5 “H”s to be a good “Human” being 1: Humble, Be 2: Honest, Be 3: Humane, Be 4: Humility, Show 5: Humanity , Serve

55YM presented with anterolateral STEMI. H/O prediabetes, hypertension and hyperlipidemia. Troponin 5,573ng/L. How would you approach the lesion in the LAD?

Pledge not to intervene before giving IC NTG. This patient had MINOCA, an important etiology of AMI, especially in the young. ahajournals.org/doi/10.1161/CI…

No one wants to relive this nightmare! What are the possible reasons for this outcome?

All you need to know about iatrogenic coronary perforations.

Pre-procedure angiogram, done at an outside institution.

1/2: One of the major anti-aging advances have been the development of senolytics; compounds that remove senescent cells and their harmful effects.

Dasatinib with Quercetin (D & Q) combination is a powerful senolytic shown to be beneficial in IPF, osteoarthritis in animal studies. Here are some food groups that one should consider in diet: surprising winners are onions & capers. Strawberries are rich in Facetin, a senolytic.

A true nightmare in the cath lab: 50M with inferior STEMI, normal coronaries, then collapsed. Aortogram clip speaks for itself. The saying goes, 'If you haven’t faced it in the cath lab, you haven’t seen enough cases.' Yoni Grossman PCRonline 🫀 mandeep singh

Remember 365 for prolonged DAPT Tradeoff For every additional year of DAPT/1000 patients Rx You save 3 stent thrombosis, 6 MI but add 5 major bleeds. It roughly translates into 1% decrease in ischemic & 1% increase in bleeding risk. Always calculate the ischemic/bleeding risks.

Antiplatelet & Anticoagulation Rx 2025 ACC/AHA ACS Recommendations

Key teaching points when you switch P2Y12i Acute<30 d: Always bolus Don't wait if you escalate from clopidogrel. For de-escalation: wait 24h Chronic >30d: Wait 24h Give maintenance dose except when switching from ticagrelor to prasugrel/clopidogrel (give bolus)

In collaboration with Dr. Michael Nanna Yale Cardiology, I am excited to launch the Cleveland Clinic Cardiovascular Center on Aging Grand Rounds & Distinguished Lecture Series Sept 25, 5–6 PM ET, for the inaugural lecture by Dr. Daniel E Forman on aging & CV care. Open to all.

My take on management of calcified lesions

Conceptual drawing underscoring the need to get the best acute gain following PCI as the late loss is predictable & similar. It highlights the need to do IV imaging to optimize results. If late loss >0.50 (DM, small vessel size, CKD, calcified vessel, SVG), leads to higher TLR.

Simplified management of femoral pseudoaneurysms

Here’s the paper. Claire Raphael and I thank all coauthors and Harmony Reynolds for the great context editorial jacc.org/doi/10.1016/j.…

Everything you want to know about Stent Thrombosis

Coronary Dissections at the Ostium are Preventable Pay Close Attention to the Procedural Techniques

Activate Cath Lab when you see these EKG patterns in absence of STEMI