Shankar Iyer @schenzker - Twitter Profile

5 days ago

My Lp(a) is 175. I have been waiting for this trial for years. Yesterday, Novartis released the results of HORIZON. The biggest Lp(a) outcomes trial in history. 8,323 patients. A drug built from the ground up to do one thing: lower Lp(a). The drug worked. The cardiovascular events did not change. This is the most important failed trial in cardiovascular medicine this year. Nobody is explaining why it failed. I will.

markkaplan20's tweet photo. My Lp(a) is 175. I have been waiting for this trial for years.

Yesterday, Novartis released the results of HORIZON. The biggest Lp(a) outcomes trial in history. 8,323 patients. A drug built from the ground up to do one thing: lower Lp(a).

The drug worked. The cardiovascular events did not change.

This is the most important failed trial in cardiovascular medicine this year. Nobody is explaining why it failed.

I will.

80

1K

231

1K

169K

schenzker retweeted

Dr Ihab Suliman

@IhabFathiSulima

9 days ago

🚨 10 striking conclusions from ESC 2026 1. HFmrEF is essentially gone. ESC now defines HFrEF as LVEF <50% and HFpEF as ≥50%. 2. MRAs have broken the EF barrier. Mineralocorticoid receptor antagonists now have a Class I recommendation in chronic HF irrespective of LVEF. Semaglutide/tirzepatide receive Class IIa recommendations for HFpEF with obesity. 3. SINGLE-AF: anticoagulation may start earlier than we thought. In AF patients at intermediate stroke risk, DOAC therapy reduced adverse clinical outcomes by 69% versus no anticoagulation. 4. Severe TR is no longer just “give diuretics and watch.” TRIC-I-HF: transcatheter tricuspid repair reduced HF hospitalisation and all-cause mortality compared with medical therapy alone. 5. Unexplained syncope deserves early prolonged ECG monitoring. ASPIRED: immediate 14-day monitoring did not prevent recurrent syncope, but substantially improved arrhythmia diagnosis/treatment and was associated with lower mortality. 6. Intermediate–high-risk PE may be entering the catheter era. PRAGUE-26: catheter-directed thrombolysis improved short-term clinical outcomes versus anticoagulation alone, without an obvious major bleeding penalty. 7. Cardiac arrest + no STEMI ≠ automatic immediate cath lab. DISCO: immediate angiography after OHCA without ST elevation did not improve 30-day survival. 8. Being ≥70 is not a reason to abandon primary-prevention statins. STAREE: atorvastatin reduced major cardiovascular events by about 30% in older adults without known CVD, although disability-free survival was unchanged. 9. AF ablation has a surprisingly large placebo component for symptoms. PVI-SHAM-AF: ablation reduced AF recurrence, yet improvement in AF-related quality of life was not significantly greater than sham treatment. 10. Even the definition of MI has changed. The 5th Universal Definition of MI replaces the traditional numbered framework with primary MI, secondary MI and procedure-related MI, while incorporating sex-specific troponin thresholds and greater use of imaging. 🔥 The one-line ESC 2026 message: Treat HF across the EF spectrum, anticoagulate selected AF patients earlier, intervene on TR, monitor syncope sooner—and stop rushing every post-arrest patient without STEMI to the cath lab.

11

612

201

531

66K

schenzker retweeted

Medicine Inter-National @Med_I_Na

almost 6 years ago

Fair and Ethical Medical Practice: @Medicine_IntNat working with colleagues and collaborators in the Sub-continent to improve Fairness and Ethics in Medical Practice! #FairEthicalMedPractice

16

28

15

0