Haven't read it all the way and have many questions but for now I'll just say "si si I'm very intrigued" biorxiv.org/content/10.110…

I feel like even with all the trials, there's a high degree of belief in the power of revasc for angina in stable cad. Honest question... is it actually beneficial and where does that data come from? The only sham trial I know of is orbita 2.

I really gotta thank my residency mentors making me intentionally stage every HF patient. Trials and guidelines clearly stratify GDMT by stage based on availability of evidence - I don't think it's immediate four-pillar GDMT for everyone.

Lol love this story about probably my fave trial in cardiology

Lololol as far as I'm concerned watchman shouldn't even be an *option* #seewhatididthere

Interesting take on the bucindolol trial, which is probably one of more perplexing HF trials. But surely our modern data can test this hypothesis a bit? Are sicker (but not decompensated) HF patients doing worse w beta blockade? cardiologytrials.substack.com/p/review-of-th…

Now a question I need to read more about - why do we treat acute myocarditis with LV dysfunction/HF like chronic HF (e.g. w gdmt) and not like MI c/b LV dysfunction (where those medications by and large don't have as much benefit)?

Also today i got asked which attending inspired my hatred of dopamine and the answer is that Josh Farkas emcrit table that says "uses for dopamine: zombie apocalypse (can't get anything better)"

im forever reminded of Charlie Weiner's legendary "lactate, who gives a shit" talk

I mean, kinda applies for the whole field. I mean look, I obvi like sc-omics, but it's funny you have a tool where it feels like more papers have been written trying to make it useful than have been actually using it usefully

jamanetwork.com/journals/jamai… I'm always down for a good juicy hot take but what about woscops? Or fame 3? I'm guessing those are looped into the cited meta-analyses, but what is the criticism of those trials on their own?

I think anyone who has worked in an ICU has felt this. We ofc always fight to give everyone a chance, and especially so if their family wants it, but sometimes you really wonder about the value of what you're doing...

Reading replies, I see that so many ppl think sdm means "patient has to make entire decision" Funny enough, my plumber seemed to intuitively understand sdm - he'd lay out the options, hear out my questions, tell me what he'd do, and adjust based on my preferences.