Internal Medicine. Cardiology. Lipidology. Multimodality Cardiac Imaging and structural heart disease. Clinical and diagnostic reasoning enthusiast.
New York, NY
Joined February 2022
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Marwan retweeted
#COURAGE at 25 years #ScientificSessions26 #AHA26
🫀 Does elective PCI in stable CAD simply need longer follow-up to demonstrate a prognostic benefit?
Extended COURAGE follow-up challenges that hypothesis.
In 959 randomized veterans followed for a median of 15 years, with observation extending to 25 years, upfront PCI + optimal medical therapy (OMT) showed no significant reduction versus OMT alone in:
▪️ Death or MI
▪️ All-cause death
▪️ MI
🔬 This is a comparison of INITIAL MANAGEMENT STRATEGIES. Subsequent revascularization in the OMT arm was part of a medical-first approach;
Limitations:
• Post hoc extended follow-up in a selected, approximately 98% male veteran cohort.
• Predominantly bare-metal stent–era PCI.
#COURAGE #StableCAD #PCI #Cardiology
LINK: jamanetwork.com/journals/jam…
Is it really non-inferior?
Presented at #ScientificSessions26:
In older adults with at least two chronic conditions and no known atherosclerotic cardiovascular disease, statin discontinuation was noninferior to continuation for a composite of myocardial infarction, stroke, or death at 2 years. Full STREAM trial results: nej.md/47U1X9N
@AHAScience
ALT A graph from the Original Article "Discontinuing Statins in Older Adults without Cardiovascular Disease." The trial name, STREAM, is in parentheses after the title. The graph shows estimated cumulative incidence of primary-outcome events. The trial results are being presented at the American Heart Association Scientific Sessions 2026. The logo of the New England Journal of Medicine is at the bottom.
Marwan retweeted
For patients with #CoronaryArteryDisease, long-term follow-up from the COURAGE trial indicates that an initial strategy of #PercutaneousCoronaryIntervention vs optimal medical therapy did not change long-term risk of death or myocardial infarction. The study had a median follow-up of 15 years, and up to 25 years. These findings do not support #PCI as an initial management strategy for stable disease. #ScientificSessions26 @nmbutala
📌 Learn more: ja.ma/4elSuvo
Marwan retweeted
Proud to have performed the first-in-USA case with the Paraclose (@AbbottNews) PVL occluder @HMHNewJersey. A purpose-built device after years of off-label options is a big step for our patients.
Case details below with @ryankaple, @PWengrofskyMD
#StructuralHeart #PVL #CardioTwitter
Marwan retweeted
Infective endocarditis isn't always about the valve itself, especially in prosthetic valves! 🫀👀
Some striking echo images of infective endocarditis reminding us to look beyond the leaflets!
#EchoFirst #CardiacImaging #Endocarditis
Marwan retweeted
Today was the worst market decline since the last one you don’t remember or care about anymore.
Marwan retweeted
Israel is beginning to lose its grip on American politics and I'm totally here for it!
Marwan retweeted
Elon Musk and Joe Rogan moved to Texas to escape liberal California and inadvertently turned Texas blue for the first time in 30 years 😂
Marwan retweeted
You fucked around with the wrong Patriots, @POTUS.
Today you found out.
Payback is a BITCH, motherfucker.
Enjoy your legacy.
Marwan retweeted
Dear @SpeakerJohnson
Goodbye you miserable evil POS.
You are a disgrace to God and used your power in my personal opinion for pure evil purposes.
Marwan retweeted
Ossoff: "In sweeping and decisive victories, the American people have rebuked the depravity, corruption, and incompetence of the failed lame duck president, Donald J Trump"
