Koen_Ameloot

Dad x3, interventional & ICU cardiologist, Marathon x4

[Koen_Ameloot @kameloot3]

@SyedYNaqvi1 We just finished our RCT with pre-procedural 3D-CT versus angio guided PCI to determine the optimal C-arm angle for ostial RCA lesions (n=30). Primary end-point coverage of the ostium by IVUS. Results will be out soon!

[Koen_Ameloot @kameloot3]

@bmorecardiology @AnnGageMD @MKIttlesonMD @tonkhueMdPhd @SusanJosephMD @GRamaniMD @PatrickBering @gcfmd @WesElyMD @toddrice_ICU @DrJohnMcP In AMI-CS we showed that ⬆️MAP to 80mmHg with vasopressors ⬇️AMI size https://t.co/MHJ8tXHR5k. ↔️in non-AMI-CS, we go for maximal unloading and evaluate end-organ perfusion

[Koen_Ameloot @kameloot3]

@FH_Verbrugge @EHJACVCEiC Great work! Provocative question: should coronary anatomy be a variable in the decision to use vasodilators? Being a big fan of nitroprusside, I am a little more hesitant in patients with severe 3VD or unknown anatomy since DBP ⬇️ could ⬇️ coronary perfusion and ⬇️ CO…

[Koen_Ameloot @kameloot3]

@JohannesGrand @thiele_holger @escardio @AGIKinterv @AnneFreund3 @krychtiukmd @PabloJ I think it may be due to the combination of (1) inadequate ventilation in the cathlab with hypo/hyperoxemia & hypo/hypercapnia (2) MAP fluctuations during the cath procedure and (3) missed diagnoses such as PE or ICB in these patients without ST elevation

[Koen_Ameloot @kameloot3]

@nolanjimradial @evandrofilhobr We are currently randomizing patients in the RADVES trial between Terumo and Silverway after the standard J-tip wire had failed to cross (NCT05231889). Results expected end Q2…

[Koen_Ameloot @kameloot3]

@JohannesGrand Impressive trial! Both Neuroprotect and COMACARE were pilot trials with (poor) surrogate end-points. Looking ffwd to the results!

[Koen_Ameloot @kameloot3]

@ElevenSportsBEn @Jupiler Wat vinden jullie bij @ElevenSportsBEn van een commentator die vindt dat Onuachu ‘op zijn poten moet blijven staan’? Beetje niveau aub…

[European Society of Cardiology Journals @ESC_Journals]

Is a higher MAP in #CardShock pts a road to success? RCTs still needed https://t.co/TIBmUnr6sC #cardiotwitter #medtwitter @drmilicaa @krychtiukmd @rafavidalperez @pascal_vranckx @mrubini @ACVCPresident @umityasarsinan1

[Koen_Ameloot @kameloot3]

@Babar_Basir @AlejandroLemor @agtruesdell @behnam_tehrani @SarahGorgis @adityadoc1 @bkolskk @perc_surgeon @NavinKapur4 @BillONeillMD Based on our randomized data on resuscitated AMI patients published in JACC, targeting ⬆️ MAP with ⬆️ vasopressors ⬇️ AMI size with no ⬆️ in arrhythmia’s (PMID: 32792079) . Therefore, I believe vasopressor use in this observational study is a marker of sicker patients..

[Mia Bertic @DrBerticMia]

@CANCARESociety journal club this Thursday with @LiorBibasMD presenting with invited first author Dr. Koen Ameloot. See you all there!

[Koen_Ameloot @kameloot3]

@ClubBrugge

[Koen_Ameloot @kameloot3]

@LiorBibasMD @JACCJournals Thnx! Agree that cMRI would have been a better estimate of AMI size! However, cMRI Would probably not be feasible at day 5-10 in many shock patients (35% of our cohort would already be death by that time)

[JACC Journals @JACCJournals]

Targeting a mean arterial pressure between 80/85 and 100 mmHg in post-arrest #cvMI patients in shock is associated with smaller myocardial injury. Learn more in #JACC: https://t.co/A2OXN2OGhK

[Koen_Ameloot @kameloot3]

@pedschwartzmann @FH_Verbrugge @JACCJournals In our forest plot, results were mainly driven by differences obtained in STEMI patients with TIMI 0 flow in the LAD.. seems like patients with the largest AMI might benefit most..

[Koen_Ameloot @kameloot3]

@pedschwartzmann @FH_Verbrugge @JACCJournals There are obviously no data at all to support a 65mmHg target.. I think there are some similarities between stroke (penumbra/core) and STEMI and that you should consider giving NE even in patients with MAP 65 and normal lactate/diuresis/brain to salvage the cardiac penumbra..

[Koen_Ameloot @kameloot3]

@drozant1 @FH_Verbrugge @JACCJournals Unfortunately, at least in our series rates of RRT are very low.. analysis will be underpowered for this.. however, data on creatinin and diuresis will be interesting!

[Koen_Ameloot @kameloot3]

@DrLbatt @Mosaad The assocation between earlier start of vasopressors and worse outcome in previous observational studies is probably just biased by patients with deeper shock getting earlier vasoactive drugs

[Koen_Ameloot @kameloot3]

@DrLbatt @Mosaad Unfortunately, it is impossible to say how our 37% reduction in AUC cTnT Would correspond with reduction of infarct size on cMRI.. however, don’t forget that each 5% reduction of infarct size is theoretically associated with a 20% reduction of death and HF hospitalizations..

[Koen_Ameloot @kameloot3]

@drozant1 @FH_Verbrugge @JACCJournals We are currently working on a pooled analysis of both trials on GFR and diuresis! Will Hopefully be published Q4 2020..