Phil Riley

Weekly Journal Scan: Aspirin and oral anticoagulation—more of a bloody mary than an AQUATIC mix This comment refers to ‘Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation’, which was published in The New England Journal

Again, No ASPIRIN with DOAC’s

academic.oup.com/eurheartj/ad...

2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Assoc... 2026 multisociety guideline for acute pulmonary embolism — evaluation, risk-based management, advanced therapies, and follow-up.

First Ever ACC/AHA Guideline for Pulmonary Embolism Treatment. #CardioSky www.jacc.org/doi/10.1016/...

I've discussed sending samples to path with our spine surgeon since the manifestation there usually occurs before the cardiomyopathy. #OneSeesWhatOneKnows

The Inherited Basis of Coronary Artery Disease | NEJM Investigations of the genetic basis of coronary artery disease have led to advances in mechanistic insights, therapeutics, prevention, and risk prediction. Indeed, most contemporary medicines for c...

Great Review: The Inherited Basis of CAD | NEJM www.nejm.org/doi/10.1056/...

OG article from the UK Biobank

I bet it’s LVH/HCM in the end

Importance of Clinical, Laboratory, and Genetic Risk Factors for Incident CAD | Circulation: Genomic and Precision Medicine BACKGROUND: Prior work suggests modifiable cardiovascular risk factors (CRFs) account for 80% to 90% of the risk for incident myocardial infarction. The contributions of genetic and other novel CRFs h...

2025: Polygenic Risk Scores vs all other known Cardiac Risk Factors …

Why aren’t we using this wonderful technology??

www.ahajournals.org/doi/10.1161/...

A multi-ancestry polygenic risk score improves risk prediction for coronary artery disease - Nature Medicine A polygenic risk score for coronary artery disease developed using data from individuals of five different ancestries has increased accuracy across diverse populations.

Later, after statistical analysis, Polygenic Risk Scores from the UK Biobank were tested against the Pooled Cohort Equation (ASCVD Score) and did even better at predicting CV events …

www.nature.com/articles/s41...

Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults: Implications for Primary Prevention

The original article for Polygenic Risk Scores in ASCVD

www.jacc.org/doi/10.1016/...

I bet the difference here is the duration (1 year post-mi) and the specific trials included (CLEAR) vs excluded (LoDoCo2 ??). It will be interesting to see what Dr Ridker says

Great share! Great lesson … if we listen

Cardiac Risk of NonCardiac Surgery: A Piece of My Mind A video from Kim Eagle (as part of MonteHeart Imaging & Clinical Lectures), posted on Aug 5, 2025.

The lesson: don’t do elective surgery on elderly patients with stroke and/or PAD history on the weekends and holidays. This doesn’t change anything that we know. The pre-op assessment refined by Dr Kim Eagle remains profound.

www.vumedi.com/video/cardia...

Great share!!

Managing HF Across the Spectrum: This interactive online course offers practical tools to assess risk, classify HF phenotypes, & apply GDMT through an interprofessional care lens. Learn how to tackle pivotal issues in #HFrEF, & more. 👇

🔖 https://bit.ly/3O8JvDp

#ACCEd #CardioSky #MedSky

Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease Context Although Chlamydia pneumoniae infection has been associated with the initiation and progression of atherosclerosis, results of clinical trials investigating antichlamydial antibiotics as adjun...

It is cholesterol and inflammation, not infection:

jamanetwork.com/journals/jam...

Antibiotics and Risk of Subsequent First-time Acute Myocardial Infarction Context Increasing evidence supports the hypothesis of a causal association between certain bacterial infections and increased risk of developing acute myocardial infarction. If such a causal associat...

Your framing is wrong. We investigated this back in the 1990’s: jamanetwork.com/journals/jam...

😉

Gift link?

Defining Success of Atrial Fibrillation Ablation: Burden Is the New Black

Somebody help me understand how A-Fib ablation “decreases mortality” when 35% of people with a “Sham procedure” felt better in the SHAM-PVI trial.

Explain it like I’m Five (ELI5).

#CardioSky

#WhyDoIHaveSoMany90YOWithPermanentAF

I agree that burden is endpoint tho

www.jacc.org/doi/10.1016/...

Biobeat - FDA Cleared Cuffless 24-hour Ambulatory Blood Pressure Monitoring The Biobeat monitoring platform measures vital signs in real-time using wireless, non-invasive, medical-grade technology.

Same!! That’s the low-hanging fruit.

We’re close! I’m sure you’ve seen this:

www.bio-beat.com

#CardioSky

EXERTION: Is Exercise SBP Associated With Increased CV Risk? - American College of Cardiology Exercise systolic blood pressure (SBP) relative to level of fitness was associated with an increased risk of cardiovascular events, according to results from the EXERTION study published Jan. 13 in EH...

Interesting 🤔

SBP/METPeak

#CardioSky

www.acc.org/Latest-in-Ca...

Similarly, if the patient is volume overloaded, they tend to do well (without further worsening of their hypotension) with low dose Entresto.

* ProTips for the residents and fellows.

Written by the master…

When Do Clinical Trials Expire?: Reflections on Beta-Blockers and the Half-Life of Evidence

Great EDITORIAL by @hmkyale.bsky.social

Interesting that I'm getting old enough to see this happen in my practice. WHEW!! :)

When Do Clinical Trials Expire?: Reflections on Beta-Blockers and the Half-Life of Evidence | JACC www.jacc.org/doi/10.1016/...

The World's Most Important Machine YouTube video by Veritasium

Y’all.

This has nothing to do with Cardiology … but everything to do with humanity … and how amazing humans are … and how we share information. Please get a coffee and watch. #CardioSky #MedSky We do things because they’re hard.

youtu.be/MiUHjLxm3V0?...

High-sensitivity cardiac troponin I and risk of dementia: the 25-year longitudinal Whitehall II study AbstractBackground and Aims. This study hypothesizes that subclinical myocardial injury during midlife, indexed by increases in cardiac troponin I, is asso

The REAL question here is “What’s causing subclinical Tpn ⬆️”

Answer: blood pressure (+/- subclinical atherosclerosis)

Heart-Brain Axis is easy if we pay attention to Trad Risk Factors + APOE4 gene

#CardioSky

academic.oup.com/eurheartj/ar...

It’s only hard because we make it hard. I sometimes make the statement “Surprisingly normal diastolic function parameters”. Should we always thoughtlessly follow the numbers on e’ and only use the new 2025 guidelines algorithm? I’d say no. Though … we’re better than the 2016 version 🤷‍♂️

a man and a woman sit on a bench in a park with a caption that says my momma always told me ALT: a man and a woman sit on a bench in a park with a caption that says my momma always told me

“They said it was a million-dollar wound, but the Army must keep that money, 'cause I still ain't seen a nickel of that million dollars.” – Forrest Gump

“My mama always told me that miracles happen every day. Some people don’t think so, but they do.” – Forrest Gump

📢 Inaugural #JACCStats Report Reveals State of US CV Health

From rising obesity & diabetes rates to stalled hypertension control & widening disparities, the 📊 tell a powerful story. Explore the full report & join #JACC in turning insights into impact. https://bit.ly/4btuPZa

#CardioSky #MedSky

Not making excuses but the number of post-graduate training spots hasn’t increased in the same period of time. Correlation or causation?
#CardioSky