Cardiology Digest #4: Late-Breaking: AI vs. Doctors on Reddit, Hypertension Strategies in Surgery, and Iron's Role in Heart Failure: Unpacking Recent Medical Breakthroughs

This episode focuses on four intriguing studies:

STUDY #1: We begin with a fascinating study comparing 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.

Ayers JW et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Intern Med 2023 Apr 28; [e-pub]. (https://doi.org/10.1001/jamainternmed.2023.1838)

STUDY #2: Next, we 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.

Marcucci M et al. Hypotension-avoidance versus hypertension-avoidance strategies in noncardiac surgery: An international randomized controlled trial. Ann Intern Med 2023 Apr 25; 176:605. (https://doi.org/10.7326/M22-3157)

STUDY #3: Our third study is the IRONMAN trial, which 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.

Kalra PR et al. Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): An investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial. Lancet 2022 Dec 17; 400:2199. (https://doi.org/10.1016/S0140-6736(22)02083-9)

STUDY #4: Finally, 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.

Filippatos G et al. 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 2023 Apr 13; [e-pub]. (https://doi.org/10.1161/CIRCULATIONAHA.122.060757)

This episode promises to be a treasure trove of knowledge, offering insights into the role of AI in medicine, the management of hypertension in surgery, the importance of iron repletion in heart failure, and the influence of hemoglobin levels on treatment outcomes. So, grab your headphones and join us as we navigate these captivating studies. Don't miss this opportunity to enhance your understanding and make a difference in patients' lives. See you there!

00:29 - Intro: Recent Medical Studies: Chatbots, Blood Pressure & Iron Deficiency
02:22 - AI Chatbots Outperform Physicians in Patient Communication
03:58 - Perioperative anti-hypertensives
06:20 - New Studies on Iron Deficiency in Heart Failure

AI Chatbots vs. Physicians: "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."

Perioperative Hypertensives: "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."

Iron Deficiency in Heart Failure: "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."