cardiologist, teacher, seeking 'forever knowledge'; grandfather to Titan, Tucker, Tate, Tenley, AJ, Delaney, Bailey, Brooks, Hadley; PD Cardiology USF/MCOM

Tampa, Florida
Joined September 2013
xavier prida retweeted
The high-earner paradox: why people who earn the most often keep the least. Physicians, tech executives, senior corporate leaders and real estate operators share a strange problem. On paper, they are in the top few percent of earners. In practice, many reach their fifties with less real wealth than a disciplined teacher married to an engineer. Not because they are careless. Because their situation has five features that quietly work against them. 1. A late start. A physician may not earn a real salary until their mid-thirties. Compounding rewards time, and we start with less of it. 2. Income concentrated in its most expensive form. W-2 wages are taxed at ordinary rates plus payroll taxes. At the top of the scale, the federal rate on the next dollar of salary is roughly 39%, before any state tax. 3. Rising lifestyle that locks in early. The house, the cars, the schools: each is reasonable on its own. Together, they turn a high income into a high fixed cost. 4. Portfolios built without a tax lens. Good funds, held in the wrong accounts, with more turnover than anyone noticed. That is tax drag, and it compounds against you every year. 5. Risk that is under-insured. The largest asset most professionals own in their thirties and forties is their future earning power, and it is often the least protected. None of these requires a genius to fix. They require architecture: a deliberate design for how income is earned, taxed, saved, located, protected and passed on. That architecture is what I will be writing about here over the coming weeks, one framework at a time. Education, not individualized advice.
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1/ Finerenone vs spironolactone in HFpEF / EF ≥40%. Both were tested vs placebo. Zero head-to-head outcomes RCT. Here's what the data actually say 🧵
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xavier prida retweeted
The line comes from John Steinbeck’s 1952 novel East of Eden. It’s a deceptively simple sentence, and one I admittedly glossed over when I first read the book. Only later did I really understand what Steinbeck was getting at. The pursuit of perfection can be paralyzing because perfection is impossible. Once that burden is removed, though, we are free to simply try to be good. That idea fits closely with one of East of Eden’s central themes: “timshel,” the belief that human beings have the ability to choose what kind of person they become. Steinbeck makes goodness feel ordinary and attainable. You do not have to be flawless or heroic. Kindness, generosity, compassion, and making the better choice when you can are enough. In simpler terms: perfection is the enemy of good.
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🎓🩺🎓🩺 ✅ My group of second year medical students (OU College of Medicine) as they get close to end of their semester ✅ The future is bright! @OUCollegeofMed @Hragy @HeartOTXHeartMD @iamritu @OUdoim @ToddVillinesMD
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xavier prida retweeted
Our #JACCCardioonc review led by @uclaimchiefs @Tylermorad & IM res @MKeykhaeiMD & @A_SteinMerlob tackles the lesser-explored aspects of ICI myocarditis care--the outpatient care, or the aftermath. 🙏 @JACCJournals for the opportunity #bruinhearts shorturl.at/PMlfR 🧵1/
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"A Few Good Men" like you, Hari.
On the way to give cardiology grand rounds at @AHN_CVI. This is my third trip - first two times I helped them construct their #HCM program & then went back to proctor their first few alcohol ablations personally. Now with my friend @KhandelwalMD at the helm I’m looking forward!
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As it should be with us all. Be a debtor, not a creditor. The famously demanding NFL coach has quietly given millions to former players who fell on hard times. thedaily.coach/p/the-other-s…
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A prevention conundrum: - LDL-C lowering is prioritized after an ASCVD event because near-term absolute risk is high. - Yet relative benefit is greater before a first event and at younger ages. sciencedirect.com/science/ar… (Burger PM et al Atherosclerosis 2024) We need to keep moving toward improving high lifetime-risk identification before the disease declares itself.
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Excited to share our new publication in @Nature demonstrating that a newly identified inhibitor of pericyte contraction can improve myocardial microvascular perfusion in animal models of ischemia and reperfusion. Pericytes are contractile cells that wrap around capillaries and regulate their diameter. Following ischemia and reperfusion, sustained pericyte contraction can constrict capillaries, impair microvascular blood flow, and contribute to the no-reflow phenomenon, even after the blocked coronary artery has been reopened. By inhibiting pericyte contraction, we may be able to restore capillary blood flow and improve myocardial tissue perfusion following heart attack. nature.com/articles/s41586-0…
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Hispanic Heritage month concludes tomorrow. This year the theme was “unidos somos más” which means “together we are more”. Didn’t want the month to end without giving a shoutout to all my Hispanic colleagues and friends wherever you are. To celebrate, this is my rendition of “Sabor a Mi”, a bolero initially sung by Mexican Alvaro Carillo in 1959 and made popular by Luis Miguel. @jgranadacrf @AdrianaCMares @XavierPrida @AMartinezMD_ @torresrpablo @torresviera @CastroFrenchie @Julio_Farjat @saraceciliamtz @DrAngieMolina @jpcostabel @juancbatlle @SrihariNaiduMD @mmamas1973
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xavier prida retweeted
If you had told me 5 years ago that this would be the front page of JACC CI, I'm not sure I would have believed you. My thanks to these colleagues for their work.
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xavier prida retweeted
No, they can't measure blood pressure accurately. American Heart Statement: "currently available devices may be inappropriate for clinical use." and "using these devices to guide treatment could lead to inappropriate care and may pose safety risks to patients." @American_Heart ahajournals.org/doi/10.1161/… open-access gift link wsj.com/health/wellness/bloo…
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xavier prida retweeted
We just won three straight elimination games to advance! One game winning streaks. Breathe deep. Compete for every pitch. Trust the guy next you. Onward to Tampa.
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Been reading a remarkable book long since forgotten by James Thomas Flexner the son of Dr. Simon Flexner the founding Director of @RockefellerUniv and nephew of Abraham Flexner of the “Flexner Report.” It’s like a Microbe Hunters of early Colonial and American medicine. First written in 1937, detailed but not fussy, well written, lousy title, found it as one of the Dover resurrection editions of the 1970s which were common when I was a HS student
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Incredible plenary session @HFSA #HFSA2026 by @LGlaucomflecken on how much our words matter in medicine 🙏 👉Please come see her speak more about this at JCF Showdown Debates at 1115a 124 Ab Pcc North! 💜 To access her incredible pieces @JCardFail see here: onlinejcf.com/article/S1071-… onlinejcf.com/article/S1071-…
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Believing: "Vision without action is a daydream.... Action without vision is a nightmare." Former Chicago Bears coach Mike Ditka stood out for one simple leadership ideal nytimes.com/athletic/7675874…
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"The decision to intervene and the decision to observe require the same clinical rigor, the same evidence base, and the same resolve" - Signaling - Compassionate caring - Hidden motives The Quiet Half of Good Medicine jamanetwork.com/journals/jam…
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xavier prida retweeted
Exercise and remission from cancer: A randomized trial found 37% improved survival, 28% disease-free survival. But little is being done to incorporate in practice except @UPMC 1st health system covering "exercise oncology" program. gift link, by @AgrawalNina nytimes.com/2026/10/06/well/…
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