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September 11, 2020
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News From Medscape
The following recommended articles on Medscape.com are freely available through the partnership between ABC and Medscape, no registration or login required.


Mini-Dose Edoxaban May Safely Cut AF Stroke Risk in the Frail, Very Elderly
An ultra-low dose of direct oral anticoagulant (DOAC) may safely cut the risk for stroke in very elderly patients with atrial fibrillation (AF) whose bleeding risk is considered too high for standard dosages, suggests a randomized trial conducted in Japan.
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First Randomized Trial Reassures on ACEIs, ARBs in COVID-19
The first randomized study to compare continuing vs stopping angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for patients with COVID-19 has shown no difference in key outcomes between the two approaches.
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Antihypertensive Treatment Beneficial at Normal BP Levels
Lowering blood pressure with antihypertensive medication reduces future cardiovascular events even in individuals with normal or only mildly elevated blood pressure, a new study suggests.
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DAPA-CKD: SGLT2 Inhibitor Benefit Extends to Chronic Kidney Disease Without Diabetes
Add patients with chronic kidney disease with or without diabetes to the growing list of people who get proven benefit from treatment with an SGLT2 inhibitor. In the DAPA-CKD trial, treatment with the sodium-glucose cotransporter-2 (SGLT2) inhibitor dapagliflozin (Farxiga, AstraZeneca) cut the incidence of substantially worsened chronic kidney disease (CKD) by an average of 39% compared with placebo when added to standard treatment, with a number needed to treat of 19 to prevent one primary outcome event after a median of 2.4 years.
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EMPEROR-Reduced: Empagliflozin's HFrEF Benefit Solidifies Class Effects
The SGLT2 inhibitor drug class solidified its role as a major, new treatment for patients who have heart failure with reduced ejection fraction and no diabetes, with results from a second large, controlled trial showing clear efficacy and safety in this population. Patients with heart failure with reduced ejection fraction (HFrEF) treated with the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin (Jardiance, Boehringer Ingelheim/Eli Lilly) had a statistically significant 25% relative cut in their incidence of cardiovascular death or heart failure hospitalization, compared with placebo controls, when added on top of standard HFrEF treatment.
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Aspirin Alone Preferred Antithrombotic Strategy After TAVI
Aspirin alone after transcatheter aortic valve implantation (TAVI) significantly reduced bleeding compared with aspirin plus clopidogrel, without increasing thromboembolic events, in the latest results from the POPular TAVI study.
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Make sure to register for ABC’s 2020 Dr. Jay Brown Best Abstract Competition. This year, the virtual competition will be webcast on September 19, 2020 at 12 PM EST. Watch four finalists - Drs. Oluremi Ajala, Courtney Bess, Mary Branch and Adebamike Oshunbade - present their original scientific research to compete for the top award. Winner will receive a $1,000 cash award. All healthcare professionals involved in the delivery of cardiovascular care are invited, with a particular emphasis on early career physicians interested in learning ways to enhance their professional standing.

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Items of Interest


Response to an MRNA Vaccine Against SARS-CoV-2 Preliminary Report
By Jayne Morgan, MD, David Cooke, MD, and Kpodonu Jacques, MD
Nearly 4 million people in the United States are known to have been infected with SARS-CoV-2. In the face of a new disease in dire need of proven treatments, every patient not offered enrollment in a well-designed, well-conducted study represents a missed opportunity to advance scientific knowledge, develop therapeutic strategies, and ultimately improve care for everyone. The demographics of the population enrolled must mirror the demographics of the population affected by the disease.
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Seeing the Water: Seven Values Targets for Anti-Racism Action
By Camara Phyllis Jones, MD, MPH, PhD
You know the old saying, “It’s hard for a fish to see the water in which it swims?” That’s true! And in the United States, we are all swimming through a polluted ocean. More of us are starting to see the icebergs and reefs that structure our watery landscape, in part because we are starting to understand that the wreckage that they cause is not “natural.” But we have been slower to see the water. And we need to see both, because it is the very murkiness of this water in which we swim that makes it hard for us to see the structures that harm and divide us. We swim in an ocean of racism.
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OpEd | Lisa Cooper: The silver lining of COVID-19's dark clouds
Many people were caught off guard as we witnessed rising inequities in the impact of COVID-19 on communities of color. Sadly, as a physician and public health researcher who has focused on addressing inequities in health for nearly three decades, these disparities came as no surprise to me. For my team at the Johns Hopkins Center for Health Equity, the pandemic was simply shining a magnifying glass on structural racism as a public health issue. (This op-ed by Lisa A. Cooper, MD, was published in the National Urban League’s 2020 State of Black America report.)
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Bias in allocation of HF therapies low, but clinicians appear to judge women more harshly
In a survey of cardiac clinicians, researchers found that neither sex nor race of a patient predicted allocation of HF therapies, although bias was observed in the form of harsher judgment of women overall, particularly for Black women. (See the featured member section to learn more about this study, “Association of Gender and Race With Allocation of Advanced Heart Failure Therapies,” co-authored by Khadijah Breathett, MD and Sade Solola, MD)
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Perspective by Alanna Morris, MD
The study approach is innovative and addresses a critically important question within advanced HF — is practitioner bias among the reasons why women are less likely to get advanced HF therapies? When you look at the data, the number of patients who get listed for heart transplantation has been growing rapidly over the past decade, however the proportion of women candidates during that time period has been stagnant around 25%. That number seems low compared with the number of women with prevalent HF, and compared with epidemiologic data that suggest women are more likely to die of HF than men. So we really need more innovative studies like this one to understand the different factors that are driving those disparities.
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September is PAD Awareness
During September, members of the vascular care community including physicians, clinicians and patient advocates are encouraged to use tools from the Cardiovascular Coalition’s dedicated awareness page to spread the word about PAD Awareness Month among colleagues, patients and friends. You can help increase understanding of this vascular disease to improve the health of many Americans.

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Featured Articles by Members
ABC Members: We welcome your published research submissions and articles for inclusion in future issues of Clinical Updates and Insights. Email Rachel Williams at rwilliams@abcardio.org and please attach file or include links to the original published work and/or abstract.


Cardio-Oncology Preventive Care: Racial and Ethnic Disparities
Co-authored by Mary Branch, Daniel Addison and Sherry-Ann Brown (with Pooja Prasad, Daniel Asemota, & Razan Elsayed)
As cancer screening and treatment continue to improve, the number of cancer survivors is growing rapidly. Cardiovascular disease is the leading cause of death in cancer survivors. In this review, we explore racial and ethnic disparities in cardiovascular toxicity from cancer therapies, with a particular focus on prevention. In addition, we propose potential solutions to address these disparities.
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Cardio-Oncology Preventive Care: Racial and Ethnic Disparities
CLICK through Dr. Brown’s TWEETORIAL for highlights on the above published paper.

Understanding the Complexity of Heart Failure Risk and Treatment in Black Patients
Co-authored by Alanna A. Morris (Aditi Nayak, and Albert J. Hicks)
While the relative rate of HF hospitalization has improved for other race/ethnic minorities, the disparity in HF hospitalization between Black and White patients has not decreased during the last decade. Although access to care and socioeconomic status have been traditional explanations for the observed racial disparities in HF outcomes, contemporary data suggest that novel factors including genetic susceptibility as well as social determinants of health and implicit bias may play a larger role in health outcomes than previously appreciated. The purpose of this review is to describe the complex interplay of factors that influence racial disparities in HF incidence, prevalence, and disease severity, with a highlight on evolving knowledge that will impact the clinical care and address future research needs to improve HF disparities in Blacks.
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Association of Gender and Race With Allocation of Advanced Heart Failure Therapies
Co-authored by Khadijah Breathett, MD, MS and Sade Solola, MD (with Erika Yee, BS; Natalie Pool, PhD, RN; Megan Hebdon, PhD, DNP, RN; Janice D. Crist, PhD, RN; Ryan H. Yee, BS; Shannon M. Knapp, PhD; et al)
Racial bias is associated with the allocation of advanced heart failure therapies, heart transplants, and ventricular assist devices. It is unknown whether gender and racial biases are associated with the allocation of advanced therapies among women. To determine whether the intersection of patient gender and race is associated with the decision-making of clinicians during the allocation of advanced heart failure therapies. The objective of this study was to" to this last sentence: To determine whether the intersection of patient gender and race is associated with the decision-making of clinicians during the allocation of advanced heart failure therapies.
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The Cardiac Intensive Care Unit And the Cardiac Intensivist During the COVID-19 Surge in New York City
Co-authored by lead author D. Edmund Anstey MD MPH, senior author Marwah Abdalla MD MPH and Raymond Givens MD PHD (with Kevin Clerkin MD MSc, Justin Fried MD, Nellie Kalcheva MD, et al.)
Critical care cardiology has been impacted by the coronavirus disease-2019 (COVID-19) pandemic. COVID-19 causes severe acute respiratory distress syndrome, acute kidney injury, as well as several cardiovascular complications including myocarditis, venous thromboembolic disease, cardiogenic shock, and cardiac arrest. The cardiac intensive care unit is rapidly evolving as the need for critical care beds increases. Herein, we describe the changes to the cardiac intensive care unit and the evolving role of critical care cardiologists and other clinicians in the care of these complex patients affected by the COVID-19 pandemic. These include practical recommendations regarding structural and organizational changes to facilitate care of patients with COVID-19; staffing and personnel changes; and health and safety of personnel. We draw upon our own experiences at NewYork-Presbyterian Columbia University Irving Medical Center to offer insights into the unique challenges facing critical care clinicians and provide recommendations of how to address these challenges during this unprecedented time.
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We LOVE to LEARN how our ABC Members are making a difference! Please Share. Giving a keynote speech? Presenting at a Grand Round? Receiving an Award? Interviewed by the Press? Published in a journal? Presenter or Panelist at a Conference? Graduating? Email Rachel Williams at rwilliams@abcardio.org or please tag or DM us on Facebook, Twitter or Instagram with links/details, so we can spotlight your excellence in our newsletter!


Announcements

Demilade Adedinsewo, MB ChB, MPH
@demi_eni

Graduates from a general cardiology fellowship at the Mayo Clinic in Jacksonville, Florida.

Dr. Adedinsewo will continue at the same institution as a staff member.

Karol Watson, MD, Honored in 100
Trailblazing Women of UCLA Health Tribute

Congratulations to Dr. Karol Watson for being named one of UCLA Health’s “100 in 100” women trailblazers in celebration of Women’s Equality Day and in honor of the 100th anniversary of the passage of the 19th Amendment to the U.S. Constitution, establishing women’s right to vote.

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ACC 2021 Distinguished Awards Program
Help us recognize your peers

Those who drive the transformation of cardiovascular care lead by example in their actions at work and in life. These outstanding individuals come from a diversity of thought, experience and perspective and our teachers, mentors, and colleagues.

Each year, the ACC acknowledges these standout individuals with the Distinguished Awards, honoring them for their service in teaching, mentorship, innovation, science, and lifetime achievements. Help us recognize your peers by nominating them for an award that speaks to their accomplishments in the cardiovascular community.

The 2021 Distinguished Award winners will be formally recognized at the 70th Annual Convocation Ceremony at ACC.21. Visit ACC.org/DistinguishedAwards to learn more about the different awards the ACC offers. Nominations are due September 23, 2020.

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Florida A&M Student Conducting Research
on ACES/Trauma and Black Women's Heart Disease Risk
Requests Your Support

Windy Cunningham, a Florida A&M University Public Health doctoral student, is conducting a community research project, entitled Our Heart Study, on the impact of stress on Black Women’s health. Ms. Cunningham is seeking help with the virtual recruitment of 400 Black women in the Stroke Belt. Women who identify as Black and live in North Carolina, Georgia, Alabama and North Florida are eligible to complete the online questionnaire. This is an unfunded study so participants will not be paid; however, they can enter into a raffle to win one of two $50 gift cards. Please help bring awareness of and participation in the Our Heart Study by doing any or all of the following:
  • If eligible, review the information and take the Our Heart Study online questionnaire and let others know that you did;
  • Encourage Black women to review the study information on the Our Heart Study site and if they agree, complete the online questionnaire;
  • Forward the flyer and information letter to your friends, family and colleagues;
  • Visit the study website and share it with others
  • Like the Our Heart Study Facebook page
  • Share the study information on your social media pages explaining that the online questionnaire is important, confidential and simple to complete
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Share These New Public Service
Announcements from Million Hearts®

At least one in five expected emergency department visits for heart attack or stroke did not occur during the initial months of the COVID-19 pandemic, according to the CDC. CDC Million Hearts and CDC Foundation have worked with key partners to produce two, CDC-approved short (30-second), animated public service announcements (PSAs) to spotlight the importance of heart health during COVID-19 and to encourage individuals to seek emergency care for heart attacks or strokes. Please use, disseminate, and post these two PSAs to help promote and protect heart health during and beyond the COVID-19 pandemic. Click the following to access the “Emergency Care for Heart Disease During COVID-19” PSA and the “Maintaining Heart Health During COVID-19” PSA.

Additionally, download a Partner Activation Toolkit as a PDF for sample social media posts, digital communications copy and messaging to support dissemination.


Upcoming Events




Health Equity: Racial Disparities in Healthcare
Monday, September 14, 2020
What are some of the challenges to addressing disparities in care? How has Covid-19 amplified the need for addressing these disparities of care? What can we do to address racial disparities in healthcare? MedtechWomen is excited to hold space, in collaboration with our sponsor Robins Kaplan, LLP, for an honest, dynamic and timely conversation.

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The Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS) will host a virtual symposium, Advancing the Response to COVID-19: Sharing Promising Programs and Practices for Racial and Ethnic Minority Communities, on Thursday, September 17, 2020 at 12:00 pm ET to highlight local, state, tribal, and territorial responses to COVID-19 in racial and ethnic minority communities.

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The 2020 PCORI Virtual Annual Meeting - Accelerating Impact on Care and Patient-Centered Outcomes - will be held on September 16 and 17. Dr. Lisa Cooper and Liz Salmi will be the keynote speakers. PCORI Executive Director Dr. Nakela Cook will open the free 2-day event. The meeting’s agenda will include plenary and breakout sessions, featuring such topics as Health and healthcare disparities and inequities, Maternal health, Child and adolescent health, Disabilities and Telehealth.

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ABC - NBNA JOINT SESSIONS

Join ABC and the National Black Nurses Association (NBNA) for two joint online symposiums in conjunction with the NBNA's virtual 48th Annual Institute and Conference. The "2020 Highlights in Cardiac Amyloidosis: Impact of the COVID-19 Pandemic" will be held on Thursday, September 24, 2020 at 1 PM EST. The second webinar, "Advances in Access: New and Emerging Therapies in the Age of COVID-19," will start at 12 PM EST on Saturday, September 26.

RELEASE THE PRESSURE NEW ORLEANS

Join the New Orleans’ American Heart Association and American Medical Association for an intimate real talk on the impact of mental health during COVID-19 and its effect on heart health on September 24, 2020 at 4 PM CT.

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26th Annual Scientific Session and Expo
of the American Society of Nuclear Cardiology


The virtual ABC-ASNC Joint session, “Diversity and Inclusion in Clinical Nuclear Cardiology - A Case-Based Ethics Session" is scheduled for September 25, 2020, 2:00 PM - 3:00 PM EST. The session will be moderated by Ola Akinboboye, MD, FASNC and includes presentations and panel discussion from Kevin M. Alexander, MD, Brian C. Clark, MD, Anne L. Taylor, MD, Kim A. Williams Sr., MD, MASNC, and Renee Bullock-Palmer, MD, FASNC. ASNC2020: A NEW Virtual Meeting and Exhibition has been changed from an in-person gathering into a 12-month virtual experience (beginning September 9, 2020). The main program will take place virtually on September 25 and 26.

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Don’t Miss the Virtual HFSA 2020 Annual Scientific Meeting on opening day featuring a joint session with ABC on racial disparities, Beyond Socioeconomic & Access to Care: The Clinical Imperative for Understanding Racial Heart Failure Differences and Disparities,” on September 30, 2020 at 7:15 PM.

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2nd Annual Women's Heart and Vascular Symposium
From Prevention to Intervention
Saturday, November 21, 2020

A review of the most current evidence-based guidelines for the prevention of heart disease in women with a focus on the management of diseases as catered to the unique pathophysiology of women, will provide medical practitioners with a clear understanding of the best practice to ensure women are not just treated as “little men.” This full day virtual symposium is for all healthcare clinicians caring for women today and will focus on the continuum of care from prevention to early diagnosis and treatment strategies for heart disease in women. Rachel M Bond, MD, is the Course Director. Keynote Speaker will be Roxana Mehran, MD and faculty members include Keith C. Ferdinand, MD, Elizabeth Ofili, MD, MPH, and Sheila Sahni, MD.

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Amazon has proudly partnered with the Association of Black Cardiologists (ABC) through its AmazonSmile program. If you select ABC as your designated charity while shopping on Amazon.com, the AmazonSmile Foundation donates a portion of every purchase to ABC.

When you shop at smile.amazon.com, you'll support ABC too!

Click here to support ABC through your purchases on Amazon or AmazonPrime!







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