In pts with severe single-vessel CAD: • Angina burden ≠ FFR/iFR • ↑ Ischemia → ↑ Collateral flow • ↑ Collaterals → ↓ Ischemic pain 🫀 Collaterals may explain why stenosis, ischemia & symptoms don’t always align. #TCT2025 #CardioTwitter

Ever wondered why some pts feel every balloon inflation, while others feel nothing? 💭 Or why severe ischemia can be asymptomatic? Our placebo-controlled, n-of-1 study — simultaneous in #Circulation & #TCT2025 — shows collateralization may be key. 🔗 https://t.co/uyAw3gXAx3

Had a great time at #ECAS2025 as the only interventionalist at an EP conference! Fantastic to see a full session on the placebo effect in cardiology. Thanks to the organizers for the invite @ECAS_Heart . Now to #EuroPCR @PCRonline

#EuroPCR 2025 PCR’s Got TALENT 1️⃣ 3 min / 3 slides 2️⃣ 5 min / 5 slides 3️⃣ 8 min / 8 slides 🫵 Support & VOTE ! Previous WINNERS include superstars 🌟Dr Ziad Ali 🌟Dr Dejan Milasinovic 🌟Dr Tom Ford 🌟Dr Christopher Rajkumar 📌 Starts today 12:00, Rm 252A

𝐃𝐒𝐄 𝐝𝐞𝐥𝐢𝐯𝐞𝐫𝐬 𝐢𝐧 𝐎𝐑𝐁𝐈𝐓𝐀-𝟐: Stress echo ischemia identifies who 𝘳𝘦𝘢𝘭𝘭𝘺 benefits from PCI. 📖 𝐉𝐮𝐬𝐭 𝐩𝐮𝐛𝐥𝐢𝐬𝐡𝐞𝐝 𝐢𝐧 #𝐉𝐀𝐂𝐂: https://t.co/SoNkeJ0zVW @rallamee @mshunshin @rajkumar_chris @MikeFoley89 @FloSimader @ShaynaChotai

Tons of high-value case-based presentations covering CAD arrhythmia HF shock and more. Come join! @benhibbertMDPhD @stanhenkin @aelsab @RowseMD @DrDeese99 @claireraph @rajkumar_chris @MayoCVFellows

Great morning at @RCPhysicians talking about preventive Cardiology on the @BritishCardioSo @MayoClinicCV Cardiology Review Course Lots of old friends and great questions! @rajivxgulati @rajkumar_chris @ShouvikHaldar Sudhir Rathore, Louise Buchanan and Malcolm Bell #crc2025

Are the Appropriate Use Criteria (AUC) for revascularization still aligned with the latest evidence? New insights from ISCHEMIA challenge key assumptions. My two cents in @CircOutcomes It’s time to rethink outdated priorities. https://t.co/ff7N2FGzU7

Join us at our Cardiology Review Course with @MayoClinic from Monday 10 - Friday 14 March at @RCPhysicians >> https://t.co/4vObpOFwVy. This five-day course is in its 17th year and provides a comprehensive opportunity to update your knowledge through lectures and interactive

I think so, what else explains an initial high event rate which then subsides (aortic stenosis doesn’t get better!)? Great if you can manage the first 6 months of subtraction anxiety - event rate then tracks the TAVR arm. Psychology so important in clinical trials. @drjohnm

Should PCI be an option for first line management of stable angina symptoms? Point and counterpoint in @CircOutcomes with final word from @bnallamo and @TCTMD https://t.co/501Y7HHgKB @rallamee

Check out our journal club with @OPCILive on ORBITA-STAR and the symptom stratified analysis of ORBITA-2 @rallamee @FloSimader @ImperialNHLI

Excellent discussion of ORBITA-STAR by @michaeltct Simple findings like those made in this study pave the way to solve a major clinical problem. In stable patients, persistent angina is PCI’s Achilles’ heel @TCTMD @PCRonline @rallamee

Thanks to @JACCJournals and @PCRonline for showcasing, and the patients who made ORBITA-STAR possible! Hopefully a step toward more targeted treatment.

ORBITA-STAR at #EuroPCR is a fascinating & successful study of type of chest pain as a predictor of PCI success. Very difficult to ascertain if angina caused by ischemia is what patients felt. This was a concern of Gruentzig's 40 yrs ago! @rajkumar_chris @rallamee #AngioHistory

Always a privilege to work with incredible statisticians (and cardiologists) @f2harrell and @mshunshin. This time for ORBITA-STAR. @ImperialNHLI @ImperialNHS @JACCJournals

In ORBITA-STAR, angina verification with an ischaemic stimulus powerfully predicted response to PCI. #EuroPCR2024 Perhaps we have been too focused on treatment when the problem always lay in the diagnosis! Published today in #JACC https://t.co/1Yj9mJ6MxS @rallamee

Q: Does blinding matter in RCTs of surgical procedures? A: Depends on the endpoint @JAMASurgery We compared placebo-controlled and open-label surgical trials to identify when the placebo effect is most powerful @rallamee @KatieEljadi @ImperialNHLI https://t.co/CWdvfyQaJ0

Amazing to see a brilliant friend and colleague @MikeFoley89 present the #ORBITA-COSMIC trial of the coronary sinus reducer with simultaneous publication in @TheLancet @rallamee @ImperialNHLI @ImperialNHS #ACC2024 https://t.co/zzFSIYlhbz