Fipco
@fipco.bsky.social
📤 51
📥 88
📝 65
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...
add a skeleton here at some point
5 days ago
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Fipco
JAMA
6 days ago
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
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Fipco
Nayan Arora
6 days ago
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....
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Fipco
Swapnil Hiremath 🍁🇨🇦
24 days ago
The latest empadata dump:
@nephroseeker.medsky.social
writes up a
#NephJC
short on the meta analysis
www.nephjc.com/news/2025/10...
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Empagliflozin, the kidney, and what we still don’t understand — NephJC
NephJC short on an empagliflozin meta-analysis
https://www.nephjc.com/news/2025/10/20/empa-ma
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• start prevention earlier (than current guidelines suggest) • measure apoB Editorial by Angela Pirillo and Alberico Catapano
#cardiosky
academic.oup.com/eurheartj/ad...
2 months ago
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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..
.
2 months ago
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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
2 months ago
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"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/
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Apolipoprotein B outperforms low density lipoprotein particle number as a marker of cardiovascular risk in the UK Biobank - PubMed
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. Notably, risk was already elevated at as little...
https://pubmed.ncbi.nlm.nih.gov/40887080/
2 months ago
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Statin eligibility with PREVENT vs PCE 10 year risk at various thresholds by Sadiya Kahn, et al.
jamanetwork.com/journals/jam...
3 months ago
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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...
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Lp(a) testing for the primary prevention of cardiovascular disease in high-income countries: a cost-effectiveness analysis
Cost-effectiveness of Lipoprotein(a) [Lp(a)] testing is not established. We aimed to evaluate the cost-effectiveness of Lp(a) testing in the cardiovas…
https://www.sciencedirect.com/science/article/pii/S0021915025013450#appsec1
3 months ago
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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/
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Colchicine: Evidence to Treat or Equipoise? - PubMed
Colchicine: Evidence to Treat or Equipoise?
https://pubmed.ncbi.nlm.nih.gov/40825059/
3 months ago
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reposted by
Fipco
Daniel Drucker
3 months ago
From
#T2D
to
#obesity
#CVD
#OSA
and now
#MASH
The expanding benefits of GLP-1 medicines
www.novonordisk.com/news-and-med...
0
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reposted by
Fipco
Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc
3 months ago
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
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reposted by
Fipco
Daniel Drucker
3 months ago
Orforglipron notches double digit
#weightloss
investor.lilly.com/news-release...
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reposted by
Fipco
Daniel Drucker
4 months ago
SURPASS CVOT
#T2D
#Tirzepatide
Non inferior but numerically superior for some endpoints
#CVD
investor.lilly.com/news-release...
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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...
add a skeleton here at some point
4 months ago
1
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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...
add a skeleton here at some point
4 months ago
0
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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/...
4 months ago
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reposted by
Fipco
Daniel Drucker
5 months ago
A detailed look at dosing, efficacy and tolerability for Amycretin
www.thelancet.com/journals/lan...
#weightloss
#obesity
0
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Good interview with
@danieljdrucker.bsky.social
on obesity medicines. I clicked the translate button since hablo muy poco español
elpais.com/salud-y-bien...
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Daniel Drucker, padre de Ozempic: “No tenemos datos suficientes para usarlo en personas sanas, yo no vendo los fármacos”
El investigador canadiense acaba de recibir el Premio Fronteras del Conocimiento por su papel en los fármacos antiobesidad, aunque es conservador sobre su uso
https://elpais.com/salud-y-bienestar/2025-06-18/daniel-drucker-padre-de-ozempic-si-se-financiara-para-todo-el-mundo-que-quiere-perder-peso-no-quedaria-dinero-para-nada-mas.html?ssm=TW_CC
5 months ago
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Three views on GIP agonism and antagonism. Thread with 3 links.
#obesity
#cardiosky
bsky.app/profile/dani...
add a skeleton here at some point
5 months ago
0
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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...
5 months ago
0
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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/
5 months ago
1
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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...
add a skeleton here at some point
5 months ago
0
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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...
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Performance of PREVENT equations for cardiovascular risk prediction in young patients with myocardial infarction: From the MGB YOUNG-MI registry
Predicting cardiovascular risk in young adults remains challenging. The newly developed PREVENT equations offers several advantages for short and long-term cardiovascular risk prediction. To determine...
https://pmc.ncbi.nlm.nih.gov/articles/PMC12059596/
6 months ago
0
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Related editorial by Sniderman et al.
#apoB
#Lp(a
)
#cardiosky
academic.oup.com/eurheartj/ad...
bsky.app/profile/eric...
add a skeleton here at some point
6 months ago
0
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reposted by
Fipco
Daniel Drucker
6 months ago
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....
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Tirzepatide as Compared with Semaglutide for the Treatment of Obesity | NEJM
Tirzepatide and semaglutide are highly effective medications for obesity management. The efficacy and safety of tirzepatide as compared with semaglutide in adults with obesity but without type 2 di...
https://www.nejm.org/doi/full/10.1056/NEJMoa2416394
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reposted by
Fipco
Daniel Drucker
7 months ago
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...
add a skeleton here at some point
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reposted by
Fipco
Eric Topol
7 months ago
Best lab assessment for coronary artery risk consists of ApoB particles and LP(a)
academic.oup.com/eurheartj/ad...
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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...
7 months ago
1
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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...
add a skeleton here at some point
7 months ago
0
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Another good summary of the KETO-CTA study.
alexleaf.com/lean-mass-hy...
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Lean Mass Hyper-Responders Are Not Protected From Atherosclerosis - Alex Leaf, MS, CISSN
I wanted to highlight a newly published paper that’s been gaining a lot of social media attention: Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial. This study centers it...
https://alexleaf.com/lean-mass-hyper-responders-are-not-protected-from-atherosclerosis/?amp
7 months ago
0
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"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...
add a skeleton here at some point
7 months ago
2
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Fipco
Shoa Clarke
7 months ago
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/...
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Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial
https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686
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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...
add a skeleton here at some point
7 months ago
0
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Fipco
Boback Ziaeian
8 months ago
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
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The Lancet Commission on rethinking coronary artery disease: moving from ischaemia to atheroma
https://www.thelancet.com/commissions/coronary-artery-disease
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reposted by
Fipco
JACC Journals
8 months ago
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
0
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reposted by
Fipco
Erin Michos, MD
8 months ago
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
0
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reposted by
Fipco
Swapnil Hiremath 🍁🇨🇦
8 months ago
And sema for DM + PAD as well from
#ACC25
in
@thelancet.bsky.social
www.thelancet.com/journals/lan...
Glipination helps you walk 🚶🏽🚶🏻♀️🚶🏻♂️further
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fyi-The Family Heart Foundation offers a free Lp(a) test.
#cardiosky
#LpaAwarenessDay
familyheart.org/cholesterol-...
bsky.app/profile/worl...
add a skeleton here at some point
8 months ago
0
0
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Fipco
JAMA
8 months ago
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
1
20
5
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/...
8 months ago
1
1
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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...
add a skeleton here at some point
9 months ago
0
0
0
reposted by
Fipco
Eric Topol
9 months ago
Potential of Vitamin E to help vs MASH (metabolic dysfunction-associated steatohepatitis) From a small randomized controlled trial
www.cell.com/cell-reports...
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Vitamin E (300 mg) in the treatment of MASH: A multi-center, randomized, double-blind, placebo-controlled study
Song et al. prove that vitamin E 300 mg per day for 96 weeks significantly improves liver histology, including steatosis, lobular inflammation, and fibrosis stages; reduces liver stiffness measurement...
https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(25)00012-6
3
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reposted by
Fipco
Parham Eshtehardi MD
9 months ago
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
0
5
5
reposted by
Fipco
American Journal of Preventive Cardiology
9 months ago
🆕 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
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Rethinking Cardiovascular Risk: The Emerging Role of Lipoprotein(a) Screening
Lipoprotein(a) [Lp(a)] is a genetically inherited, independent risk factor for cardiovascular disease (CVD), affecting approximately 20-25% of the glo…
https://ow.ly/s6PF50V0sYO
0
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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
9 months ago
1
0
0
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...
add a skeleton here at some point
10 months ago
0
0
0
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
10 months ago
1
2
2
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...
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ACCEL Lite: The Role of Advanced Lipid Testing in 2024 - American College of Cardiology
https://www.acc.org/Latest-in-Cardiology/Articles/2025/01/21/13/51/accel-lite-21jan2025
10 months ago
0
3
3
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