Thoughtful, provocative editorial. Some fair points. Respectfully disagree with apoB/CAC examples. IMO evidence base (including health economics) for these support broader use and are incorporated in some guidelines (apoB: EAS/ESC, CCS, NLA statement) #cardiosky bsky.app/profile/jame...

Among more than 800 000 CKD-PC participants, discordance between cystatin C and creatinine eGFR values was associated with increased risk of death, cardiovascular events, and kidney failure. #KidneyWK @asnkidney.bsky.social ja.ma/4oV4DtU

Shocking first high impact trial of the day. Fish oil reduces CV events in dialysis patients! #Pisces #kidneywk Simultaneous pub in NEJM www.nejm.org/doi/full/10....

The latest empadata dump: @nephroseeker.medsky.social writes up a #NephJC short on the meta analysis www.nephjc.com/news/2025/10...

• start prevention earlier (than current guidelines suggest) • measure apoB Editorial by Angela Pirillo and Alberico Catapano #cardiosky academic.oup.com/eurheartj/ad...

ICER organization draft: Semaglutide and tirzepatide for obesity are cost effective. For context, a 2014 ACC/AHA task force suggested a less than $50k per QALY threshold as "high value". #cardiosky icer.org/assessment/o...

NATURE-Legacy study compares MR/genetically modeled life long LDL-C and blood pressure lowering (HR 0.32) to short term effects in the HOPE-3 trial (HR 0.71). By Brian Ference, et al. /1 #ESCCongress2025 #cardiosky

"This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P." Analysis of UK Biobank data by Elizabeth Epstein, et al. #cardiosky pubmed.ncbi.nlm.nih.gov/40887080/

Statin eligibility with PREVENT vs PCE 10 year risk at various thresholds by Sadiya Kahn, et al. jamanetwork.com/journals/jam...

Lp(a) testing is highly cost effective (cost saving) in this study by Morton, et al. Applies to US and various other countries. #cardiosky #lpa #cea www.sciencedirect.com/science/arti...

Somewhat lukewarm view of colchicine in this editorial. "the CLEAR SYNERGY results have brought considerable clinical equipoise for the prescription of colchicine to reduce ASCVD risk" pubmed.ncbi.nlm.nih.gov/40825059/

From #T2D to #obesity #CVD #OSA and now #MASH The expanding benefits of GLP-1 medicines www.novonordisk.com/news-and-med...

This "living" guideline document will unlive many people with diabetes if applied. Why are guideline ppl addicted to sulfunylureas/nsulin/metformin ? Those are useful to lower A1c from stratospheric levels, but if we are thinking hard outcomes improvement, the answer is #flozin & #glp1 #fail

Orforglipron notches double digit #weightloss investor.lilly.com/news-release...

SURPASS CVOT #T2D #Tirzepatide Non inferior but numerically superior for some endpoints #CVD investor.lilly.com/news-release...

Looking below the surface... PREVENT equations seem better calibrated vs PCE in other studies compared to recent JACC study. VA, Kaiser, UK Biobank (ex-US), and others. /1 bsky.app/profile/fipc...

On the surface, in this dataset of 240k, the PCE calibration seems closer to actual than PREVENT. Excerpt S-Table 45. bsky.app/profile/pnat...

In Norway🇳🇴, 4 years after DAPA-HF, 85% of those with reduced ejection fraction heart failure get an SGLT2i. In the US🇺🇸, it's under 30%. #gdmt #flozins #cardiosky www.hcplive.com/view/study-h... onlinelibrary.wiley.com/doi/10.1002/...

A detailed look at dosing, efficacy and tolerability for Amycretin www.thelancet.com/journals/lan... #weightloss #obesity

Good interview with @danieljdrucker.bsky.social on obesity medicines. I clicked the translate button since hablo muy poco español elpais.com/salud-y-bien...

Three views on GIP agonism and antagonism. Thread with 3 links. #obesity #cardiosky bsky.app/profile/dani...

Systemic review of discordance studies by Daniel Sehayek, et al. finds apoB generally outperforms LDL-C and non-HDL-C. (prior post of recent study adds to this evidence) #cardiosky www.lipidjournal.com/article/S193...

Mid-sized 🇬🇷discordance study (n=3042, 20 year follow-up) favors apoB over traditional lipid measures. By Giannakopoulou et al. /1 #cardiosky pubmed.ncbi.nlm.nih.gov/40386959/

Merck's enlicitide, an oral PCSK9i, meets LDL-C and other endpoints in 2 phase 3 trials. Details to come. "There were no clinically meaningful differences in incidences of AEs and SAEs in either trial" #cardiosky www.merck.com/news/merck-a... bsky.app/profile/fipc...

Pooled Cohort Equations and newer PREVENT 10 year risk equations won't identify many of those who had early MIs. #cardiosky pmc.ncbi.nlm.nih.gov/articles/PMC...

Related editorial by Sniderman et al. #apoB #Lp(a) #cardiosky academic.oup.com/eurheartj/ad... bsky.app/profile/eric...

SURMOUNT-5 Among participants with #obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight and waist circumference at week 72 www.nejm.org/doi/full/10....

With an editorial from the expert, Dr. Alice E. Adriaenssens @cambridgeuni.bsky.social disentangling divergent neural networks that explain the success of both GIPR gain and loss of function strategies for promoting #weightloss #obesity @naturemetabolism.bsky.social www.nature.com/articles/s42...

Best lab assessment for coronary artery risk consists of ApoB particles and LP(a) academic.oup.com/eurheartj/ad...

Soap opera of KETO-CTA study continues. Revision of paper expected per last author Budoff. Another cohort NATURE-CT with similar demographics - age, no statin - had ~1/4 the non-calcified plaque progression of the keto group 4.9 v 18.8. bsky.app/profile/fipc...

Lilly provides top line results of oral GLP-1 orforglipron phase 3 study ACHIEVE-1 in type 2 diabetics. At top dose, 1.5% ⬇️ HbA1c, 7.9% weight loss from baseline at 40 weeks. (efficacy estimand) No liver safety signal noted. #cardiosky bsky.app/profile/fipc... investor.lilly.com/news-release...

Another good summary of the KETO-CTA study. alexleaf.com/lean-mass-hy...

"majority [had] minimal progression"- co-author of KETO-CTA study. The values in Figure 1 for non-calcified plaque imply a 50% increase in median at 1 year. Big ⬆️'s in many w/ CAC=0. Nakanishi paper suggests annual increase in non-diabetics of 2.8 mm^3. bsky.app/profile/shoa...

Sigh. This study claiming a lack of association between ApoB & plaque has blown up in the media with the typical podcaster/youtuber grifters jumping on it. Beyond the obvious (small N, non-randomized), here are a few reasons the study doesn't show what people claim 🧵: www.jacc.org/doi/10.1016/...

Congratulations @danieljdrucker.bsky.social . Excellent series of talks. Minor point: JUPITER trial of rosuvastatin stopped at interim with 44% risk reduction in MACE-5. bsky.app/profile/dani...

The Lancet Commission on rethinking coronary artery disease: moving from ischaemia to atheroma Excited to have contributed to this work. #AHA25 www.thelancet.com/commissions/... @thelancet.bsky.social

At #ACC25, Dr. Michael J. Koren & colleagues present the results of PURSUIT, which found that a novel oral #PCSK9i achieved LDL reductions on top of background statin therapy with a similar side effect profile to placebo jacc.org/doi/10.1016/... #JACC

Exciting new development in lipid field! The early Phase 2 #PURSUIT trial showed a novel oral #PCSK9i (that can be taken with food) lowered LDL-C by 51% at 12 weeks. 84% achieved LDL-C of <70 mg/dL. #ACC25 @accintouch.bsky.social

And sema for DM + PAD as well from #ACC25 in @thelancet.bsky.social www.thelancet.com/journals/lan... Glipination helps you walk 🚶🏽🚶🏻‍♀️🚶🏻‍♂️further

fyi-The Family Heart Foundation offers a free Lp(a) test. #cardiosky #LpaAwarenessDay familyheart.org/cholesterol-... bsky.app/profile/worl...

Coronary artery calcium score–informed preventive strategies were associated with slower plaque progression vs usual care in intermediate-risk patients with a family history of coronary artery disease. ja.ma/3F9kVxV #MedSky #CardioSky

Age at which CAC becomes detectable in young adults by sex, race, and risk factors (based on CARDIA & CAC Consortium) by Yvette Yeboah-Kordieh et al. Potential paradigm for early prevention. #cardiosky www.ahajournals.org/doi/10.1161/...

More Updates - per this discussion (recommended) with Paul Ridker, vimeopro.com/zurichhearth... ZEUS trial (event driven, no interim) readout could be mid 2026. bsky.app/profile/fipc...

Potential of Vitamin E to help vs MASH (metabolic dysfunction-associated steatohepatitis) From a small randomized controlled trial www.cell.com/cell-reports...

Measure Apo B If We Believe What We Say About Precision Medicine #CardioSky #cvPrev #ApoB www.ahajournals.org/doi/10.1161/... @ahajournals.bsky.social @erinmichos.bsky.social @psatishmd.bsky.social @drlipid.bsky.social @vietheartpa.bsky.social @michaeldshapiro.bsky.social

🆕 Just Published: Rethinking Cardiovascular Risk: The Emerging Role of Lipoprotein(a) Screening 🔬 As our understanding of cardiovascular health evolves, Lipoprotein(a) screening is gaining attention as a key factor in risk assessment. 📖 Read more: ow.ly/s6PF50V0sYO #CardioSky #MedSky

On Lp(a)HORIZON, "There's been no interim analysis. So, no interim analysis drove this. This is just event rate modeling on the blinded event rates that we saw."-Novartis CEO - Friday /1

Update: Novartis now guides to 2026 readout for event driven trial Lp(a)HORIZON. clinicaltrials.gov still lists 1º completion May '25. bsky.app/profile/fipc...

After recent colchicine disappointments, a cautious review of inflammation targeting for CV disease by Kevin Williams. h/t Pablo Corral.. Similar skepticism from @kaulcsmc.bsky.social pubmed.ncbi.nlm.nih.gov/39846349/ #cardiosky /1

On apoB and Lp(a) testing... "they have the greatest evidence supporting their value above and beyond the traditional lipid panel." Good discussion with @drlaxmimehta.bsky.social and @michaeldshapiro.bsky.social #cardiosky www.acc.org/Latest-in-Ca...