Mary Banks (Branch), MD MS

Mary BB 👑| Olivia & Corgi-Queen Elizabeth I’s mom, 4️⃣ th Gen. AA Doc 🩺, Cardiologist🫀, Medical Media Solutions LLV CEO. 📓🎥 | @millenialcardiologist

[Mary Banks (Branch), MD MS @millenialcardio]

I just published Philosophies to Live By https://t.co/Fh91I0nwkp

[Mary Banks (Branch), MD MS @millenialcardio]

@cardiojaydoc02 Just saw his post. So moving!

[Mary Banks (Branch), MD MS @millenialcardio]

@HeartOTXHeartMD Yasssss

[C. Michael Gibson MD @CMichaelGibson]

In HFpEF, the randomized clinical trial evidence supporting the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenoneis more robust than that supporting steroidal MRAs, such as eplerenone.

Steve Greene and I examine the differences between steroidal and nonsteroidal MRAs, the contrasting findings from randomized clinical trials, and the 2026 Expert Consensus Decision Pathway (ECDP) guidance on optimizing treatment with SGLT2 inhibitors and finerenone in patients with HFpEF.

The key takeaway? A shared mechanism of action does not necessarily translate into equivalent clinical outcomes. When making treatment decisions, it is the evidence for the individual agent, not simply the drug class, that matters.

Watch our discussion to learn why not all MRAs are created equal. https://t.co/UZwkZ1KVjY

#HFpEF #Finerenone #HeartFailure #Cardiology #EvidenceBasedMedicine s/b Bayer

[Mary Banks (Branch), MD MS @millenialcardio]

Thoughts on a forum for real-time cardiac case discussion similar to Reddit?

Working in a rural area can be isolating and I would love to phone a friend. AI is just not the same. Works very well for cardio-oncology.
#ruralcardiology

@ACCinTouch @EricTopol @patrick_ellinor @HFnursemaghee @ABCardio1 @kcferdmd @datsunian @DrQuinnCapers4 @kewatson

[Mary Banks (Branch), MD MS @millenialcardio]

Twitter cardiology, what are your thoughts on the structure in apex?

This is from a gentleman who also had a significant left or right shunt, and no right to shunt who presented with an embolic stroke. The left right nature is quite perplexing.

Any insight on this case would be helpful
#cardiotwitter #ACC #cardionerds #echo

[Mary Banks (Branch), MD MS @millenialcardio]

@cardiojaydoc02 I could’ve really benefited from this. Postpartum depression symptoms during cardiology fellowship was not ideal.

[Mary Banks (Branch), MD MS @millenialcardio]

@kidfromkidnplay Your frog ain’t jumping in my direction; there’s a new tadpole in town

[Mary Banks (Branch), MD MS @millenialcardio]

@HeartOTXHeartMD Please do !

[Mary Banks (Branch), MD MS @millenialcardio]

All I have is an elevated Lp(a) of 184 and no other risk factors. LDL <100 mg/dL.

My PCP wanted to start me on a statin and I said no……🍵🍵

Questions remain; we don’t have to throw the baby out with the bathwater. But, we may need to slow down with Lp(a) frenzy.

Thoughts?

[C. Michael Gibson MD @CMichaelGibson]

Some take aways from what we know about HORIZONS phase 3 trial of Lp(a) lowering
1. We know very little. We only know the primary endpoint in the entire population.
2. We do not know if some subgroups may have benefited more like those with a higher baseline Lp(a).
3. Do those who were not on dual or single anti platelet therapy benefit?
4. Did efficacy vary by baseline and on treatment LDL?
5. Did efficacy vary by achieved Lp(a)?
6. We need more sophisticated analyses of the particle composition and oxidizing potential of the patient’s Lp(a) particle to assess for heterogeneity in response.
7. Were the results different in MI patients vs stroke vs PAD patients? These vascular beds behave differently in response to therapeutic interventions.
8. Were the results different in patients with single vessel disease vs multivessel disease where there were more targets for modification.
9. This was a time to first event analysis and not a time to any event analysis (a multiple event analysis). A multiple event analysis captures disease burden and may be more highly powered.
10. For those who were on dual antiplatelet therapies, once these were discontinued, was there an event reduction which would suggest optimal antiplatelet therapy may have reduced residual risk so much it could not be modified?
11. Much has been made of observational data suggesting aspirin may modify risk in patients with an elevated Lp(a). Was there an interaction with aspirin therapy ?
12. Mendelian randomization / genetics captures lifetime exposure and not several years of exposure as in this trial. Were the KM curves diverging late suggesting prolonged therapy might have been needed?
13. Were the assumptions regarding the magnitude of the potential efficacy signal too optimistic and was the trial underpowered?
14. In a trial this long patients may go missing. How good was the follow up? Was there informative censoring?
15. The results of primary prevention trials where LDL lowering and antiplatelet therapy may not have been as aggressive may still show benefit.
16. This ONE trial does not negate the potential causal role of Lp(a). The LDL and antiplatelet therapy may have reduced residual risk so much that there was very little risk to be modified. A trial Lp(a) lowering only would share more light on this question (a trial will never be done). What would happen if all patients were on Lp(a) lowering therapy. Would LDL lowering further improve outcomes? We don’t know for sure.
17. Was there an interaction with CRP, gender age risk score?
18. Obviously there are more questions than answers at this point. I raise these questions as exploratory hypotheses, to further our understanding of the biology, not to salvage a neutral trial.

We all anxiously await the full recitation of results and answers to these questions as well as others.

Thank you to the patients who participated.

[Mary Banks (Branch), MD MS @millenialcardio]

🙏🏽🙏🏽🙏🏽🙏🏽🙏🏽🫀🫀🫀🫀

[Christopher KID Reid @kidfromkidnplay]

HE❤️RT-IVERSARY WEEK💜❤️💜
“TIN MAN” VIDEO DROPS 8/19 on ⁦@YouTube⁩ ⁦@Spotify⁩

[Mary Banks (Branch), MD MS @millenialcardio]

@cardiojaydoc02 @Lizzs_Lockeroom Lolllll I have heard the Vanessa Williams resemblance before

[Mary Banks (Branch), MD MS @millenialcardio]

@cardiojaydoc02 Outstanding film

[C. Michael Gibson MD @CMichaelGibson]

I always overestimate what I can do in a year

I always underestimate what I can do in 10 years

A year rewards ambition

A decade rewards persistence

Ambition x persistence = what you accomplish. Persistence is a force multiplier #cmgsays

[Mary Banks (Branch), MD MS @millenialcardio]

Yay!

[C. Michael Gibson MD @CMichaelGibson]

Eli Lilly to allow more patients to apply for special access to unapproved obesity drug.

Doctors seeking early access to unapproved retatrutide after Lilly granted drug to 79-year-old patient.

https://t.co/WGBjUzzqMf via @statnews

[Mary Banks (Branch), MD MS @millenialcardio]

@HeartOTXHeartMD 🥹🥹🥹

[Mary Banks (Branch), MD MS @millenialcardio]

@DrMarthaGulati 💯

[Jonathan Reiner @JReinerMD]

We have a tendency to view people as good or bad. It’s often not that simple.

Whitman wrote:
“Do I contradict myself?
Very well then I contradict myself,
(I am large, I contain multitudes.)”

I think that’s about right.

[Mary Banks (Branch), MD MS @millenialcardio]

My life

[Steve Harvey @IAmSteveHarvey]

What was the last thing you accomplished that seemed impossible?