayed a higher incidence of thromboembolic events and DRT, and combined SEC grade and #AFib type independently predicted these events. Further research is needed jacc.org/doi/10.1016/j.… #JACCCEP

@JingnanH @Ircad @uabmedicine Congrats Jingnan!!!

Had a fantastic time at the SEEP Conference @IRCAD . It’s truly one of the most educational EP courses for fellows. Honored to have received the runner-up prize in the fellow case competition representing UAB @uabmedicine. Looking forward to next year!

Echo Clues for Aortic Coarctation: 🔹 Suprasternal view: Color Doppler shows aliasing and turbulent high-velocity flow at the distal aortic arch (just after the LSCA). 🔹 CW Doppler (distal arch): Increased peak velocity with a characteristic diastolic “tail” or runoff. 🔹 PW Doppler (abdominal aorta): Reduced pulsatility with continuous diastolic forward flow. 📌 Teaching pearl: Diastolic runoff in the arch + continuous diastolic flow in the abdominal aorta = Think coarctation.

🚀 Don’t miss the exciting lineup of #ACCCardioOnc events at #ACC26! 🫀💙 Sharing key Cardio-Oncology sessions, including the must-attend pre-conference program featuring experts focused on improving CV outcomes for patients with cancer & survivors @DSadlerMD @ACCinTouch

@thetrueshelby Also Frank’s crease on the ear!

Okay, medical twitter. WTF is this?

Anatomic relationship of the mitral and aortic valves #echofirst in #3DTEE from atrial (surgeon’s) and ventricular aspect @iamritu @NMerke @alexsfelixecho @CASivaram1 @DrRajeshG1 @StellEkaterina @echo_stepbystep @bwoody58 @echo_batman @OungSavly @dr_benoy_n_shah @ParrasJorge2

I'm 58. If you're in your 20s, please listen to me before it's too late:

Old PE stratification mixed BP, RV strain, biomarkers, and outcomes into blunt labels. Result: • Stable-looking patients who crashed • Overtreatment of others The 2026 guideline fixes this by focusing on physiology & trajectory.