Cardiology Digest podcast: Episode #3

Study #1

The final 15-month results of the MASTER-DAPT trial by Landi et al. (2023) show that abbreviated antiplatelet therapy is non-inferior to standard antiplatelet therapy for high-bleeding-risk patients undergoing percutaneous coronary intervention (PCI). The trial found that abbreviated therapy significantly reduced the risk of bleeding, with no increase in the risk of ischemic events.

"The initial results at twelve months demonstrated that there was no difference in adverse cardiovascular events and less bleeding in patients receiving abbreviated dual antiplatelet therapy, meaning switching to single antiplatelet therapy after a month, than in those receiving a standard dual antiplatelet therapy regimen, meaning receiving at least three to six months of dual antiplatelet therapy."

Landi, A, Heg, D, Frigoli, E, et al. 2023. Abbreviated or standard antiplatelet therapy in HBR patients: Final 15-month results of the MASTER-DAPT trial. JACC Cardiovasc Interv. 7: 798–812.(https://doi.org/10.1016/j.jcin.2023.01.366) 

Study #2

The prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players are discussed in a recent study by Bhatia et al. (2023). The study found that over 20% of the players had de-novo ECG changes, which were associated with myocardial inflammation and fibrosis. The authors recommend routine ECG screening for athletes post-COVID-19 infection.

"This study raises questions about the need to screen athletes without symptoms, since none of the athletes had functional limitations or adverse events. However, it also highlights that a post-infection ECG could be useful in detecting myocarditis in athletes, even those without symptoms."

Bhatia, RT, Malhotra, A, MacLachlan, H, et al. 2023. Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players. Heart. 12: 936–943. (https://doi.org/10.1136/heartjnl-2022-322211)

Study #3 

Haupt et al. (2023) discuss the benefits, limits, and risks of AI-generated medical advice in their recent JAMA article. They argue that AI-generated advice has the potential to improve clinical decision-making and reduce errors, but highlight the need for appropriate training, validation, and regulation to ensure patient safety.

"The authors who were involved in the creation of GPT-4 discuss that the routine use of large language models like GPT-4 could help to ease the burden of clinical documentation in electronic medical records. It could also shorten the often time consuming and frustrating task of pre-visit chart review."

Haupt, CE and Marks M. 2023. AI-generated medical advice—GPT and Beyond. JAMA. 16: 1349–1350. (https://doi:10.1001/jama.2023.5321)

Study #4 

Lee et al. (2023) discuss the benefits, limits, and risks of ChatGPT-4 as an AI chatbot for medicine in their recent NEJM article. They note that while GPT-4 has the potential to improve patient education and communication, it also raises concerns about privacy, liability, and bias. The authors highlight the need for further research and guidelines on the use of AI chatbots in healthcare.

"Large language models don't naturally understand text. Instead, they synthesize intelligible-appearing text, which isn't always grounded in truth. This means that AI could potentially misrepresent clinical reality at any given time. Despite the potential challenges, we remain optimistic about the advantages of AI in medicine. With AI taking over more tedious tasks, healthcare providers could focus more on the patient's needs."

Lee P, Bubeck S, and Petro J. 2023. Benefits, limits, and risks of GPT-4 as an AI chatbot for medicine. N Engl J Med. 13: 1233–1239. (https://www.nejm.org/doi/10.1056/NEJMsr2214184)

Join us for this informative overview of contemporary research, as we break down complex medical concepts into digestible nuggets of knowledge, suitable for both medical students and healthcare professionals eager to keep up-to-date in cardiology.

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