Cardiology Digest podcast: Episode #4

Study #1

A fascinating study compares the responses of an AI chatbot and physicians to medical questions posted on a Reddit forum. The results might surprise you and prompt a rethink on how AI can assist in routine physician duties.

"What was striking is that the evaluators preferred the Chatbot responses almost 80% of the time. Interestingly, the Chatbot's responses were longer, with a mean of 180 versus 52 words, and ranked higher in quality of information. Chatbot responses also showed more empathy, with a staggering 45% of responses categorized as empathetic or very empathetic, whereas only 5% of physicians responses were categorized as such."

Ayers, JW, Poliak, A, Dredze, M, et al. 2023. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Intern Med. 6: 589–596. (https://doi.org/10.1001/jamainternmed.2023.1838)

Study #2

Delve into the POISE-3 trial, which examined the effects of hypotension-avoidance versus hypertension-avoidance strategies in noncardiac surgery. The findings could have significant implications for the management of patients with hypertension undergoing surgery.

"The authors suggest that continuing ACE inhibitors and ARBs through surgery is reasonable. So, provided that your patient is not particularly prone to hypotension, it seems from this study that it's perfectly safe to continue these drugs."

Marcucci, M, Painter, TW, Conen, D, et al. 2023. Hypotension-avoidance versus hypertension-avoidance strategies in noncardiac surgery: An international randomized controlled trial. Ann Intern Med. 5: 605–614. (https://doi.org/10.7326/M22-3157) 

Study #3 

The IRONMAN trial investigated the effects of intravenous ferric derisomaltose in patients with heart failure and iron deficiency. The results provide further support for the benefit of iron repletion in this population.

"Well, the studies provide some evidence for the use of intravenous iron repletion in individuals with heart failure and iron deficiency. Current guidelines already recommend intravenous iron replication in these patients, regardless of hemoglobin level. It's recommended that physicians screen for iron deficiency in heart failure patients and treat it when present."

Kalra, PR, Cleland, JGF, Petrie, MC, et al. 2023. Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): An investigator-initiated, prospective, randomized, open-label, blinded-endpoint trial. Lancet. 10369: 2199–2209. (https://doi.org/10.1016/S0140-6736(22)02083-9) 

Study #4 

We discuss a subgroup analysis of the AFFIRM-AHF trial, exploring the association between hemoglobin levels and the efficacy of intravenous ferric carboxymaltose in patients with acute heart failure and iron deficiency. The findings shed light on the role of hemoglobin levels in the treatment outcomes of these patients.

“The studies provide some evidence of the use of intravenous iron repletion in individuals with heart failure and iron deficiency. It’s recommended that physicians screen for iron deficiency in heart failure patients and treat it when present.”

Filippatos, G, Ponikowski, P, Farmakis, D, et al. 2023. Association between hemoglobin levels and efficacy of intravenous ferric carboxymaltose in patients with acute heart failure and iron deficiency: An AFFIRM-AHF subgroup analysis. Circulation. 22: 1640–1653.(https://doi.org/10.1161/CIRCULATIONAHA.122.060757)

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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