David Winchester
@drdavemd.bsky.social
Cardiology & health services research. Posts do not reflect positions of my employers. K index 1.42.
Photon counting CT dramatically improves signal-to-noise ratios by directly measures x-ray photons, instead of indirect measurement of visible light photons as with traditional CT. www.jacc.org/doi/10.1016/... #YesCCT #cardiosky @jaccjournals.bsky.social
Photon-Counting Computed Tomography in Cardiac Imaging:
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www.jacc.org
November 12, 2025 at 7:40 PM
Photon counting CT dramatically improves signal-to-noise ratios by directly measures x-ray photons, instead of indirect measurement of visible light photons as with traditional CT. www.jacc.org/doi/10.1016/... #YesCCT #cardiosky @jaccjournals.bsky.social
CRISPR-Cas9 has been used in humans to reduce non-HDL cholesterol by ~50% (also reduced HDL by ~24%) www.nejm.org/doi/full/10.... #cardiosky
Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3 | NEJM
Angiopoietin-like protein 3 (ANGPTL3) inhibits lipoprotein and endothelial lipases. ANGPTL3 loss-of-function genetic variants are associated with decreased levels of low-density lipoprotein cholest...
www.nejm.org
November 12, 2025 at 1:51 PM
CRISPR-Cas9 has been used in humans to reduce non-HDL cholesterol by ~50% (also reduced HDL by ~24%) www.nejm.org/doi/full/10.... #cardiosky
Cardiac Rehab continues to be one of the least utilized Class 1 recommendations in all of Cardiology www.ahajournals.org/doi/10.1161/...
American Heart Association Journals
www.ahajournals.org
November 11, 2025 at 10:47 PM
Cardiac Rehab continues to be one of the least utilized Class 1 recommendations in all of Cardiology www.ahajournals.org/doi/10.1161/...
Thank you and welcome home to all who served, it is an honor to work for the Veterans Health Administration
November 11, 2025 at 10:39 PM
Thank you and welcome home to all who served, it is an honor to work for the Veterans Health Administration
Patients are people, so are doctors. Getting to know your doctor is associated with better patient satisfaction. www.ahajournals.org/doi/10.1161/... #cardiosky
Who Is That Cardiology Fellow? A Cluster Trial Examining the Impact of Cardiology Fellows' Biographical Information on Patient Perceptions of Patient‐Centered Care | Journal of the American Heart Asso...
www.ahajournals.org
November 10, 2025 at 4:45 PM
Patients are people, so are doctors. Getting to know your doctor is associated with better patient satisfaction. www.ahajournals.org/doi/10.1161/... #cardiosky
PCSK9i reduced MACE in primary prevention population, RRR 25%, ARR 1.8%, NNT~ 56. $239/mo on Goodrx. 4.5 yrs f/u X 12 months of tx X 56 ~ $722K to prevent one MACE. www.nejm.org/doi/full/10.... #cardiosky
Evolocumab in Patients without a Previous Myocardial Infarction or Stroke | NEJM
The proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor evolocumab reduces
the risk of major adverse cardiovascular events (MACE) among patients with a previous
myocardial infarction, s...
www.nejm.org
November 10, 2025 at 3:42 PM
PCSK9i reduced MACE in primary prevention population, RRR 25%, ARR 1.8%, NNT~ 56. $239/mo on Goodrx. 4.5 yrs f/u X 12 months of tx X 56 ~ $722K to prevent one MACE. www.nejm.org/doi/full/10.... #cardiosky
The DECAF trial, presented at AHA last week, showed that in patients with atrial fibrillation, random assignment to drinking 1 caffeinated coffee a day resulted in less AFib recurrence when compared to coffee abstinence. jamanetwork.com/journals/jam... @jama.com #cardiosky
Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation
This clinical trial compares the effect of caffeinated coffee consumption vs abstinence from coffee and caffeine on recurrent atrial fibrillation.
jamanetwork.com
November 10, 2025 at 2:09 PM
The DECAF trial, presented at AHA last week, showed that in patients with atrial fibrillation, random assignment to drinking 1 caffeinated coffee a day resulted in less AFib recurrence when compared to coffee abstinence. jamanetwork.com/journals/jam... @jama.com #cardiosky
Concise clinical guidance from @ACCinTouch on the assessment and management of cardiac amyloidosis @JACCJournals @MKIttlesonMD @PanjrathG www.jacc.org/doi/epdf/10.... #cardiosky
Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance
www.jacc.org
November 7, 2025 at 5:10 PM
Concise clinical guidance from @ACCinTouch on the assessment and management of cardiac amyloidosis @JACCJournals @MKIttlesonMD @PanjrathG www.jacc.org/doi/epdf/10.... #cardiosky
"In elderly patients with NSTEMI, routine invasive strategy does not improve primary outcomes of all-cause mortality or cardiac-related death but may reduce recurrent myocardial infarction and the need for urgent revascularization." www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
Routine Invasive vs Conservative Management of NSTEMI in Elderly Patients: Updated Meta-Analysis of Randomized Trials
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www.jacc.org
November 3, 2025 at 3:01 PM
"In elderly patients with NSTEMI, routine invasive strategy does not improve primary outcomes of all-cause mortality or cardiac-related death but may reduce recurrent myocardial infarction and the need for urgent revascularization." www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
A team from UWashington successfully removed a bullet from a patient's right ventricle, via a transfemoral approach, then closed the venotomy sire with Perclose 👀 www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
Percutaneous Removal of a Bullet From the Right Ventricle:
www.jacc.org
November 3, 2025 at 2:27 PM
A team from UWashington successfully removed a bullet from a patient's right ventricle, via a transfemoral approach, then closed the venotomy sire with Perclose 👀 www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
@accintouch.bsky.social Provides feedback to FTC on non-compete clauses, using data from the BOG paper on the topic www.acc.org/~/media/31EC... #cardiosky
www.acc.org
November 2, 2025 at 10:09 PM
@accintouch.bsky.social Provides feedback to FTC on non-compete clauses, using data from the BOG paper on the topic www.acc.org/~/media/31EC... #cardiosky
Physical activity improves just about everything, in latest HTN mgmt GL's, diet was #1 and exercise was #2 among 22 nonpharma strategies for BP lowering www.jacc.org/doi/10.1016/... www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College o...
www.jacc.org
October 29, 2025 at 1:53 PM
Physical activity improves just about everything, in latest HTN mgmt GL's, diet was #1 and exercise was #2 among 22 nonpharma strategies for BP lowering www.jacc.org/doi/10.1016/... www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
MedAxiom's Annual report on Cardiology productivity, compensation, and workforce is now available info.medaxiom.com/2025compsurvey @accintouch.bsky.social #cardiosky
2025 Comp Survey
Gain strategic insights for 2026 with our 2025 Cardiovascular Provider Compensation & Production Survey, designed exclusively for cardiology professionals.
info.medaxiom.com
October 28, 2025 at 4:36 PM
MedAxiom's Annual report on Cardiology productivity, compensation, and workforce is now available info.medaxiom.com/2025compsurvey @accintouch.bsky.social #cardiosky
Interesting review summarizing the psychological impact that ICDs can have on patients www.ajconline.org/article/S000... #cardiosky
The Psychological Impact of Implantable Cardioverter Defibrillators: A Narrative Review
Implantable cardioverter defibrillators (ICDs) are critical to the prevention of sudden
cardiac death caused by life-threatening arrhythmias such as ventricular tachycardia
and fibrillation. While the...
www.ajconline.org
October 27, 2025 at 7:58 PM
Interesting review summarizing the psychological impact that ICDs can have on patients www.ajconline.org/article/S000... #cardiosky
Care Innovations: Introducing the OUTPACE Framework for Health Care Quality Improvement www.ahajournals.org/doi/10.1161/... #cardiosky
Care Innovations: Introducing the OUTPACE Framework for Health Care Quality Improvement | Circulation: Cardiovascular Quality and Outcomes
Equitable, timely, and evidence-based care remains a central goal across health care
ecosystems, yet significant quality gaps, care variability, and health disparities
persist. Professional societies,...
www.ahajournals.org
October 22, 2025 at 2:44 PM
Care Innovations: Introducing the OUTPACE Framework for Health Care Quality Improvement www.ahajournals.org/doi/10.1161/... #cardiosky
When your patient dies, thoughtful reflections from @jaccjournals.bsky.social s editor @hmkyale.bsky.social www.jacc.org/doi/10.1016/...
When Your Patient Dies:
www.jacc.org
October 21, 2025 at 7:08 PM
When your patient dies, thoughtful reflections from @jaccjournals.bsky.social s editor @hmkyale.bsky.social www.jacc.org/doi/10.1016/...
19 million non-cardiac chest CT's done annually in the US, each one an opportunity to identify and treat occult CAD www.ahajournals.org/doi/10.1161/... #cardiosky
Opportunistic Detection of Coronary Artery Calcium on Noncardiac Chest Computed Tomography: An Emerging Tool for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Assoc...
Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis that confers
increased risk of atherosclerotic cardiovascular disease. Measured by noncontrast
cardiac computed tomography, CAC...
www.ahajournals.org
October 20, 2025 at 1:40 PM
19 million non-cardiac chest CT's done annually in the US, each one an opportunity to identify and treat occult CAD www.ahajournals.org/doi/10.1161/... #cardiosky
The PADME cohort explores the increasing burden of CVD complications in pregnancy #cardiosky www.ahajournals.org/doi/10.1161/...
a woman is crying with the words `` you 're breaking my heart '' written next to her .
ALT: a woman is crying with the words `` you 're breaking my heart '' written next to her .
media.tenor.com
October 14, 2025 at 3:03 PM
The PADME cohort explores the increasing burden of CVD complications in pregnancy #cardiosky www.ahajournals.org/doi/10.1161/...
A bold and exciting hypothesis in this issue of JACC from Dr. Milton Packer on how adipose tissue could be a good model for understanding HFpEF @jaccjournals.bsky.social www.jacc.org/doi/10.1016/... #cardiosky
The Adipokine Hypothesis of Heart Failure With a Preserved Ejection Fraction: A Novel Framework to Explain Pathogenesis and Guide Treatment
www.jacc.org
October 14, 2025 at 2:21 PM
A bold and exciting hypothesis in this issue of JACC from Dr. Milton Packer on how adipose tissue could be a good model for understanding HFpEF @jaccjournals.bsky.social www.jacc.org/doi/10.1016/... #cardiosky
"The CDSS did not reduce the number of inappropriate imaging requests ordered by physicians in academic hospital settings." @JAMA_current jamanetwork.com/journals/jam...
Evaluation of a Clinical Decision Support System for Imaging Requests
This cluster randomized clinical trial compares the effect of implementing a clinical decision support system on the appropriateness of medical imaging ordering behavior vs no clinical decision suppor...
jamanetwork.com
October 10, 2025 at 3:40 PM
"The CDSS did not reduce the number of inappropriate imaging requests ordered by physicians in academic hospital settings." @JAMA_current jamanetwork.com/journals/jam...
Thoughts from Dr. Harlan Krumholz on the ABCVM application to be an independent certifying board for cardiologists @accintouch.bsky.social @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
Rethinking Physician Certification: A Call for a Modern, Meaningful Standard
www.jacc.org
October 10, 2025 at 3:31 PM
Thoughts from Dr. Harlan Krumholz on the ABCVM application to be an independent certifying board for cardiologists @accintouch.bsky.social @jaccjournals.bsky.social www.jacc.org/doi/10.1016/...
Daily IVC US was not superior to clinical assessment for adjudicating congestion (based on BNP) in hospitalized pts with acute HF www.jacc.org/doi/10.1016/... #cardiosky
Inferior Vena Cava Ultrasound to Guide Decongestion in Acute Decompensated Heart Failure: A Randomized Controlled Trial
www.jacc.org
October 9, 2025 at 3:54 PM
Daily IVC US was not superior to clinical assessment for adjudicating congestion (based on BNP) in hospitalized pts with acute HF www.jacc.org/doi/10.1016/... #cardiosky
@accintouch.bsky.social and other orgs seek relief for physicians from H1B visa fees. The potential impact on health care delivery, especially in rural areas, is massive. cardiovascularbusiness.com/topics/healt...
Pushback against Trump's $100K visa fee continues with new lawsuit
As a new lawsuit targets the unpopular policy, the American College of Cardiology and other medical societies worry that $100,000 fees will make the ongoing physician shortage much worse.
cardiovascularbusiness.com
October 9, 2025 at 2:39 PM
@accintouch.bsky.social and other orgs seek relief for physicians from H1B visa fees. The potential impact on health care delivery, especially in rural areas, is massive. cardiovascularbusiness.com/topics/healt...
How does prior auth affect average patients and clinicians? tradeoffs.org/2025/09/25/a...
A Closer Look at a Widely Despised Health Insurance Policy
Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires a patient’s health insurer to sign off before chemotherapy, surgery or countless othe...
tradeoffs.org
October 9, 2025 at 2:32 PM
How does prior auth affect average patients and clinicians? tradeoffs.org/2025/09/25/a...
Scammers are developing AI voice models to imitate colleagues and loved ones and asking for money @planetmoney.bsky.social y www.npr.org/2025/10/08/n...
Two ways AI is changing the business of crime (Two Indicators) : Planet Money
Pre-order the Planet Money book here for your free gift. Our sister show, The Indicator, is chronicling the evolving business of crime for its Vice Week series. Today, we bring to you two cases of cri...
www.npr.org
October 9, 2025 at 2:09 PM
Scammers are developing AI voice models to imitate colleagues and loved ones and asking for money @planetmoney.bsky.social y www.npr.org/2025/10/08/n...