EP 103: CCS-AMI: New Classification for Acute Myocardial Infarction with Dr Kumar
On October 28th, 2023, the Canadian Cardiovascular Society (CCS) released a new classification system for acute atherothrombotic myocardial infarction (MI) based on stages of tissue injury severity (CCS-AMI). This expert consensus is the result of decades of data on acute MI with reperfusion therapy.
Dr Ankur Kalra is joined this week on Parallax by Dr Andreas Kumar, Chairperson of the Writing Group of the Expert Consensus Statement, Associate Professor of Medicine at the Northern Ontario School of Medicine, Cardiologist at Health Sciences North, and President of the Canadian Society of Cardiovascular MRI.
In this informative episode, Dr Kumar shares what led his team and the CCS to introduce a new classification scheme for acute MI. He discusses how research from the past 15 years highlighted the need to incorporate tissue changes resulting from acute myocardial infarction (MI) into clinical practice. Dr Kumar outlines the four stages of CCS-AMI, and we gain insight into how this novel classification scheme could impact bedside medicine.
Dr Kalra asks about treatment optimization based on stages of tissue injury severity. Dr Kumar delves into the risks associated with the four stages, with a particular focus on CCS Stage 4, MI with reperfusion haemorrhage. Finally, Dr Kumar highlights how the use of the classification system can lay the foundation for future research studies and bring us closer to finding answers and identifying agents suitable for different stages of acute MI.
What are the key messages from CCS-AMI? What are the data behind the new scheme? How might the new classification scheme impact the development of new treatment options?
Resources:
Kumar A, et al. The Canadian Cardiovascular Society Classification of Acute Atherothrombotic Myocardial Infarction Based on Stages of Tissue Injury Severity: An Expert Consensus Statement. CJC 2023. https://doi.org/10.1016/j.cjca.2023.09.020
Gaba P & Bhatt DL. Promise of a Novel Classification System for Acute Myocardial Infarction. CJC 202. https://doi.org/10.1016/j.cjca.2023.10.011
Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode.
Guest: @AndreasKumarMD Host: @AnkurKalraMD and produced by: @RadcliffeCARDIO.
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In this thought-provoking episode, Dr Ankur Kalra is joined by Dr Anuradha Lala. They delve into the critical topic of disparities in care within the healthcare system from a cardiologist's point of view and explore actionable steps towards a more inclusive and fair healthcare landscape.
This series is supported by ZOLL and is intended for Health Care Professionals.
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This series is supported by ZOLL and is intended for Health Care Professionals.
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This week’s guest, Prof Roxana Mehran, Professor of Medicine at Mount Sinai and Founding Director of Women as One, is a phenomenon in interventional cardiology. Her pioneering work as clinician, trialist and advocate is well known within the community. In this episode, we learn what makes Roxana tick and what were the odds she had to defy as an immigrant from Iran to fulfil her ‘impossible dream’.
The charity organisation, Women as One is an agent for women and men to be part of medicine that is built on talent, rather than a privilege. Roxana and Ankur discuss the role of mentorship and family-friendly work environment in mending the broken house of cardiology. Roxana talks about the practical tools that are available for women to take the next steps in their career and achieve their goals.
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The charity organisation, Women as One is an agent for women and men to be part of medicine that is built on talent, rather than a privilege. Roxana and Ankur discuss the role of mentorship and family-friendly work environment in mending the broken house of cardiology. Roxana talks about the practical tools that are available for women to take the next steps in their career and achieve their goals.
This week’s guest is Dr Laura Mauri who became Vice President of Global Clinical Research and Analytics at Medtronic in 2018 after an illustrious career in academic medicine at Brigham and Women’s Hospital and Harvard Medical School.
Dr Kalra asks Dr Mauri about early influences and her traineeship with legendary interventionalists, the late Donald Baim and Richard Kuntz. Dr Mauri talks openly about her decision-making process and the importance of selecting your priorities and committing to them. Ankur asks Laura about her decision to go into industry. Laura shares her thoughts on medical innovations and meeting urgent needs with unique perspectives.
What is Dr Mauri’s advice for a young cardiologist? How did she balance research and patient care? What are the questions that helped her decision making? How does Dr Mauri think about innovations in medicine?
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Dr Kalra asks Dr Mauri about early influences and her traineeship with legendary interventionalists, the late Donald Baim and Richard Kuntz. Dr Mauri talks openly about her decision-making process and the importance of selecting your priorities and committing to them. Ankur asks Laura about her decision to go into industry. Laura shares her thoughts on medical innovations and meeting urgent needs with unique perspectives.
What is Dr Mauri’s advice for a young cardiologist? How did she balance research and patient care? What are the questions that helped her decision making? How does Dr Mauri think about innovations in medicine?
In the early days of the Black Lives Matter movement, a group of internal medicine residents posed a question: What can we do about racial disparity within our institution?
Brigham and Women’s Hospital’s Health Equity Committee decided to confront the status quo by asking: How is racism on a structural level present within our walls?
Ankur Kalra’s guests Michelle Morse (Founding Co-Director of EqualHealth and Assistant Professor at Harvard Medical School) and Lauren Eberly (Cardiology Fellow at the University of Pennsylvania) are co-authors of a retrospective study that demonstrated what had previously only been observed: That black or brown heart failure patients ended up in general medicine rather than specialised cardiology services. Following the publication of the study in November 2019, the Health Equity Committee started to roll out anti-racism trainings and to work on objective admission guidelines to mitigate biased behaviours.
Aarti Bhatt (Assistant Professor of Medicine at the University of Minnesota), member of the Minnesota chapter of Campaign Against Racism, talks about their initiative to support projects that have a positive impact on local communities on a global scale.
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Brigham and Women’s Hospital’s Health Equity Committee decided to confront the status quo by asking: How is racism on a structural level present within our walls?
Ankur Kalra’s guests Michelle Morse (Founding Co-Director of EqualHealth and Assistant Professor at Harvard Medical School) and Lauren Eberly (Cardiology Fellow at the University of Pennsylvania) are co-authors of a retrospective study that demonstrated what had previously only been observed: That black or brown heart failure patients ended up in general medicine rather than specialised cardiology services. Following the publication of the study in November 2019, the Health Equity Committee started to roll out anti-racism trainings and to work on objective admission guidelines to mitigate biased behaviours.
Aarti Bhatt (Assistant Professor of Medicine at the University of Minnesota), member of the Minnesota chapter of Campaign Against Racism, talks about their initiative to support projects that have a positive impact on local communities on a global scale.
Heart surgery is not the best option for every patient suffering from structural heart disease. This was recognized by interventional cardiologist Anmar Kanaa’N and cardiac surgeon Joseph Lahorra who decided to unify their skillsets and bring the Structural Heart Program to life. Their vision was to offer patients with heart valve diseases all available options at Cleveland Clinic’s Akron General.
In this week’s Parallax, Dr Kanaa’N, the director of the program, and Dr Lahorra, chairman of the Heart, Vascular & Thoracic Department of Akron General introduce the listeners to the foundations of their program and the paradigm shift brought by TAVR.
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In this week’s Parallax, Dr Kanaa’N, the director of the program, and Dr Lahorra, chairman of the Heart, Vascular & Thoracic Department of Akron General introduce the listeners to the foundations of their program and the paradigm shift brought by TAVR.
The State of Ohio reported its first coronavirus cases on March 9. Prior to that, on February 28, the Cleveland Clinic announced that they are prepared to open 1,000 additional hospital beds if needed. Ohio was one of the states to follow recommendations and intervene quickly.
Ankur Kalra asks Grant W Reed, Director of the Cleveland Clinic’s STEMI program, to reflect on the actions they took and the challenges of delaying cardiovascular procedures in the wake of the coronavirus pandemic. Dr Reed offers insight on the factors that influenced the Cleveland Clinic’s STEMI policy for COVID-19. Ankur and Grant discuss the triage considerations for patients with structural heart disease and the steps the clinic took to protect its healthcare workers.
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Ankur Kalra asks Grant W Reed, Director of the Cleveland Clinic’s STEMI program, to reflect on the actions they took and the challenges of delaying cardiovascular procedures in the wake of the coronavirus pandemic. Dr Reed offers insight on the factors that influenced the Cleveland Clinic’s STEMI policy for COVID-19. Ankur and Grant discuss the triage considerations for patients with structural heart disease and the steps the clinic took to protect its healthcare workers.
Lisa Rosenbaum has been writing extensively about the human face of medicine. Her articles have been widely circulated by publications like The New York Times, The New Yorker and The New England Journal of Medicine.
In this edition of Parallax Dr Kalra asked Dr Rosenbaum about the influences that shaped her choices as a writer and as a healthcare professional. Dr Rosenbaum opens up about her childhood and how she connected to her grandfather through writing and medicine. We learn about Lisa’s first day at medical school and her latest writing project.
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In this edition of Parallax Dr Kalra asked Dr Rosenbaum about the influences that shaped her choices as a writer and as a healthcare professional. Dr Rosenbaum opens up about her childhood and how she connected to her grandfather through writing and medicine. We learn about Lisa’s first day at medical school and her latest writing project.
A week after Jag Singh had tested positive for 2019-nCoV, he became a patient in his hospital’s intensive care unit. This week he joins Ankur Kalra, MD to tell us about his journey as a clinician-scientist.
Jagmeet P Singh, associate chief of the cardiology division at Massachusetts General Hospital and professor of medicine at Harvard Medical School joins Ankur Kalra for a deep conversation about his journey across three continents. Dr Singh talks about the importance of choosing fulfilment over success. We gain more insights on the recent late-breaking trial, MADIT-CHIC focusing on cardiac resynchronization therapy. Ankur asks Jag about his experience of being on the other side of the healthcare system and his enrolment in the since halted remdesivir trial.
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Jagmeet P Singh, associate chief of the cardiology division at Massachusetts General Hospital and professor of medicine at Harvard Medical School joins Ankur Kalra for a deep conversation about his journey across three continents. Dr Singh talks about the importance of choosing fulfilment over success. We gain more insights on the recent late-breaking trial, MADIT-CHIC focusing on cardiac resynchronization therapy. Ankur asks Jag about his experience of being on the other side of the healthcare system and his enrolment in the since halted remdesivir trial.
“It’s a tsunami not just a wave. The worst tsunami you can imagine”
Prof Michele Senni is Director of Cardiology at Papa Giovanni XXIII Hospital, Bergamo Italy. He contracted COVID-19 himself and in this latest podcast he meets with Ankur Kalra, MD to discuss his personal experience in dealing with patients and COVID-19 in Europe’s outbreak epicentre.
Hear them discuss the burden on healthcare, patient selection, the importance of testing and PPE and how COVID has resulted in a reduction of acute myocardial infarction and heart failure in patients.
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Prof Michele Senni is Director of Cardiology at Papa Giovanni XXIII Hospital, Bergamo Italy. He contracted COVID-19 himself and in this latest podcast he meets with Ankur Kalra, MD to discuss his personal experience in dealing with patients and COVID-19 in Europe’s outbreak epicentre.
Hear them discuss the burden on healthcare, patient selection, the importance of testing and PPE and how COVID has resulted in a reduction of acute myocardial infarction and heart failure in patients.
“We are at war with a pandemic and the enemy is not each other, it’s the virus.”
In this latest episode, Ankur Kalra, MD meets with Andrew Sauer, MD, co-author of an upcoming paper in US Cardiology Review on COVID-19 and Cardiovascular Disease that provides a concise and current summary of cardiovascular complications from COVID-19.
Hear them discuss the latest issues surrounding the pandemic, the known cardiac implications and the rapidly emerging data.
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In this latest episode, Ankur Kalra, MD meets with Andrew Sauer, MD, co-author of an upcoming paper in US Cardiology Review on COVID-19 and Cardiovascular Disease that provides a concise and current summary of cardiovascular complications from COVID-19.
Hear them discuss the latest issues surrounding the pandemic, the known cardiac implications and the rapidly emerging data.
In these unprecedented times, we provide an early release episode to gain insight on dealing with the COVID-19 pandemic from Deputy Editor in Chief of US Cardiology Review, a BDG interventional cardiologist, Bill Gogas, MD, PhD practising in East Asia.
Hear Bill’s take on how East Asia responded to and successfully managed the pandemic and how they are now seeing a significant reduction in cases outside the epicentre. Hear how the strategy resulted in only 93 patients in Bill’s city of Nanjing, testing positive for coronavirus with a city population of 8 million.
Learn about effective responses, the importance of early control and how as a cardiovascular physician, your life and practice may be impacted by the virus.
Submit your question to Ankur via: podcast@radciffe-group.com.
Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.
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Hear Bill’s take on how East Asia responded to and successfully managed the pandemic and how they are now seeing a significant reduction in cases outside the epicentre. Hear how the strategy resulted in only 93 patients in Bill’s city of Nanjing, testing positive for coronavirus with a city population of 8 million.
Learn about effective responses, the importance of early control and how as a cardiovascular physician, your life and practice may be impacted by the virus.
Submit your question to Ankur via: podcast@radciffe-group.com.
Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.
In 2020, women still only represent 16% of editorial boards.
US Cardiology Review journal, has recently seen a 7-fold increase in female editorial board members in response to journal-based strategic initiatives and the stellar work of USC editorial board leadership, Ankur Kalra (Editor in Chief) and Bill Gogas (Deputy Editor in Chief), who were keen to drive this change. With thanks to Dr Anastasia Mihailidou’s tenure as a new board member and her suggested nominees, ten new female board members have recently joined US Cardiology Review’s editorial board.
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US Cardiology Review journal, has recently seen a 7-fold increase in female editorial board members in response to journal-based strategic initiatives and the stellar work of USC editorial board leadership, Ankur Kalra (Editor in Chief) and Bill Gogas (Deputy Editor in Chief), who were keen to drive this change. With thanks to Dr Anastasia Mihailidou’s tenure as a new board member and her suggested nominees, ten new female board members have recently joined US Cardiology Review’s editorial board.
One of the first things painted by the young Mike Gibson, today Professor of Medicine at Harvard, researcher and interventional cardiologist, was a cloud. Years later while painting angiograms Dr Gibson came up with the idea of myocardial blush: The blush was that cloud of dye in the heart muscle.
In this episode, Mike opens up about his childhood in Stilwell, Oklahoma. Ankur and Mike discuss how the inductive quality of art can complement the deductive principles of science. Mike recalls earlier stages of his career and warns about the blinding effect of the ego-driven, competitive culture of cardiology. Ankur asks Mike about fatherhood and about his role as an educator.
What does it mean to be fearless as a medical professional? How can you protect yourself from the emotional toll of the profession? What is Mike’s advice to early career cardiologists?
Sponsored by Edwards.
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In this episode, Mike opens up about his childhood in Stilwell, Oklahoma. Ankur and Mike discuss how the inductive quality of art can complement the deductive principles of science. Mike recalls earlier stages of his career and warns about the blinding effect of the ego-driven, competitive culture of cardiology. Ankur asks Mike about fatherhood and about his role as an educator.
What does it mean to be fearless as a medical professional? How can you protect yourself from the emotional toll of the profession? What is Mike’s advice to early career cardiologists?
Sponsored by Edwards.
In this week’s episode Ankur Kalra asks Dr Suzanne J Baron, Director of Interventional Cardiovascular Research at Lahey Hospital & Medical Center: How do we measure the value of a novel technology?
During her interventional cardiology fellowship, Dr Baron became fascinated by the implementation of novel technologies. She earned her degree in Clinical Epidemiology and spent a year working at the FDA’s Device Evaluation unit.
In 2019 Dr Baron presented the results of her late-breaking trial, COAPT. Ankur invites Suzanne to discuss the economic analysis of the study and to give a short introduction to cost-effectiveness analysis. Suzanne provides an overview of the trial and they talk about the importance of understanding the value and benefits of new devices from both the patient and the health-economic point of viewpoint.
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During her interventional cardiology fellowship, Dr Baron became fascinated by the implementation of novel technologies. She earned her degree in Clinical Epidemiology and spent a year working at the FDA’s Device Evaluation unit.
In 2019 Dr Baron presented the results of her late-breaking trial, COAPT. Ankur invites Suzanne to discuss the economic analysis of the study and to give a short introduction to cost-effectiveness analysis. Suzanne provides an overview of the trial and they talk about the importance of understanding the value and benefits of new devices from both the patient and the health-economic point of viewpoint.
In this week’s Parallax, host Ankur Kalra is joined by Charles (Chuck) Simonton, Vice President and Chief Medical Officer of Abiomed. Chuck talks about how his father’s leadership and service as a Methodist minister inspired him to become a doctor. He recalls the dawn of interventional cardiology: the birth of angioplasty and stenting. Drawing from his experiences as a trialist who worked with some of the most influential minds, he offers practical tips to young doctors. Finally, Ankur asks Chuck about the Impella device controversy and the recent decision of Abiomed to accelerate their clinical research.
How should you start building a research programme? What are Chuck Simonton’s thoughts on the relationship between doctors and the industry? What is Chuck’s message to young cardiologists?
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How should you start building a research programme? What are Chuck Simonton’s thoughts on the relationship between doctors and the industry? What is Chuck’s message to young cardiologists?
Martha Gulati, Professor of Medicine and the Chief of Cardiology at the University of Arizona joins Ankur Kalra to continue the important conversation on how the cardiovascular community can stand up against sexism.
After the #MedBikini campaign provoked by a misogynistic study that scrutinized female doctors’ social media posts, this episode is about creating a safer environment for female healthcare professionals.
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After the #MedBikini campaign provoked by a misogynistic study that scrutinized female doctors’ social media posts, this episode is about creating a safer environment for female healthcare professionals.