Geoff Barnes
@GBarnesMD
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Vascular Cardiologist @umichCVC. #thrombosis, #CVcoag, #ImpSci. Co-director @MAQI_2. Board of Directors @AnticoagForum. Tweets my own. RT≠endorsement. 🏳️🌈
Ann Arbor, MI
Joined September 2014
Merry Christmas and Happy Holidays from my family to yours!
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I'm honored to receive this notice of promotion to Associate Professor with tenure from @umich @UMichCardiology. I've been extremely fortunate to have amazing mentors and colleagues to guide my career development. Excited for the next chapter!
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Where are DOAC drugs absorbed in GI tract? It depends on the drug!
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Happy #NationalComingOutDay. Grateful to have such a wonderful and loving family! Fortunate to help care for courageous transgender patients. 🏳️🌈🏳️⚧️
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How does @MarcCarrier1 approach the choice between #DOAC and #LMWH for patients with #cancer assoc #VTE? Here are his key decision factors
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I was honored to join Melanie Bloom on @TODAYshow with @alroker to raise awareness around blood clots. Thanks to @isth for leading the @thrombosisday campaign for 10 years! #MoveAgainstThrombosis
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Did you know what warfarin stands for? A little humor (but mostly true!) from @AnticoagPharmD #aha22
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It may be called a "small research grant", but I'm sure it will lead to BIG things. We are excited to develop electronic health tools that are designed for patient safety and easy clinician use! Thanks @nih_nhlbi for supporting our team's work. @umichCVC @UM_IHPI
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Proud to celebrate #NationalComingOutDay with my amazing family and friends. I’m looking forward to the day when we no longer have to celebrate coming out. 🏳️🌈 🏳️⚧️
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Are you asked about if/when to restart #cvCoag after an intracranial hemorrhage? Good news… several recent or ongoing RCTs will give us important data to guide this decision. Stay tuned!
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I was honored to share the #ACC23 stage with Dr Fuster to discuss #COVID thromboprophylaxis. Thanks @dranulala for the awesome photo!
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If you’re going to order thrombophilia testing, don’t make these mistakes! Dr. @DrewOostra reviews at @myAVLS meeting.
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We may live in a town defined by Maize and Blue, but today our family is proud to wear green. Happy #StPatricksDay !!
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A somber face for somber times. I have a lot of work to do to be a better ally, but I’m committed to doing that work in both my professional and personal life. Please join me! #WhiteCoatsForBlackLives
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Are you making the diagnosis of antiphospholipid antibody syndrome? The criteria are being updated. Note the importance of looking at both clinical features AND labs. But it’s not just any APS lab that matters. Know which test and what level. #ACForum23
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.@bhwords highlights a perspective piece from @RPTHjournal recommending that MTHFR be removed from thrombophilia testing panels. #PERT2022
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We know that patients with #cancer assoc #VTE need 6 months of #cvCoag therapy, minimum. Who needs longer vs shorter therapy? @KSanfilippoMD shares her approach.
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How does @MarcCarrier1 select between LMWH or DOAC when treatment a patient with cancer-associated thrombosis? Here is a practical flow chart to make evidence-based therapy decisions. #ACForum23
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Halloween should always be on a weekend!! Hope your holiday was as sweet as ours
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Do you use #DOAC meds in obese patients? New data from @UPMC shows better results with DOAC than warfarin across BMI range, including BMI>40. @AnticoagForum.
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Have you seen the newest perioperative #cvCoag guidelines from @accpchest? I've had some time to digest this exciting new document and wanted to share a few take away points.
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There is no better way to celebrate your birthday than cheesecake delivered by a princess!!
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I’m asking those who love the outdoors to post a picture. A picture that YOU took. Just a picture. No description. The goal is to regain peace harmony without negativity. Please copy the text,put a picture on YOUR page,and let's look at these beautiful pictures
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Can pre-op testing lead to adverse outcomes? Absolutely! Dr Kerr shows how pre-op testing for cataract surgery can delay ophthalmology treatment and lead to falls. Pre-op testing is not always beneficial… we need to ensure there is value when we order tests.
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Who knew that posting a picture of your husband and adorable daughter on Christmas was the best way to get new followers :) 🌈👨👨👧#GayMedTwitter @DrScottHadland @acweyand @cleebennett @NTConnell @cjstreed @P_StLaurent
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I’m honored to serve on the @ACCinTouch LLOC (Lifelong Learning Oversight Committee) with @KBerlacher & team. ACC is a leader in health care professional education across the globe. I’m excited to help advance that mission for trainees, faculty, and CV team members!
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The only thing better than getting a fundable R18 score is knowing that you get to work with some awesome colleagues promoting #cvCoag medication safety and pharmacists for the next 3 years! @notthatdrsmith @DorschMike
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How do you summarized the key elements of #VTE treatment into a single figure? We tried our best. What else would you have added? @JACCJournals
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The apixaban package insert does NOT recommend dose reduction for CKD in patients with #VTE. But perhaps we should re-consider? Interesting analysis in @ThrombosisRese1
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Thanks to @Delta and @KoreanAir_KE for getting my family and me safely from DTW to BKK! Excited for an amazing 5 days of science with all my #ISTH2024 friends and colleagues @isth
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As I prepare to head home from #ISTH2023, I want to give a huge shout out to @SusanRKahn1, @RodgerMarc, and the entire @isth team for an amazing congress. Cutting edge science, practice-relevant education, career-defining networking, and a TON of fun.
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Was that #VTE event provoked or unprovoked? @LanaCastellucci reminds us that it’s not dichotomous, but more accurately a gradient of recurrence risk. It might be best to use “persistent” and “transient” descriptors along with major/minor to better classify risk factors #PERT2023
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Combined #DOAC plus #aspirin when there isn't a strong indication is associated with higher rates of non-major bleeding. Similar findings with warfarin use. Important findings from @MAQI_2 in @JAMAInternalMed
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I’m thrilled to start working with @notthatdrsmith and colleagues from @UM_IHPI @umichCVC to identify best methods for alerting clinicians about safe #cvCoag prescribing; how best to utilize nurses and pharmacists? Thank you to @AHRQNews for supporting our team’s work!
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Is a combined oral contraceptive pill REALLY the provoking factor for a #VTE event? Ask when the OCP was started. If recently, probably a key provoking factor. If >12 mo prior, consider other factors that may be contributing to VTE risk. Great advice from Dr Vazquez @ACForum23
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The results of the HOME-PE study are fascinating! ~1/3 of patients with acute PE could be safely managed at home (we're no where close to that in US). @klinelab @PERTConsortium @mmonrealriete @DJC6998
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Do you use apixaban in patients with #AFib and #ESRD? This new trial looked at lower-dose apixaban 2.5 bid vs VKA. Similar adverse event rates, but note the high rate of bleeding in both arms! #ACForum23
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.@connors_md demonstrates very high rates of #VTE recurrence over 5 years in men, even if they had a “negative” d-dimer. Women without estrogen use also with somewhat high recurrence risk. Why not low-dose DOAC for most except estrogen-provoked VTE? #ISTH2019
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Here is how @DebSiegal approaches the management of restarting #cvCoag drugs when a patient experiences a bleeding event.
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Reflections after my first day on Gen med since 2012. It’s a bit easier when everyone (well, all but one patient) has the same diagnosis. But it’s really frustrating when there is so little that we can do to relieve suffering from #COVID19 (cough, chest pain).
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Hey #ACC23, Artie is committed to health equity!! I’m proud to help him with this critical work. @ACCinTouch
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In fellowship, I was taught that diuresis is ALWAYS the right answer for patients with Pulmonary Hypertension exacerbations. Might the same be true for acute PE with right ventricular dysfunction? Interesting study showing some benefit. @PERTConsortium
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When I was in training, we used to think rate and rhythm control were “equal” for #cvAFib. We now know that rhythm control has significant benefits! #BackToHeart22
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I’m always excited to visit @ACCinTouch Heart House, but especially when I get to #GoRedForWomen with so many #EmergingFaculty alumni and friends!!
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Grateful that our @A2BryPatSchools elementary school celebrates diversity in all its forms… including #LGBTQ families like ours. I wish the same for all families in Florida
My kids go to a school where they can safely talk about their parents — two gay dads. 👨👨👧👦. What about families like ours in Florida? You can’t erase me, my husband, or my kids, and I won’t stand by while lawmakers try. ✊🏻🌈 #DontSayGay.
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Did you know that the risk of upper GI bleeding is markedly elevated in patients taking #cvCoag and #aspirin simultaneously? We need to stop ASA in these patients when we can. When we can’t, PPI therapy can be protective! @jekurlander @MAQI_2
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What #cvCoag strategy do you use for acute PE? @RosovskyRachel shows data that <50% of patients receiving UFH are therapeutic by 24 hrs. LMWH is much more reliable and rapid onset! And most catheter-based procedures can be done safely after LMWH, right @jaygirimd? #PERT2023
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Can you give DVT prophylaxis in a patient with intracranial bleed? A nice review article from neurosurg experts says YES! #ACForum23
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Holding apixaban for 48hrs is perfectly safe before surgical procedures. No lab testing needed!.
From the June issue:.For patients taking apixaban, guidelines recommend cessation 48 h prior to surgery. How does this perform in a clinical setting?. Merli et al. measure drug levels in 111 in patients following apixaban discontinuation prior to surgery.
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I’m getting excited for #ACC24. It’s sunny, beautiful, and the convention center is close to centennial park. Gotta stop by and see the Olympic rings!
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Morning thoughts about #PE: although a patient with PE may have a high 30-day mortality risk according to PESI score, it does not mean their mortality is PE-related or that intervention of PE will reduce that risk. Cancer and age are big components of risk, not impacted by lysis.
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In the past 5 years, I’ve found myself using d-dimer less often to decide when extended #cvCoag is warranted in #VTE. This cohort study justifies that choice. Unprovoked VTE needs long-term anticoag. Low-dose apixaban and rivaroxaban are good options, IMO.
D-dimer and reduced dose apixaban for extended treatment after unprovoked venous thromboembolism: the Apidulcis stu…
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Everyone needs an opportunity to recharge. I think this will do!
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Congratulations to @KBerlacher on a hugely successful tenure leading the @ACCinTouch Lifelong Learning Oversight Committee. So many innovative education programs in the pipeline thanks to her leadership!! #ACC23
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Here’s to a new year with new hope for better health and re-connecting ✈️ with friends from around the world!
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While we all know that #VTE can cause significant morbidity and mortality, the psychological impact of a diagnosis can be overwhelming. How can we best care for the physical AND psychological well-being of our patients with VTE? @grelegal @leslieskeith #ISTH2022
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The data just keeps adding up… #DOACs can be used for a broad range of thrombotic conditions. For me, only major “restrictions” on DOAC use are mechanical valves and high-risk anti-phospholipid syndrome. How about you?.
Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT): A Multicenter International Study .@heatherlgornik @SVM_tweets.
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Amber. in nearly every situation that I can think of, patients get better care when physicians partner with pharmacists. It just makes sense!.
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.@crowthrm shares his “Rules of Hematology” at #ACFORUM19. Good to remember that #cvCoag drugs don’t CAUSE bleeding, they just make it more prominent and longer lasting when it occurs. Always look for a source, don’t just blame a drug
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Do you rely on the "Chest Guidelines" for #VTE #cvCoag management? Then check out their 2021 update here: Great work with practical PICO questions by @SCWollerMD @Lbkreuziger @PhilWellsMD1 and many more! @accpchest.
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An excellent graphical representation of #VTE recurrence risk. I’ll probably start using this in my talks and with patients in clinic!!.
This is really helpful data when thinking about duration of anticoagulation @canvector @ThrombosisCan
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Please stop ordering MTHFR polymorphism tests for hyperhomocysteinemia in patients with #VTE. And please do NOT tell your patients with #VTE that have elevated homocyteine levels that they have a thrombophilia!.
A call to action: MTHFR polymorphisms should not be a part of inherited thrombophilia testing @connors_md @bhwords @GBarnesMD
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Pardon the Gen Med reflection interruption for a #SocialDistance weekend win. first time using pedals! #BalanceBikeIsBest
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Excellent talk by @AArmbruster09 on anticoagulation considerations in cancer-associated VTE #askyourpharmacist #ACC19 @ACCinTouch @accpcardprn.
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I’ve got my hotel and flight booked for #ISTH2024 in Bangkok. Join me for great science and great friendship!
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Can you use a DOAC for patients with CTEPH? This RCT of warfarin vs edoxaban shows similar outcomes in patients with prior endarterectomy or BPA treatment. Patients find DOACs much easier to take. #AHA23
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How do you define a perfect summer evening? I’d vote for a family bike ride to get ice cream at @DairyQueen!.
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Check out this fun and engaging tweetorial that I put together discussing #cvCoag treatment options and current limitations of #DOAC therapy. Test your knowledge with fun multiple-choice questions and earn #CME!.
1) Welcome to a 🆕accredited #tweetorial for 0.5hr CE/#CME from @cardiomet_ce. In this program our returning expert faculty @GBarnesMD from @umichCVC & @AnticoagForum discusses limitations of #DOACs and how emerging #anticoagulants may address them.
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Which patients with stable #CAD/#PAD should get rivaroxaban 2.5mg BID+ASA? Two great analyses in @JACCJournals today help us identify: Pts with 1) multi-vessel disease, 2) CKD, 3) CHF, 4) DM. Worth considering in smokers as well.
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DOACs made a HUGE step forward over VKA. But bleeding is still a major problem for many patients. Can we do better? #AHA23
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Which thrombophilias are associated with ARTERIAL thrombosis? Dr May provides an outline for which are relevant and which are not. She notes APS is probably the most relevant for arterial thrombosis. #ACForum23
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.@DebSiegal highlights why I work so hard to help patients avoid bleeding complications from #cvCoag meds… bleeding is associated with HIGH risk of death. Think about aspirin de-prescribing, correcting #DOAC doses, using PPI if 2+ antithrombotic meds
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A great example of how data visualization really influences how we interpret said data!.
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IVC filters. an example of when guidelines may not always guide. Can we come together to create single guideline on which consensus can be built? @SVM_tweets
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Congratulations to @RosovskyRachel @KSanfilippoMD @connors_md and colleagues on the completion of the CANVAS RCT of DOAC vs. LMWH for #cancer-associated #VTE.
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.@JerroldLevy showed a lack of concordance between aPTT and anti-Xa levels for patients on heparin. We use anti-Xa almost exclusively at @umichCVC. How about your center? #ISTH2021
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I’m a cardiologist and vascular specialist who helps prevent & treat blood clots that occur in #COVID19. My husband and I are both vaccinated. We hope to enroll our daughter in a clinical trial for pediatric #COVID19Vaccine and will vaccinate her as soon as we are able.
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