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Why is improved plaque identification important?
1. Most stress tests are normal!
2. Most events occur in pts with normal function studies
3. Plaque burden predicts risk, better than stenosis
Dr. B. Weber #RNL2024 @RheumNow https://t.co/Qs19qIYj5v
Dr. Rachel Tate uptoTate ( View Tweet)
ICYMI: new guidelines published in 2019 for CV prevention. It's important to assess CV risk in our patients because inflammatory diseases is now included as a risk factor (helps when deciding on starting pts on JAKi)- Dr. B Weber #RNL2024 @RheumNow https://t.co/nBQjs49avu https://t.co/apyDjaxudi
TheDaoIndex KDAO2011 ( View Tweet)
ICYMI: new guidelines published in 2019 for CV prevention. It's important to assess CV risk in our patients because inflammatory diseases is now included as a risk factor (helps when deciding on starting pts on JAKi)- Dr. B Weber #RNL2024 @RheumNow https://t.co/nBQjs49avu https://t.co/apyDjaxudi
TheDaoIndex KDAO2011 ( View Tweet)
Primary ASCVD Prevention Guidelines for your reference from Dr. B. Weber. #RNL2024 @RheumNow https://t.co/erxIgeeLNU
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. B. Weber's review of the 2019 ASCVD risk factors which now includes inflammatory diseases (RA, HIV, PsO).
She believes this will help us to better understand and grow our knowledge around patient risk. @RheumNow #RNL2024 https://t.co/9bV7VfExNf
Dr. Rachel Tate uptoTate ( View Tweet)
Nuclear imaging assesses cardiac function, anatomy & microvascular dysfunction (MD). MD is underrecognized but can be measured by coronary flow reserve. MD is associated with worse longterm outcomes in systemic inflammatory disease – Dr. Weber #RNL2024 @rheumnow https://t.co/Bv22UKi6mM
TheDaoIndex KDAO2011 ( View Tweet)
Coronary Microvascular Dysfunction is associated with poor prognosis/outcomes in our systemic inflammatory disease patients.
What is the gold standard for evaluating microvascular dysfunction?
Coronary Flow Reserve (CRF)
This is only one component to fully understand and assess… https://t.co/bMV5npkFwm https://t.co/ZYBXpQLPIF
Dr. Rachel Tate uptoTate ( View Tweet)
Coronary Microvascular Dysfunction is associated with poor prognosis/outcomes in our systemic inflammatory disease patients.
What is the gold standard for evaluating microvascular dysfunction?
Coronary Flow Reserve (CRF)
This is only one component to fully understand and assess… https://t.co/bMV5npkFwm https://t.co/ZYBXpQLPIF
Dr. Rachel Tate uptoTate ( View Tweet)
Link between inflammation and cardiovascular disease, increased 1.5x in RA and 2-3 in PsA, treating inflammation is important to reduce CV risk, Brittany Weber #RNL2024 @RheumNow https://t.co/FCrOxa3drZ
Dr. Antoni Chan synovialjoints ( View Tweet)
Dr. B Weber gave a wonderful review of inflammation and cardiac risk in SLE, PsO/PsA, and RA.
*SLE pts has a 50-fold increased risk of MI
*RA pts are a 1.5x risk of CVD
*PsO and PsA pts are also at increased risk for CVD
#RNL2024 @RheumNow https://t.co/Hy4TmLzhzO
Dr. Rachel Tate uptoTate ( View Tweet)
"The link between RA and CVD is the shared inflammatory pathways involving IL-1, IL-6 and TNF" -Dr. B Weber #RNL2024 @rheumnow https://t.co/aGPA8ZFNHj
TheDaoIndex KDAO2011 ( View Tweet)
CV disease risk is increased in patients with inflammatory rheumatic diseases. More data emerging in SLE, psoriasis, RA. – Dr. B Weber #RNL2024 @rheumnow https://t.co/wF9izGZug3
TheDaoIndex KDAO2011 ( View Tweet)
#RNL2024 @RheumNow
Weber:
Asymptomatic Lupus has higher rate of atherosclerosis at all age grps
35-44 yo F with SLE: 50X increased risk of MI compared to healthy pts in Framingham
RA pts at 1.5x risk of CVD https://t.co/TJ5dLXwvNc
Eric Dein ericdeinmd ( View Tweet)
#RNL2024 @RheumNow
Brittany Weber on Cardio-Rheumatology:
"Everything has changed" on inflammation and CVD
- Canakinumab 150 mg v PBO HR 0.85, p =0.02
- Colchicine v PBO HR 0.69, P<0.001
2023: FDA approval for colchicine as 1st anti-inflammatory for reducing CV events https://t.co/Tlv5Np2BHf
Eric Dein ericdeinmd ( View Tweet)
Check out some of the "newer" modalities available to us for evaluation of our rheumatology patients to better understand their cardiac risk. "Everything has changed in cardiac rheumatology." Dr. B. Weber #RNL2024 @RheumNow https://t.co/fki73W4Fk8
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. B Weber discusses new CV Imaging Tools beyond the exercise EKG and ECHO to assess our rheum patients who are at higher risk for CV disease: coronary CT, Stress CMR, stress PET #RNL2024 @RheumNow https://t.co/DAuUptHMuF
TheDaoIndex KDAO2011 ( View Tweet)
Dr. Brittany Weber showcases the diverse manifestations that we can see in rheumatology and the increasing complexity and use of imaging in field. #RNL2024 @RheumNow https://t.co/0dOJdPazXL
Dr. Rachel Tate uptoTate ( View Tweet)
Dead Words Eulogy
The trouble with rheumatology may be the words we live by. Welcome to the eulogy for rheumatology 'dead words'. We're here today to celebrate the loss of rheumatology past. These are dead words in rheumatology, words fortified unfortunately by history and habit. The lexicon of rheumatology is unique, it's challenging and it's mostly incomprehensible to those who don't know...but those are the cornerstones of the greatest of medical subspecialties.
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Anti-Drug Antibodies and Biologic Drug Responses
A prospective cohort study suggests the presence of antidrug antibodies may be associated with bDMARDs nonresponse in rheumatoid arthritis (RA). Should we be monitoring ADAbs (especially in nonresponders)?
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Study of 235 newly Dx #RA patients (157 females) found that 11 pts (5%) had carpal tunnel syndrom (CTS) at the time of initial RA diagnosis. Such pts were more likey to be older, female, CCP negative and have a longer Sx duration. https://t.co/0CfF0lKBgk https://t.co/tx9CvQ4TWX
Dr. John Cush RheumNow ( View Tweet)