IC - Peripheralist🫀🦶// Social Media Ambassador #ACC26 #TCTAP2025 #ISICAM2025
Jakarta Barat, DKI Jakarta
Joined May 2009
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📢 OPENING CEREMONY - MAIN ARENA
👉 Welcome Remark
👉 Congratulatory Remark
👉 Brief Overview of TCTAP 2026 Program Highlights
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#TCTAP2026
@summitmd_cvrf – at Gangnam-gu, Republic of Korea
📢 LIVE CASE 1: LEFT MAIN
MAIN ARENA
Complex LM PCI in heavily calcified lesions isn’t just technique—it’s pressure.
Every move counts. Imaging guides you, calcium fights you, and the margin is razor thin.
Stay calm, prepare well, trust your steps.
#TCTAP2026 @summitmd_cvrf – at Gangnam-gu, Republic of Korea
🔥 Essential Updates in Peripheral Intervention - #TCTAP2026 @summitmd_cvrf – at Gangnam-gu, Republic of Korea
Markz Sinurat retweeted
Congratulations to all of the new FACCs who took part in #ACCAsia Convocation! Welcome to YOUR professional home. We are excited to have you join us. See everyone next year in Hong Kong.
Markz Sinurat retweeted
At #ACCAsia, #ACCPresident @Drroxmehran discussed the role of CYP2C19 genetic testing in the era of de-escalation, highlighting the key question: “Why now?”
Tailoring P2Y12 therapy is key, especially in East Asians where CYP2C19 LOF alleles hit ~60%.
Genetic-guided de-escalation is noninferior to standard care (POPular Genetics), but beware: dropping aspirin early may spike stent thrombosis risks (Natsuaki et al). 🧬💊
#ACCAsia @ACCinTouch @JACCJournals – at Gyeongju-si, Republic of Korea
East Asian Paradox: Higher bleeding/lower ischemic risk vs Western 👨👨🦱.
Unguided de-escalation to clopidogrel reduces bleeding (HR0.48) without ischemic loss.
Caution: In HBR patients, 1mo DAPT spikes MACCE (HR1.724) vs 3mo. Balance is key. 🩸📉
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
De-escalating DAPT in AMI patients reduces bleeding but isn't a "one-size-fits-all" fix. 📉
✅ Best: Ticagrelor monotherapy after 1–3 months.
⚠️ Caution: Clopidogrel (CYP2C19 risk) & "ultra-early" (<1 week) stops.
⚖️ High-risk/complex cases still need the standard 12-month DAPT.
#ACCAsia @ACCinTouch @JACCJournals – at Gyeongju-si, Republic of Korea
CHIP-BCIS3 🚨
Routine LV unloading (Impella) in complex PCI NO benefit on MACE, but ↑ mortality signal (CV HR ~1.9). 👉 Protection ≠ outcome.
Use MCS selectively—not routinely in stable high-risk PCI.
#ACCAsia @ACCinTouch @JACCJournals – at Gyeongju-si, Republic of Korea
CHAMPION-AF 🚨 LAA closure (Watchman FLX) = noninferior to NOACs for CV death/stroke/SE at 3 yrs, with less non-procedural bleeding. But stroke/SE numerically higher.
👉 Not a replacement—a strong alternative for selected AF pts. #ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
HI-PEITHO 🚨 Intermediate-risk PE: USCDT (EKOS) + AC vs AC alone.
Patients: RV strain, ↑troponin, stable. Outcome (7d): ↓PE death/decomp/recurrence with USCDT. No ↑ major bleeding or ICH.
👉 Selective escalation works—don’t wait until crash.
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
DCB in bifurcation PCI 🎯 (when to use?)
Use DCB if:
• Small side branch
• Good lesion prep ✅
• No heavy calcium
• TIMI 3 flow
Avoid DCB if:
• Heavy calcification ⚠️
• Large thrombus
• Poor flow
• Acute recoil
💡 DCB = no metal, less DAPT
🫀 Select carefully → outcomes ≈ DES
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
Balloon uncrossable lesion 🚧 (PCI nightmare)
Causes:
• Severe calcium ⚠️
• Calcified nodule
• Tortuosity / CTO cap
Step-up:
• ↑ guide support
• Small balloon / anchor
• Microcatheter + wire escalation
🛠 If stuck:
• Laser / Rotablation
• Javelin lithotripsy (PAD) ⚡ → forward energy, useful when balloon can’t cross [off-label]
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
Markz Sinurat retweeted
Functional mitral regurgitation 💓 classified into VFMRst, VFMRat, AFMR; left atrial strain 📊, LV longitudinal strain 📈, and diastolic BP 💉 predict mortality ⚠️. jacc.org/doi/10.1016/j.jacas… #JACCAsia
Cardiovascular Medicine in the Age of Intelligent Systems: From Data to Trust 💭💬
📣 Harlan M Krumholz - JACC
📨 The goal of life is not health. Health is what enables people to live a wonderful life.
#ACCAsia @JACCJournals @ACCinTouch
Markz Sinurat retweeted
At #ACCAsia this weekend? 👀
Swing by ACC Booth #1 📍 to grab your FREE copy of #JACCJournals, packed with cutting-edge research, fresh insights, and can’t-miss science 🔥 @ACCinTouch
Markz Sinurat retweeted
ACC's Concise Clinical Guidance report provides a framework for clinicians to medically manage obesity using the "ever-expanding set of tools to assist patients in diagnosis, weight reduction, & #CVD risk mitigation."
More: bit.ly/4vAqzii #ACCAsia #cvPrev @JACCJournals
Secondary MR: intervene or wait? 🤔
• Start with GDMT (3–6 mo)
• Add CRT if indicated
• Reassess symptoms + LV
Intervene (TEER) if:
• Severe SMR persists
• LVEF ~20–50%
• Suitable anatomy (COAPT-like)
💡 Timing = after optimization, not too early
🫀 Heart Team decision is key
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
Markz Sinurat retweeted
Hormones, rhythm and risk were the focus of a dedicated #ACCAsia session exploring #CVD and women. Thanks to @Drroxmehran, @DrBonnieKy, Pam Taub, Yae Min Park, @AndreaRussoEP, Junya Ako, Mi Na Kim and Mi-Seung Shin. Read more in a #JACC Special Issue: bit.ly/4tR2MZJ
Tricuspid TEER 🚨 (challenging but evolving)
Pitfalls:
• Complex leaflet anatomy ⚠️
• Large coaptation gap
• Poor leaflet visualization
• Suboptimal grasp/alignment
• Device–leaflet mismatch
• Severe tethering / annular dilation
💡 Imaging is everything (TEE ± ICE)
🛠 Patient selection + planning = success
#ACCAsia @JACCJournals @ACCinTouch – at Gyeongju-si, Republic of Korea
