This took 7 years. Presented today. Among patients with COPD and no cardiovascular disease, metoprolol did not improve outcome. But metoprolol was safe and associated with better prognosis in women. @drjohnm @mmamas1973 @SVRaoMD @DLBHATTMD @cpgale3 @elmir1omerovic @GreggWStone

𝐉𝐮𝐬𝐭 𝐩𝐮𝐛𝐥𝐢𝐬𝐡𝐞𝐝! Original Article by J. Sundh et al.: Metoprolol in Chronic Obstructive Pulmonary Disease without Cardiovascular Disease eviden.cc/4ctWTvo #ERSCongress | @EuroRespSoc @SundhJosefin @FrobertOle

🧠🫀 When cardiology forgets to ask “why”: a timely wake-up call This 2025 Open Heart viewpoint by Francesco Tona is not an attack on modern cardiology—but a deeply reasoned warning about what we risk losing amid unprecedented technological power  . ⚙️ The paradox Cardiology has never been more capable. We replace valves percutaneously, map anatomy in exquisite detail, and deploy AI to predict risk. Yet, the author argues, capability is increasingly replacing curiosity. Decisions are often driven by what can be done, not whether it should be done. 🧠 From “why” to “can” Historically, cardiology advanced through physiologic questions and clinical reasoning. Today, the sequence is reversed: - A device appears - Anatomy fits - The procedure proceeds - Reflection, appropriateness, and patient-centred benefit too often come after execution—if at all. 🩺 When feasibility replaces judgement Tona highlights a subtle but dangerous shift: - Anatomical suitability eclipses clinical appropriateness - Procedural success is mistaken for patient benefit - Futility becomes “well-executed” rather than questioned This is not failure of skill—but failure of restraint. 💼 The silent drivers Industry influence, guideline structures, and training environments normalize interventionist reflexes. Research increasingly validates existing technologies using surrogate endpoints, while negative or null results fade into obscurity. 🤖 AI: help or shortcut? AI can augment care—but risks outsourcing thinking. When clinicians validate algorithmic outputs instead of interrogating them, clinical reasoning atrophies. Precision without purpose is not progress. 🔮 The real message This is not anti-innovation. It’s a call to reclaim the “why”: Teach restraint as a clinical skill Design guidelines around meaningful patient benefit Prioritize outcomes that matter to patients, not systems 🧭 Bottom line When cardiology stops asking why, it doesn’t become more efficient—it becomes less human. Technology should serve judgement, not replace it.

Happy New Year from the team saving hearts at Örebro Hospital!

Keeping up with this topic is really exhausting. Stop everything—here’s a new meta-analysis, this time in patients with myocardial infarction and preserved ejection fraction (≥50%). The first piece of news is that, after I don’t know how many years since the last cardiovascular one, it’s published in @NEJM (and yes, it’s very concise but stylish, of course). The second piece of news is that my post below, which was somewhat of a guess, turned out to be correct. Patients who have had a myocardial infarction and maintain a normal ejection fraction cannot expect any difference in mortality, reinfarction, or heart failure if they take a beta-blocker. If their ejection fraction is below 50%, however, benefits can be expected—and that is what I will do from now on. Until the next trial is published the day after tomorrow, of course. #AHA25 nejm.org/doi/full/10.1056/NE…

Spoke at Charité Berlin today. Protect yourself and your patients with a flu shot, not with RFK Jr.’s wellness insights @DavidAgus @DLBHATTMD @DrEricDing @Tobjizzle @SVRaoMD @DGlaucomflecken @drjohnm @PeterHotez

Do p-tau217 levels rise without amyloid or tau aggregates? 🐻 In our Acta Neuropathologica paper, we show that 🩸 p-tau217 increases ~300% during bear hibernation, while hibernating hamsters also show ⬆️ p-tau but no changes in MTBR tau. link.springer.com/article/10…

Bears tolerate ventricular tachycardia while humans don’t. Our newly published findings have biomimetic potential for humans. @Lpa_Doc @GreggWStone @gunnar_heine @cpgale3 @SVRaoMD @ItaiYanai

Vaccination as a new form of cardiovascular prevention: a European Society of Cardiology clinical consensus statement just published in EHJ. doi.org/10.1093/eurheartj/eh… @ESCardio @ESC_Journals #vaccines

💉 Influenza vaccination as cardiovascular prevention – the evidence is growing. Co-authored with @FrobertOle, and collegues – our new review in Atherosclerosis highlights the data behind flu shots reducing CV events. 🧠 Simple, low-cost, life-saving. atherosclerosis-journal.com/…

2nd new PROSPECT II publ, this in JACC Int: hs-CRP (inflammation) was independently associated with both diffuse cor plaque and lipid deposition as well as focal vulnerable plaques. Coupled with the JACC article: LDL & CRP → diffuse plaque and lipid whereas Lp[a] & CRP → VP.

We have a new Lp(a) paper, led by @derlinge from PROSPECT 2 using IVUS/NIRS. It shows high Lp(a) associates most with vulnerable plaque characteristics, whereas LDL-C with plaque burden. Lp(a) was measured by our @UCSDCardiology assay, the only Lp(a) assay I am aware of that is truly isoform-independent (uses monoclonal antibody LPA-KIV9). This study creates a rationale to perform an imaging study with Lp(a) lowering drugs and assess effect of features of high-risk plaques. doi.org/10.1016/j.jacc.2025.…

Published a letter in @TheEconomist @mmamas1973 @SVRaoMD @cpgale3 @DavidLBrownMD @drjohnm @Lpa_Doc @NielsRHolm

This #JACCINT analysis of 42,887 patients from the #SWEDEHEART registry shows comparable rates of #MACE (31.3% vs. 32.2%) between IFR vs FFR-guided #PCI and no difference in all-cause mortality over 5 years. jacc.org/doi/10.1016/j.jcin.… @MGtberg

We are looking for a PhD student, with an interest in skeletal muscle physiology and stem cell biology, to conduct a trial in elderly subjects. Preferably with an MD background since the trial will involve a number of invasive procedures 🧑‍🏫 Please share and reach out…

1/2 Finally we can share this now published analysis of iFR vs. FFR and outcome from Swedeheart registry. In all 3 different models we find similar outcome. No signal of increased mortality. This should put the debate of between iFR and FFR at rest. sciencedirect.com/science/ar…