POPULARITY
44 episodes with ascvd
11 episodes with ascvd
30 episodes with ascvd
9 episodes with ascvd
10 episodes with ascvd
3 episodes with ascvd
6 episodes with ascvd
3 episodes with ascvd
3 episodes with ascvd
3 episodes with ascvd
5 episodes with ascvd
5 episodes with ascvd
3 episodes with ascvd
5 episodes with ascvd
4 episodes with ascvd
5 episodes with ascvd
4 episodes with ascvd
3 episodes with ascvd
3 episodes with ascvd
4 episodes with ascvd
3 episodes with ascvd
3 episodes with ascvd
6 episodes with ascvd
5 episodes with ascvd
5 episodes with ascvd
3 episodes with ascvd
3 episodes with ascvd
พี่ปุ๋มเพิ่งได้งานวิจัยที่ถือว่าดีที่สุดฉบับแรกที่ได้อ่านในรอบครึ่งปีนี้ เพิ่งตีพิมพ์เมื่อ 25 มิ.ย.2568 ใน Current Opinion of Lipidology ค่ะมีงานวิจัยสนับสนุนหนักแน่นเพิ่มมากขึ้นตลอดระยะเวลา 264 ปีของความเข้าใจคอเลสเตอรอล และกระบวนการเกิด Atherosclerosis คือ1. LDL คือ independent risk factor ในการเพิ่มความเสี่ยง Atherosclerotic Cardiovascular Disease2. ทั้งจำนวนและปริมาณคอเลสเตอรอลที่อยู่ใน ApoB-Containing lipoproteins คือ major risk factors ของ โรคหลอดเลือดหัวใจแต่สิ่งที่น่าสนใจที่สุดจากงานวิจัยฉบับนี้ที่เสริมข้อ 1 และ 2 คือ3. คุณสมบัติที่แตกต่างของ ApoB containing lipoproteins ในคนแต่ละคนที่ติดตัวมา ส่งผลต่อความสามารถในการก่อโรคหลอดเลือดหัวใจอุดตันไม่เท่ากัน (หัวข้อนี้น่าทึ่งสุดๆค่ะ)4. การจัดเรียงตัวและประเภทของไขมันที่แตกต่างกันภายใน lipoprotein particles และ dynamic ของ ApoB-100 ที่อยู่บนผิวของ lipoprotein particle ส่งผลต่อเสถียรภาพของ lipoproteins ชนิดนั้น ในการทำปฏิกิริยาต่อ receptors, ความสามารถในกระบวนการก่อกำเนิด atherosclerosis ที่แตกต่างกัน5. มีปัจจัยที่ส่งอิทธิพลต่อเสถียรภาพของ Low-density lipoprotein particle และ ApoB-100 ซึ่งเปิด frontier ใหม่ของการพัฒนากลยุทธ์การลดความเสี่ยง ASCVD เฉพาะรายบุคคลความก้าวหน้าทางเทคโนโลยีทำให้นักวิจัยเข้าใจ ApoB-100 และ Low-density lipoprotein แบบ molecular structural insightful มากขึ้นค่ะ งานวิจัยเรื่อง ApoB-containing lipoproteins กับ ความสามารถในการก่อ Atherosclerosis เขาก้าวหน้ากันไปถึงไหนแล้ว กูรู้สุขภาพยังงมอยู่กับ “เรื่องเล่า” กับ เคสรายบุคคล (anecdotal case) ที่ไม่ได้อยู่บน evidence-based medicine เลย#หาคำตอบสุขภาพจากงานวิจัยไม่ใช่จากเรื่องเล่า#FatoutHealthspans่มขึ้น
In this episode, CardioNerds Dr. Gurleen Kaur, Dr. Richard Ferraro, and Dr. Jake Roberts are joined by Cardio-Rheumatology expert, Dr. Monica Mukherjee, to discuss the role of utilizing multimodal imaging for cardiovascular disease risk stratification, monitoring, and management in patients with chronic systemic inflammation. The team delves into the contexts for utilizing advanced imaging to assess systemic inflammation with cardiac involvement, as well as the role of imaging in monitoring various specific cardiovascular complications that may develop due to inflammatory diseases. Audio editing by CardioNerds academy intern, Christiana Dangas. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Cardiovascular Multimodality Imaging & Systemic Inflammation Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk stratification, and implementation of therapeutic strategies to address these risks and disease-specific complications. As an example, patients with SLE have a 48-fold increased risk for developing ASCVD compared to the general population. They may also develop disease-specific complications, such as pericarditis, that require focused imaging approaches to detect. In addition to increasing the risk for CAD, systemic inflammatory diseases can also result in cardiac complications, including myocardial, pericardial, and valvular involvement. Assessment of these complications requires the use of different imaging techniques, with the modality and serial studies selected based on the suspected disease process involved. In most contexts, echocardiography remains the starting point for evaluating cardiac involvement in systemic inflammatory diseases and can inform the next steps in terms of diagnostic study selection for the assessment of specific cardiac processes. For example, if echocardiography is completed in an SLE patient and demonstrates potential myocardial or pericardial inflammation, the next steps in evaluation may include completing a cardiac MRI for better characterization. While no current guidelines or standards of care directly guide our selection of advanced imaging studies for screening and management of CVD in patients with systemic inflammatory diseases, our understanding of cardiac involvement in these patients continues to improve and will likely lead to future guideline development. Due to the vast heterogeneity of cardiac involvement both across and within different systemic inflammatory diseases, a personalized approach to caring for each individual patient remains central to CVD evaluation and management in these patients. For example, patients with systemic sclerosis and symptoms of shortness of breath may experience these symptoms due to a range of causes. Echocardiography can be a central guiding tool in assessing these patients for potential concerns related to pulmonary hypertension or diastolic dysfunction. Based on the initial echocardiogram, the next steps in evaluation may involve further ischemic evaluation or right heart catheterization, depending on the pathology of concern. Show notes - Cardiovascular Multimodality Imaging & Systemic Inflammation Episode notes drafted by Dr. Jake Roberts. What are the contexts in which we should consider pursuing multimodal cardiac imaging, and are there certain inflammatory disorders associated with systemic inflammation and higher associated CVD risk for which advanced imaging can help guide early intervention? Systemic inflammatory diseases are associated with elevated CVD risk, which has significant implications for early detection, risk stratification, prognostication, and implementation of therapeutic strategies to address CVD risk and complicat...
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/when-and-why-to-use-cac-scoring/35818/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/where-does-this-patient-land-making-sense-of-risk-and-ldl-c-goals/35815/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/expanding-access-alternative-models-for-delivering-lipid-lowering-therapy/35817/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/the-dose-matters-optimizing-statin-intensity-in-ascvd-management/35816/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/statins-and-safety-what-the-data-say-about-dementia-cancer-and-more/35819/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/closing-the-loop-practical-strategies-for-timely-lipid-panel-follow-up/35820/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/target-in-sight-escalating-therapy-to-reach-ldl-c-goals/35821/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/personalizing-ldl-c-treatmentnovel-options-that-align-with-patient-preferences/35822/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/unmasking-hidden-risk-the-role-of-lpa-in-cardiovascular-risk-assessment/35823/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 10-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/bridging-ascvd-care-between-academic-and-rural-settings/35824/ Join our experts for case-based episodes that focus on bridging the gap between rural health and cardiovascular disease. Experts will explore ASCVD prevention and treatment by reviewing patient risk factors and determining ASCVD risk reduction strategies. This activity is designed to empower healthcare professionals with the knowledge and tools needed to make impactful decisions in cardiovascular care.
CME credits: 1.00 Valid until: 30-05-2026 Claim your CME credit at https://reachmd.com/programs/cme/remnant-cholesterol-the-missing-link-in-ascvd-risk/33226/ There is an unmet need for patients with FCS, SHTG, and mixed hyperlipidemia, as most patients are non-responsive to current standard of care. Recent developments on APOC3 inhibition show promising results for the management of these patient groups. Four experts discuss the characteristics, diagnostic criteria and the risks of patients with FCS, SHTG, and mixed hyperlipidemia, and review the recent evidence of clinical trials with new APOC3 inhibitors.
Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! Top 5 Healthcare Headlines for May 12-18, 2025. FDA Approves Once-Daily Roflumilast (ZORYVE) Foam 0.3% for Scalp and Body Psoriasis The FDA approved once-daily roflumilast (Zoryve) foam 0.3% for treating plaque psoriasis on the scalp and body in patients aged 12 and older. This marks the fifth overall indication for roflumilast, adding to its existing approvals in psoriasis and atopic dermatitis. FDA Warns About Rare, Severe Itching After Stopping Cetirizine or Levocetirizine The FDA issued a warning about severe pruritus that can occur after stopping long-term cetirizine or levocetirizine use. Manufacturers will be required to add a label warning noting that symptoms may improve if the medications are restarted. FDA Approves Susvimo for Treatment of Diabetic Retinopathy The FDA approved Genentech's Susvimo, a ranibizumab delivery system, as the first continuous refillable treatment for diabetic retinopathy. Susvimo offers sustained vision maintenance with refills needed only once every nine months. Olezarsen Cuts Triglyceride Levels at 6 Months in Essence Study The Essence study showed olezarsen significantly reduced triglyceride levels in patients with moderate hypertriglyceridemia at ASCVD risk. Monthly doses achieved about 60% reductions, with most patients reaching normal triglyceride levels after six months. Ruxoprubart Shows Efficacy for PNH in Interim Phase 2 Trial Results Interim Phase 2 results showed ruxoprubart met all primary efficacy endpoints in adults with paroxysmal nocturnal hemoglobinuria. The therapy led to transfusion avoidance, improved hemoglobin, reduced LDH, and increased PNH clone size at 12 weeks.
Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! Top 5 Healthcare Headlines for April 28-May 4, 2025: Obicetrapib Achieves Robust LDL-C Reductions in Phase 3 ASCVD Trials Obicetrapib significantly reduced LDL-C as monotherapy and in combination with ezetimibe in ASCVD patients inadequately controlled by statins, according to Phase 3 data presented at EAS 2025. MAR001 Cuts Remnant Cholesterol, Triglycerides by 50% in Phase 2a Trial MAR001, a novel ANGPTL4-targeting monoclonal antibody, reduced remnant cholesterol and triglycerides by over 50% in high-risk patients, suggesting a promising new cardiovascular intervention strategy. Oral Zervimesine Reduces Geographic Atrophy Lesion Growth in Phase 2 Trial Zervimesine (CT1812) slowed lesion progression in geographic atrophy secondary to AMD in Phase 2 MAGNIFY trial results, offering a potential oral treatment option. UBX1325 Matches Aflibercept in Vision Gains for DME at 36 Weeks UBX1325 demonstrated noninferiority to aflibercept in visual acuity gains in patients with diabetic macular edema over 36 weeks in the Phase 2b ASPIRE study. Roflumilast Foam 0.3% for Scalp, Body Psoriasis Effective, Safe for Patients Roflumilast foam 0.3% achieved significant efficacy and rapid symptom control in scalp and body psoriasis, with an FDA decision expected by late May 2025.
Host: Ty J. Gluckman, MD, MHA, FACC, FAHA, FASPC Host: Rishi Wadhera, MD, MPP, Mphil This on-demand knowledge primer explores key challenges and evidence-based strategies for improving atherosclerotic cardiovascular disease (ASCVD) management in rural populations. Led by two expert faculty members, the program provides a comprehensive overview of disparities in ASCVD care, guideline-directed therapies, and practical approaches to overcoming barriers in rural settings. Participants will gain essential knowledge to enhance patient outcomes and optimize cardiovascular care in underserved communities.
CME credits: 1.00 Valid until: 02-04-2026 Claim your CME credit at https://reachmd.com/programs/cme/establishing-best-practices-for-collaborative-care-for-patients-with-ascvd-between-academic-and-rural-providers/29824/ This on-demand knowledge primer explores key challenges and evidence-based strategies for improving atherosclerotic cardiovascular disease (ASCVD) management in rural populations. Led by two expert faculty members, the program provides a comprehensive overview of disparities in ASCVD care, guideline-directed therapies, and practical approaches to overcoming barriers in rural settings. Participants will gain essential knowledge to enhance patient outcomes and optimize cardiovascular care in underserved communities.=
CardioNerds co-founders Dr. Daniel Ambinder and Dr. Amit Goyal are joined by Dr. Spencer Weintraub, Chief Resident of Internal Medicine at Northwell Health, Dr. Michael Albosta, third-year Internal Medicine resident at the University of Miami, and Anna Biggins, Registered Dietitian Nutritionist at the Georgia Heart Institute. Expert commentary is provided by Dr. Zahid Ahmad, Associate Professor in the Division of Endocrinology at the University of Texas Southwestern. Together, they discuss a fascinating case involving a patient with a new diagnosis of hypertriglyceridemia. Episode audio was edited by CardioNerds Intern Student Dr. Pacey Wetstein. A woman in her 30s with type 2 diabetes, HIV, and polycystic ovarian syndrome presented with one day of sharp epigastric pain, non-bloody vomiting, and a new lower extremity rash. She was diagnosed with hypertriglyceridemia-induced pancreatitis, necessitating insulin infusion and plasmapheresis. The CardioNerds discuss the pathophysiology of hypertriglyceridemia-induced pancreatitis, potential organic and iatrogenic causes, and the cardiovascular implications of triglyceride disorders. We explore differential diagnoses for cardiac and non-cardiac causes of epigastric pain, review acute and long-term management of hypertriglyceridemia, and discuss strategies for the management of the chylomicronemia syndrome, focusing on lifestyle changes and pharmacotherapy. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Hypertriglyceridemia Cardiac sarcoidosis can present with a variety of symptoms, including arrhythmias, heart block, heart failure, or sudden cardiac death. The acute management of hypertriglyceridemia-induced pancreatitis involves prompt recognition and initiation of therapy to lower triglyceride levels using either plasmapheresis or intravenous insulin infusion +/- heparin infusion. Insulin infusion is used more commonly, while plasmapheresis is preferred in pregnancy. Medications such as fibrates and omega-3 fatty acids can be used to maintain long-term triglyceride reduction to prevent the recurrence of pancreatitis, especially in patients with persistent triglyceride elevation despite lifestyle modifications. Statins can be used in patients for ASCVD reduction in patients with a 10-year ASCVD risk > 5%, age > 40 years old, and diabetes or diabetes with end-organ damage or known atherosclerosis. Consider preferential use of icosapent ethyl as an omega-3 fatty acid for triglyceride lowering if the patients fit the populations that appeared to benefit in the REDUCE IT trial. Apply targeted dietary interventions within the context of an overall healthy dietary pattern, such as a Mediterranean or DASH diet. Limit full-fat dairy, fatty meats, refined starches, added sugars, and alcohol. Encourage high-fiber vegetables, whole fruits, low-fat or fat-free dairy, plant proteins, lean poultry, and fish. Pay special attention to the cooking oils to ensure the patient is not using palm oil, coconut oil, or butter when cooking. Instead, use liquid non-tropical plant oils. Initiate a very low-fat diet (< 5% of total daily calories from fat) for 1-4 weeks when TG levels are > 750 mg/dL. Recommend and encourage patients to exercise regularly, with a minimum goal of 150 minutes/week of moderate-intensity aerobic activity. If weight loss is required, aim for more than >225 - 250 minutes/week. Develop patient-centered and multidisciplinary stra...
New RNA Therapies for Treatment of ASCVD, Prevention, and Dyslipidemia Guest: R. Scott Wright, M.D. Host: Stephen L. Kopecky, M.D. RNA therapies are growing in number as targeted treatments for dyslipidemia including LDL-c, Lp(a) and Triglycerides. The podcast will explore the science behind these therapies, the evidence for safety and how clinicians can utilize them in their practices. Topics Discussed: What are the new RNA therapies available or soon to be available? How are RNA based therapies being used? How do they compare to the COVID-19 vaccine? What is their effectiveness and side effect profile? Are there side effects or concerns? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.
Welcome to The HCPFive, your go-to roundup for the latest healthcare news and breakthroughs, curated specifically for busy healthcare professionals. Each week, we highlight 5 key developments or headlines from healthcare that you need to know—whether it's a cutting-edge treatment, regulatory updates, or innovations shaping the future of medicine. This week's top stories included the US Food and Drug Administration's (FDA) acceptance of a Biologics License Application (BLA) for a cholesterol-lowering drug, long-term data on a dermatologic treatment for hidradenitis suppurativa, an expanded dosing label for a blinding eye disease treatment, and more! With The HCPFive, you'll get the essential takeaways to stay informed and ahead of the curve. Here's your quick dive into the top stories for the week of February 09, 2025—let's jump in! Interested in oncology news? Check out The OncFive, from our sister publication OncLive. Top News for Healthcare Providers from the Week of 02/09 1. FDA Accepts Lerodalcibep BLA for LDL-C Reduction in High-Risk Patients The FDA accepted the BLA for lerodalcibep, targeting reductions in low-density lipoprotein cholesterol (LDL-C) levels in patients with or at high risk for atherosclerotic cardiovascular disease (ASCVD) and primary hyperlipidemia. The agency set a Prescription Drug User Fee Act (PDUFA) action date of December 12, 2025, and announced no plans to hold an advisory committee meeting. 2. Travere Therapeutics Plans FSGS Submission for Sparsentan Travere Therapeutics announced its intent to submit a supplemental New Drug Application (sNDA) for sparsentan (Filspari) with the FDA for the treatment of focal segmental glomerulosclerosis (FSGS) at the end of Q1. The announcement arrived soon after the completion of a Type C meeting with the FDA, with the sNDA based on existing data from the Phase 3 DUPLEX and Phase 2 DUET studies. 3. Bimekizumab Long-Term Hidradenitis Suppurativa Data Support Efficacy, Safety Profile Bimekizumab (Bimzelx) was associated with sustained disease control for up to 2 years in patients with hidradenitis suppurativa (HS), according to presentation of long-term data from the BE HEARD trials. Presented at the 14th Conference of the European Hidradenitis Suppurativa Foundation (EHSF), bimekizumab reduced the symptoms of HS, achieved a low rate of flares, and improved health-related quality of life. 4. Rosnilimab Demonstrates Historic Responses for Rheumatoid Arthritis Rosnilimab achieved historic American College of Rheumatology (ACR) and clinical disease activity index (CDAI) low disease activity (LDA) responses in patients with rheumatoid arthritis (RA), according to new Phase 2b findings. A depleter and agonist of PD-1+ T cells, rosnilimab was evaluated in the global 424-patient RENOIR trial for efficacy, safety, tolerability, pharmacokinetics, and pharmacodynamics in patients with moderate-to-severe RA on background conventional disease-modifying antirheumatic drugs (cDMARDs). 5. FDA Expands Dosing Label for Avacincaptad Pegol for Geographic Atrophy The FDA approved an expanded label for avacincaptad pegol intravitreal solution (IZERVAY) for geographic atrophy (GA), extending the approved dosing beyond 12 months. Announced by Astellas Pharma, the decision comes after the company resubmitted its supplemental New Drug Application (nDA) in December 2024, based on feedback received from the FDA. The company received a Complete Response Letter (CRL) the month prior. See you next week! Editor's note: this was created with the assistance of AI tools.
Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis. Traditional lipid-lowering therapies have minimal impact on Lp(a), necessitating novel treatments. Zerlasiran, a small-interfering RNA (siRNA), significantly reduces Lp(a) (~85%) by inhibiting hepatic apolipoprotein(a) synthesis via subcutaneous injection. Muvalaplin, an oral small-molecule inhibitor, prevents Lp(a) particle formation, reducing levels by up to 85.8%. Both drugs were well-tolerated in Phase 2 trials, with further studies needed to evaluate cardiovascular event reduction.
Heart disease is often thought of as a "man's disease," but the reality is that it affects women just as much—if not more. The problem? Women aren't getting the information they need to take control of their heart health. Did you know that heart disease is the leading killer of women, yet so many of us remain unaware of the risks? We sit down with the brilliant Dr. Martha Gulati, a leading expert in preventative cardiology, to uncover the real facts about heart health. From debunking myths about hormone replacement therapy (HRT) to explaining how women can take proactive steps to protect their hearts, this conversation is packed with game-changing insights. Whether you're in your 30s, 40s, or beyond, understanding your heart health now could save your life in the future. Don't miss this essential episode—your heart will thank you! What You'll Learn in This Episode: The Truth About Heart Disease in Women – Why it's often overlooked and why it's crucial to start screening early. Hormone Replacement Therapy (HRT) & Heart Health – Does it actually help prevent heart disease? Dr. Gulati sets the record straight. How to Assess Your Own Risk – Learn about risk scores like the ASCVD and the new PREVENT score to better understand your heart health. The Role of Lifestyle in Prevention – Small changes can have a big impact! Discover how diet, exercise, and stress management play a role in keeping your heart strong. Coronary Calcium Scoring & Advanced Testing – Who should consider getting additional tests for heart disease risk? The Importance of Knowing Your Numbers – Why you should get tested for LP(a), ApoB, cholesterol, and blood pressure levels. Connect with Us: Please sign up for our SUBSTACK so you can forward this information to all your friends inboxes! For more episodes, merch, or to send us direct messages: Website: https://yourdoctorfriendspodcast.com Email: yourdoctorfriendspodcast@gmail.com Socials: Follow @your_doctor_friends on Instagram, TikTok, and YouTube. DM or send us a voice memo—we might feature it on the show! Resources & Links: ASCVD Risk Calculator – Find your heart disease risk score here Your Doctor Friends Podcast Website – www.yourdoctorfriendspodcast.com Email Us Your Questions! – yourdoctorfriendspodcast@gmail.com Follow Dr. Martha Gulati – [Twitter | Instagram | Website] Support the Show! If you found this episode helpful, please take a moment to rate Your Doctor Friends on Apple Podcasts and Spotify. A five-star review helps us reach more listeners and spread life-saving health information. Don't forget to share this episode with a friend—because when it comes to heart health, knowledge is power! Join the Conversation! Have a question about heart health? Leave us a voicemail on our website, and we might feature your question in an upcoming episode! Thanks for tuning in to another episode of Your Doctor Friends! Stay heart-smart, and we'll see you next time.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Tom Dayspring is a world-renowned expert in clinical lipidology and a previous guest on The Drive. In this episode, Tom explores the foundations of atherosclerosis and why atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide for both men and women. He examines how the disease develops from a pathological perspective and discusses key risk factors, including often-overlooked contributors such as insulin resistance and chronic kidney disease. He breaks down the complexities of cholesterol and lipoproteins—including LDL, VLDL, IDL, and HDL—with an in-depth discussion on the critical role of apolipoprotein B (apoB) in the development of atherosclerosis. Additionally, he covers the importance of testing various biomarkers, the impact of nutrition on lipid levels, and the vital role of cholesterol in brain health, including how cholesterol is synthesized and managed in the brain, how it differs from cholesterol regulation in the rest of the body, and how pharmacological interventions can influence brain cholesterol metabolism. We discuss: Defining atherosclerotic cardiovascular disease (ASCVD): development, risks, and physiological impact [2:45]; The pathogenesis of ASCVD: the silent development over decades, and the importance of early detection for prevention of adverse outcomes [10:45]; Risk factors versus risk markers for ASCVD, and how insulin resistance and chronic kidney disease contribute to atherosclerosis [17:30]; How hyperinsulinemia elevates cardiovascular risk [24:00]; How apoB-containing lipoproteins contribute to atherosclerosis, and why measuring apoB is a superior indicator of cardiovascular risk compared to LDL cholesterol [29:45]; The challenges of detecting early-stage atherosclerosis before calcification appears [46:15]; Lp(a): structure, genetic basis, and significant risks associated with elevated Lp(a) [55:30]; How aging and lifestyle factors contribute to rising apoB and LDL cholesterol levels, and the lifestyle changes that can lower it [59:45]; How elevated triglycerides, driven by insulin resistance, increase apoB particle concentration and promote atherosclerosis [1:08:00]; How LDL particle size, remnant lipoproteins, Lp(a), and non-HDL cholesterol contribute to cardiovascular risk beyond apoB levels [1:21:45]; The limitations of using HDL cholesterol as a marker for heart health [1:29:00]; The critical role of cholesterol in brain function and how the brain manages its cholesterol supply [1:36:30]; The impact of ApoE genotype on brain health and Alzheimer's disease risk [1:46:00]; How the brain manages cholesterol through specialized pathways, and biomarkers to track cholesterol health of the brain [1:50:30]; How statins might affect brain cholesterol synthesis and cognitive function, and alternative lipid-lowering strategies for high-risk individuals [1:57:30]; Exciting advancements in therapeutics, diagnostics, and biomarkers coming in the next few years [2:09:30]; Recent consensus statements on apoB and Lp(a) from the National Lipid Association (NLA) [2:12:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Host: Keith C. Ferdinand, MD, FACC, FAHA , FASPC, FNLA, FPCNA A concerning number of patients with atherosclerotic cardiovascular disease (ASCVD) reached suboptimal LDL-C levels between 2021 and 2022. Even with new strategies that can help lower LDL-C, an analysis of over 3 million ASCVD patients in the Family Heart Database shows that these treatments are not being properly utilized. Join Dr. Keith C. Ferdinand as he delves into an analysis of management trends among these patients, which he presented at the 2024 Family Heart Foundation Global Summit. Dr. Ferdinand is a Professor of Medicine and the Gerald S. Berenson Endowed Chair in Preventative Cardiology at the Tulane University School of Medicine in New Orleans, Louisiana.
JACC Associate Editor Muthiah Vaduganathan, MD speaks with author Ambarish Pandey, MD about the LookAHEAD trial published in JACC and presented at AHA. Among adults with T2D and overweight/obesity in the Look Action for Health in Diabetes (AHEAD) trial, an intensive lifestyle intervention targeting weight loss led to sustained reductions in hs-cTnT at 1- and 4-year follow-up, and a rise in NT-proBNP at 1 year that attenuated at 4 years. After accounting for baseline biomarker levels and baseline and changes in risk factors, longitudinal increase in NT-proBNP was associated with higher risk of ASCVD and incident HF. In contrast, increase in hs-cTnT was significantly associated with ASCVD but not incident HF.
Elevated lipoprotein(a) levels increase the risk of atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis. Cleveland Clinic's Steven E. Nissen, MD, speaks with JAMA Executive Editor Gregory Curfman, MD, about how zerlasiran produced more than 80% reductions in time-averaged lipoprotein(a) concentration. Related Content: Zerlasiran—A Small-Interfering RNA Targeting Lipoprotein(a)
In this episode, CardioNerds Dr. Gurleen Kaur and Dr. Akiva Rosenzveig are joined by Cardio-Rheumatology experts, Dr. Brittany Weber and Dr. Michael Garshick to discuss treating inflammation, delving into the pathophysiology behind the inflammatory hypothesis of atherosclerotic cardiovascular disease and the evolving data on anti-inflammatory therapies for reducing ASCVD risk, with insights on real-world implementation. Show notes were drafted by. Dr. Akiva Rosenzveig. This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Lexicon Pharmaceuticals. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Treating Inflammation Our understanding of the pathophysiology of atherosclerosis has undergone a few iterations from the incrustation hypothesis to the lipid hypothesis to the response-to-injury hypothesis and culminating with our current understanding of the inflammation hypothesis. Both the adaptive and innate immune systems play instrumental roles in the pathogenesis of atherosclerosis. After adequately controlling classic modifiable risk factors such as blood pressure, dyslipidemia, glucose intolerance, and obesity, systemic inflammation as assessed by CRP can be ascertained as CRP is associated with ~1.8-fold increased risk of cardiovascular events Although the most common side effect of colchicine is gastrointestinal intolerance, colchicine can induce lactose intolerance, so a lactose free diet may help ameliorate colchicine-induced GI symptoms. Anti-inflammatory therapeutics have shown promise in reducing cardiovascular risk but much more is to be learned with ongoing and future basic, translational, and clinical research. Show notes - Treating Inflammation What are the origins of the inflammatory hypothesis? The first hypothesis as to the pathogenesis of atherosclerosis was the incrustation hypothesis by Carl Von Rokitansky in 1852. He suggested that atherosclerosis begins in the intima with thrombus deposition.In 1856, Rudolf Virchow suggested the lipid hypothesis whereby high levels of cholesterol in the blood lead to atherosclerosis. He observed inflammatory changes in the arterial walls associated with atherosclerotic plaque growth, called endo-arteritis chronica deformans.In 1977, Russell Ross suggested the response-to-injury hypothesis, that atherosclerosis develops from injury to the arterial wall.In the 1990's the role of inflammation in ASCVD became more recognized. Both the adaptive and innate immune system are critical in atherosclerosis. Lipids and inflammation are synergistic in that lipid exposure is required but they translocate through damaged endothelium which occurs by way of inflammatory cytokines, namely within the NLRP3 inflammasome (IL-1, IL-6 etc.).Smooth muscle cells are also involved. They migrate to the endothelial region and secrete collagen to create the fibrous cap. They can also transform into macrophage-like cells to take up lipids and become foam cells. T, B, and K cells are also part of this milieu. In fact, neutrophils, macrophages and monocytes make up only a small portion of the cells involved in the atherosclerotic process. What are ways to individually optimize one's ASCVD risk?Ensure the patient is on appropriate antiplatelet therapy, lipid lowering therapy, blood pressure is well controlled, and the Hemoglobin A1c is well controlled. Smoking cessation is pivotal.If the patient has an elevated Lipoprotein (a), pursue more aggressive lipid lowering therapy. Targeted therapies may become available in the future. Assess the patient's systemic inflammatory risk as measured by C-Reactive Protein (CRP)
People with kidney disease are at an increased risk for atherosclerotic cardiovascular disease, or ASCVD, and cardiovascular disease is the leading cause of death in people with kidney disease. In this episode of the Kidney Commute our interprofessional panel of experts discusses what ASCVD is, how patients can be evaluated for their ASCVD risk, and strategies for managing and reducing this risk. We cover risk calculators, pharmaceutical options, communication strategies, and areas where we can all work together to educate patients about risk. Thank you for joining us on this ride of The Kidney Commute! Click here to claim CE Credit.
A 72-year-old woman with a 20-year history of hypertension and dyslipidemia-- both at EBP goals with appropriate drug therapy, as well as a remote history of peptic ulcer disease-- presents for follow up. She is a nonsmoker, drinks about 1- 2 glasses of wine per week and denies the use of other substances. Her daily routine includes a 2- 3 mile walk and she denies history of acute coronary syndrome or other ASCVD related conditions. She mentions that one of her friends takes an aspirin a day to “prevent a heart attack or a stroke”, and further states, “I live alone, and I need to maintain my independence.” According to the latest recommendations from US Preventative Services Task Force, which of the following is the most appropriate advice regarding low dose aspirin use in this patient?A. Start low dose aspirin therapy 81 mg daily as the vascular benefits outweigh the risk.B. Best evidence for primary prevention of ASCBT event is with higher dose aspirin at 325 mg a day.C. The risks associated with aspirin therapy in this patient outweigh the potential benefits.D. Start aspirin therapy only if the patient has a family history of heart disease and 1st degree relatives.---YouTube: https://www.youtube.com/watch?v=9uK3CINTFOg&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=91Visit fhea.com to learn more!
CardioNerds Dan Ambinder and Dr. Devesh Rai join cardiology fellows and National Lipid Association lipid scholars Dr. Jelani Grant from Johns Hopkins University and Dr. Alexander Razavi from Emory University. They discuss a case involving a patient with familial hypercholesterolemia. Dr. Archna Bajaj from University of Pennsylvania provides expert commentary. Drs. Jelani Grant and Alexander Razavi drafted notes. CardioNerds Intern Pacey Wetstein engineered episode audio. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. A classic finding in patients with familial hypercholesterolemia is the presence of markedly elevated levels of total and low-density lipoprotein cholesterol (LDL-C) with an LDL-C concentration of 190 mg/dL or greater. However, severe hypercholesterolemia is not inevitably present, and many patients who carry this diagnosis may have lower LDL-C levels. This case history describes a young woman whose mother and brother met clinical and genetic criteria for heterozygous familial hypercholesterolemia but who had only a mild elevation in LDL-C, falling to 130 mg/dL after dietary intervention. Despite this finding, genetic testing revealed the presence of the same genetic variants as were noted in her mother and brother. In addition, a second genetic variant predisposing them to cholesterol gallstone formation was identified in all three family members. If genetic testing had not been performed, the diagnosis may have been missed or delayed, resulting in an increased risk for vascular complications associated with familial hypercholesterolemia. This case supports the value of genetic testing of family members of those with familial hypercholesterolemia, even when LDL-C levels are not severely elevated. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Exposing an Unusual Presentation of Familial Hypercholesterolemia – National Lipid Association Familial hypercholesterolemia (FH) is among the most common autosomal co-dominant genetic conditions (approximately 1:200 to 1:300 for HeFH, 1:160,000 to 1:300,000 for HoFH). Genetic testing has a role for all first-degree relatives when a family history of FH is strongly suggestive, regardless of LDL-C level. Heterogeneity in ASCVD risk among individuals with FH is derived from background polygenic risk, clinical risk factors (e.g., timing of lipid-lowering initiation and adjacent risk factors), as well as subclinical atherosclerosis burden. In clinical or genetically confirmed FH, an LDL-C goal of 55 mg/dL is recommended. Beyond statins, FDA-approved non-statin therapies for FH include ezetimibe, PCSK9 mAb, bempedoic acid, inclisiran, evolocumab (only HoFH), lomitapide (only HoFH), and LDL apheresis. Notes - Exposing an Unusual Presentation of Familial Hypercholesterolemia – National Lipid Association What are the diagnostic criteria for FH? Dutch Lipid Clinic Network1 Variables: family history, clinical history, physical exam, LDL-C level, DNA (LDLR, APOB, PCSK9) Simon-Broome1 Variables: total or LDL-C, physical exam, DNA (LDLR, APOB, PCSK9), family history Emphasis on clinical history and physical exam reduces sensitivity U.S. Make Early Diagnosis Prevent Early Death (MEDPED) 1 Only one of the three where no genetic testing is required, may work well in cascade screening Variables: age, total cholesterol, family relative (and degree) with FH Definite, probable, possible, unlikely Emphasis on clinical history and physical exam reduces sensitivity
In this CCO Nephrology podcast episode, hear from cardiologist Erin D. Michos, MD, MHS, FACC, FAHA, FASE, FASPC, and nephrologist Mark J. Sarnak, MD, MS, as they explore the pathophysiology and novel therapeutic strategies to target residual inflammatory risk associated with ASCVD and CKD. Episode outline: Moving beyond lipid lowering to address residual inflammatory riskNovel anti-inflammatory targets for ASCVD To learn more about targeting residual risk associated with systemic inflammation, find more educational activities and resources with the links below: CME-certified text module with animated pathophysiology video and faculty voice audio clipsClinicalThought commentariesPodcast episode 1, discussing residual risk associated with systemic inflammation and the role of cardiologists and nephrologists in mitigating risk in ASCVD and CKD Podcast episode 3, featuring faculty discussion of new and emerging therapies to target inflammatory risk in patients with ASCVD and CKD
In this CCO Nephrology podcast episode, hear from cardiologist Erin D. Michos, MD, MHS, FACC, FAHA, FASE, FASPC, and nephrologist Mark J. Sarnak, MD, MS, as they explore new and emerging strategies to target residual risk associated with systemic inflammation in patients with ASCVD and CKD. Episode outline: The relationship among systemic inflammation, ASCVD, and CKD The role of cardiologists and nephrologists in screening and mitigating systemic inflammation To learn more about targeting residual risk associated with systemic inflammation, find more educational activities and resources with the links below: CME-certified text module with animated pathophysiology video and faculty voice audio clips ClinicalThought commentaries Podcast episode 2, discussing novel therapeutic approaches to address residual inflammatory risks in patients with ASCVD and CKD Podcast episode 3, featuring faculty discussion of new and emerging therapies to target inflammatory risk in patients with ASCVD and CKD
In this CCO Nephrology podcast episode, hear from cardiologist Erin D. Michos, MD, MHS, FACC, FAHA, FASE, FASPC, and nephrologist Mark J. Sarnak, MD, MS, as they discuss new and emerging therapies designed to target residual inflammatory risk associated with ASCVD and CKD. Episode outline: Colchicine: inhibition of NLRP3 inflammasome assembly/activationCanakinumab (anti–IL-1β monoclonal antibody)Ziltivekimab (anti–IL-6 monoclonal antibody)Other emerging targets/therapies To learn more about targeting residual risk associated with systemic inflammation, find more educational activities and resources with the links below: CME-certified text module with animated pathophysiology video and faculty voice audio clips ClinicalThought commentaries Podcast episode 1, discussing residual risk associated with systemic inflammation and the role of cardiologists and nephrologists in mitigating risk in ASCVD and CKD Podcast episode 2, discussing novel therapeutic approaches to address residual inflammatory risks in patients with ASCVD and CKD
CardioNerds Dan Ambinder and Dr. Devesh Rai join cardiology fellows and National Lipid Association lipid scholars Dr. Oby Ibe from Temple University and Dr. Elizabeth Epstein from Scripps Clinic. They discuss a case involving a patient with elevated Lp(a). Dr. Jessica Pena provides expert commentary. Drs. Oby Ibe and Elizabeth Epstein drafted notes. CardioNerds Intern Christiana Dangas engineered episode audio. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. This is a 63-year-old man with hypertension, hyperlipidemia, and active tobacco smoking who presented with acute dyspnea. He was tachycardic but otherwise initially hemodynamically stable. The physical exam demonstrated warm extremities with no murmurs or peripheral edema. Chest X-ray revealed diffuse pulmonary edema, and the ECG showed sinus tachycardia with T-wave inversions in the inferior leads. A bedside echocardiogram revealed a flail anterior mitral valve leaflet. The patient was taken for cardiac catheterization that revealed nonobstructive mid-RCA atheroma with a distal RCA occlusion, which was felt to reflect embolic occlusion from recanalized plaque. PCI was not performed. Right heart catheterization then demonstrated a low cardiac index as well as elevated PCWP and PA pressures. An intra-aortic balloon pump was placed at that time. A TEE was performed soon after which showed the posteromedial papillary muscle was ruptured with flail segments of the anterior mitral leaflet as well as severe posteriorly directed mitral regurgitation. The patient ultimately underwent a successful tissue mitral valve replacement and CABG. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Little (a), Big Deal – National Lipid Association You are never too young to see a preventive cardiologist! The field of preventive cardiology is shifting focus towards the identification of early upstream risk and intervention before the development of clinical ASCVD (1,5). Patients who have a strong family history of cardiovascular disease, a personal history of CVD at an early age, multiple risk factors, or genetic disorders such as familial hypercholesterolemia especially benefit from early cardiovascular risk assessment and reduction. Female-specific risk factors to incorporate into a young woman's cardiovascular risk assessment include polycystic ovarian syndrome, hormone contraceptive use, early menarche (age 5 pregnancies), early menopause (age
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this special episode, Peter provides a comprehensive introduction to longevity, perfect for newcomers or those looking to refresh their knowledge. He lays out the foundational concepts of lifespan, healthspan, and the marginal decade. Additionally, Peter discusses the four main causes of death and their prevention, as well as detailing the five key strategies in his longevity toolkit to improve lifespan and healthspan. Detailed show notes provide links for deeper exploration of these topics, making it an ideal starting point for anyone interested in understanding and improving their longevity. We discuss: Key points about starting exercise as an older adult [2:45]; Overview of episode topics and structure [1:45]; How Peter defines longevity [3:45]; Why healthspan is a crucial component of longevity [11:15]; The evolution of medicine from medicine 1.0 to 2.0, and the emergence of medicine 3.0 [15:30]; Overview of atherosclerotic diseases: the 3 pathways of ASCVD, preventative measures, and the impact of metabolic health [26:00]; Cancer: genetic and environmental factors, treatment options, and the importance of early and aggressive screening [33:15]; Neurodegenerative diseases: causes, prevention, and the role of genetics and metabolic health [39:30]; The spectrum of metabolic diseases [43:15]; Why it's never too late to start thinking about longevity [44:15]; The 5 components of the longevity toolkit [46:30]; Peter's framework for exercise—The Centenarian Decathlon [47:45]; Peter's nutritional framework: energy balance, protein intake, and more [58:45]; Sleep: the vital role of sleep in longevity, and how to improve sleep habits [1:08:30]; Drugs and supplements: Peter's framework for thinking about drugs and supplements as tools for enhancing longevity [1:13:30]; Why emotional health is a key component of longevity [1:17:00]; Advice for newcomers on where to start on their longevity journey [1:19:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
CardioNerds (Amit Goyal and Dan Ambinder), Dr. Jaya Kanduri, and Dr. Jason Feinman discuss foundations of cardiovascular prevention with Dr. Stephen Kopecky. In this episode, the CardioNerds and topic expert Dr. Stephen Kopecky tackle cardiovascular prevention. They focus on how to identify patients at risk for cardiovascular disease by using the pooled cohort equation and discuss how to incorporate additional risk-enhancing factors in risk estimation. Later, they discuss the role of non-invasive imaging and testing for further patient risk stratification. Last, they discuss the appropriate pharmacologic interventions for patient care, how to determine what LDL-c to target for each patient, and how to modify your treatment modalities in response to side effects or the need for further lipid-lowering therapies. Notes were drafted by Dr. Jason Feinman. Audio was engineered by CardioNerds Intern Christiana Dangas. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Foundations of Cardiovascular Prevention The 2018 cardiovascular prevention guidelines indicate that a single equation, like the pooled risk equation, does not fit everyone. There are additional risk enhancers that are not factored into the pooled risk equation that can impact an individual's risk These factors are often conditions that increase inflammation but can also include family history, ethnicity, chronic kidney disease, metabolic syndrome, premature menopause or gestational diabetes, and rheumatologic conditions Data from Get With The Guidelines demonstrates that the average LDL at the time of the first myocardial infarction is 105 mg/dL. Coronary artery calcium scores or a carotid ultrasound can be used to further risk stratify patients. However, CAC is likely to be negative in young women. A CAC of zero can be used to “de-risk” some patients but should not be used to guide therapy in the setting of tobacco usage, diabetes mellitus, or familial hypercholesterolemia. Strategies to mitigate risk include healthy lifestyle habits and selectively targeting key risk factors including LDL, hypertriglyceridemia, inflammation, and the GLP1-pathway. Upcoming medications may address elevated Lp(a). Notes - Foundations of Cardiovascular Prevention Notes: Notes drafted by Dr. Jason Feinman. How do you assess an individual's risk for cardiovascular disease? The paramount role of primary prevention is the assessment and mitigation of an individual's risk for ASCVD event.1 The 10-year ASCVD risk calculator is a commonly used tool to assess an individual's risk and to guide shared decision-making conversations and recommendations.2 Individuals can be characterized as having low (less than 5%), borderline (5%-7.5%), intermediate (7.5%-20%), or high (greater than 20%) risk.2 The 10-year ASCVD risk calculator has varying validation in ethnic minorities, and other risk calculators, such as the Framingham CVD risk score, may be considered in those groups.3-5 Additional risk enhancers may be used to guide recommendations for individuals at borderline or intermediate risk.1 What additional imaging testing may be beneficial in the assessment of an individual's risk? Individuals with intermediate or borderline risk may benefit from further non-invasive imaging to help guide therapeutic recommendations.2 Coronary artery calcification is a marker of underlying atherosclerosis, which can help to reclassify patients to be at higher risk for ASCVD events and support interventions to help lower t...
Dr. Vyvyane Loh returns to STEM-Talk for her second appearance to talk about atherosclerotic heart disease. Also known as ASCVD, the disease has been reported to affect 26 million people in the U.S., and annually leads two million hospitalizations and more than 400,000 deaths. Vyvyane is a board-certified physician in obesity and internal medicine. In episode 142 of STEM-Talk, we talked to Vyvyane about her Boston-based preventative-care practice that specializes in weight management and the treatment of chronic metabolic diseases such as diabetes, hypertension and dyslipidemia. In today's podcast, Vyvyane and host Dr. Ken Ford talk about ASCVD as well as recent research that has shown substantial individual variability in the response to statin therapy as a way to lower cardiovascular risk. Vyvyane and Ken also discuss how the current knowledge base informing clinical practice in medicine today is far behind advances in the biological sciences, especially in the field of ASCVD. Show notes: [00:03:15] Ken welcomes Vyvyane back to STEM-Talk and encourages listeners to check out Vyvyane's first interview, episode 142. Ken goes on to mention that atherosclerotic heart disease has been reported to affect 26 million people in the U.S. and that despite the wide use of statins as a primary prevention of atherosclerotic heart disease, the effects of this treatment have been variable with regards to major adverse cardiac events. Ken asks Vyvyane for her thoughts. [00:05:32] Ken asks Vyvyane about recent developments in atherosclerotic heart disease research, specifically in regard to the anatomical aspects of the disease-model itself. [00:08:43] Ken follows up asking Vyvyane how the knowledge we have of glycocalyces, and the endothelial lining of the blood vessels, could affect clinical practice. [00:12:19] Ken asks if there are any other recent updates to the anatomical model of atherosclerotic disease that people should be aware of. [00:13:09] Ken asks Vyvyane how she would characterize the significance of the tunica intima of the coronary artery. [00:15:25] Ken asks about the third recent anatomical highlight to blood vessels relevant to the discussion. [00:19:19] Ken follows up, asking if this is how the vasa vasorum contributes to our understanding of the development of atherosclerosis. [00:21:05] Ken asks Vyvyane to explain what endothelial dysfunction is and what are its downstream effects. [00:26:09] Ken asks Vyvyane to expound on the link between atherosclerotic disease and auto-immunity. [00:31:01] Ken asks, given the link to inflammation, if there have been any therapeutic developments made in the treatment of atherosclerotic disease. [00:34:54] Ken asks about the vaccine that is being developed for atherosclerosis. [00:37:53] Ken mentions that another recent development in the field is the growing appreciation for clonal hematopoiesis in atherosclerosis. Ken asks Vyvyane to explain what clonal hematopoiesis is. [00:39:55] Ken asks Vyvyane what some actionable takeaways are from our discussion on atherosclerosis that listeners can take home with them. [00:43:17] Ken asks Vyvyane about her passion for dance, and how much time she invests in that area of her life. [00:48:11] Ken follows up asking Vyvyane what drives her to pursue dance so passionately. [00:53:34] In closing the interview, Ken encourages listeners to check out Vyvyane's podcast as well as her website. Links: Vyvyane Loh website Vlmdrounds.com Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page
p>Obesity drugs as ASCVD-modifiers, HR monitors, when journals publish obvious facts, and effect scores and sorting out signals from RCTs are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Denmark Notes II. FDA approval of Semaglutide FDA Approves Semaglutide for Cardiovascular Risk Reduction https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix Select Trial III. PPG Monitor Accuracy Research Letter https://doi.org/10.1016/j.jacc.2024.01.024 IV. AAD and Bradycardia Anti-arrhythmic Drugs Linked to Bradycardia in Patients With AF https://www.medscape.com/viewarticle/anti-arrhythmic-drugs-linked-bradycardia-patients-af-2024a10004vw JACC paper on AAD Adverse Effects https://doi.org/10.1016/j.jacc.2024.01.013 V. Finding Signals in RCTs JAMA paper on Treatment Effects of Oxygen Targets DANISH trial https://www.nejm.org/doi/full/10.1056/nejmoa1608029 LAFFLIN et al. Scoring System to Assess Generalizability of Trial Results https://doi.org/10.1177/2047487318815967 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
Download the 9-Page "Cognitive Enhancement Blueprint" Discover my premium podcast The Aliquot Show notes are available by clicking here Peter Attia, MD is a highly respected expert in preventive medicine, focused on the crucial subject of longevity and cardiovascular health. He's also the author of the NY Times best selling book Outlive - which I highly recommend if you have not read it already. Peter's philosophy transcends the conventional goal of merely extending lifespan; it's about enriching the quality of every year, ensuring that each stage of life is lived with optimal health and vitality. In this episode, we discuss: (00:07:36) Defining cardiovascular disease (00:09:43) Coronary plaque and fatality risk (00:11:09) What is cholesterol? (00:13:34) How ApoB predicts heart disease (00:21:34) Factors elevating ApoB (00:25:24) ApoB reference range explained (00:27:23) Does high ApoB cause cardiovascular disease (00:37:01) ApoB thresholds for ASCVD prevention (00:40:27) Dietary factors raising ApoB (00:39:33) Genetics of ApoB and LDL (00:53:24) Does low LDL increase cancer? (00:56:19) Cholesterol-lowering drugs (00:59:59) Statins, uses, and side effects (01:03:12) Are statins toxic to mitochondria? (01:09:56) Ubiquinol for statin-induced muscle soreness (01:11:09) How to train in zone 2 (01:17:09) Statins and neurodegenerative disease risk (01:21:54) Cholesterol synthesis in the brain (desmosterol role) (01:25:58) Statin alternatives – pros and cons (01:27:30) Ezetimibe (01:31:01) Bempedoic acid (01:36:49) Berberine for CVD Risk Reduction? (01:39:36) Muscle as a glucose sink (01:45:58) Chronic glucose toxicity and vascular impact (01:51:38) Hemoglobin A1C Levels and Mortality Data (01:55:35) 80/20 Zone 2/VO2 Max Training Protocol (02:02:12) Insights from VO2 max testing data (02:12:17) How obesity increases cancer risk (02:15:03) Cancer screening benefits and risks (02:20:47) Dr. Attia's recommended cancer screening age (02:28:54) Liquid biopsies for detecting cancer (02:34:48) CT scans, mammograms and radiation concerns (02:40:32) Menopause – hormonal shifts and health effects (02:45:13) Hormone replacement therapy (HRT) (02:58:57) Perimenopause diagnosis with hormone levels (03:02:04) HRT's impact on dementia, cancer, and heart disease risk (03:04:49) Estrogen's role in bone density (03:07:42) Vitamin D (03:16:24) Testosterone replacement for women's sexual function (03:18:47) HRT safety 10 years post-menopause (03:23:05) Treating low testosterone in men (03:29:53) TRT side effects and risks (03:32:33) Ways to reduce blood pressure (03:39:33) How to measure blood pressure (03:45:30) Peter's longevity optimization routines Become a FoundMyFitness premium member to get access to exclusive episodes, emails, live Q+A's with Rhonda and more: https://www.foundmyfitness.com/premium
© 2020-2025 Ivy Podcast Discovery LLC
