The LDL Cumulative Exposure Hypothesis The longer your arteries are exposed to high LDL-C, the ⬆️ the risk of atherosclerosis. 📈 🔬 Early & sustained LDL lowering = lifelong CV benefit. 🔗 #CardioTwitter #MedTwitter #FOAMed #MedED @ACCinTouch @escardio @atheroaussie @society_eas

✅ aspirin ✅ lipid lowering therapy - LDL goal < 1.4mmol (ESC), but with that 👆🏼 at 57yo I’d prefer lower (<1 if easily attainable) ❌ acei/Blocker unless symptomatic OR bp> 120/80 📝 check for FH, Lp(a), TRL’s & look for other factors that might contribute to endothelial dysfunction (smoking, diabetes, inflammatory dx etc)

Triglycerides, the forgotten lipid 🩸 🧪 Fun fact 👉🏼 triglyceride rich lipoprotein remnants are actually more atherogenic than LDL on a per particle basis 📕 Check this out for a great overview of TG’s 👌🏼 #MedTwitter #MedEd #cardiotwitter #FOAMed @atherosociety @ATHjournal @atheroaussie

Hypertriglyceridemia 👉🏼higher CV Risk 📊 A #JAHA study shows in a low-risk Italian cohort, TG >1.7 mmol/L linked to: - 1.6 - 2.3 x higher ASCVD risk 📈 - Increased all-cause mortality ☠️ 🔗 #CardioTwitter #Lipidology #MedTwitter #Atherosclerosis #MedEd #FOAMed @society_eas

❤️ ESC LDL goals for ASCVD risk ❤️ 🧮 Conversion - mmol/L ↔️ mg/dL - Low 👉🏼 3.0 / 116 - Moderate 👉🏼 2.6 / 100 - High 👉🏼 1.8 / 70 - Very High 👉🏼 1.4 / 55 - Very High*👉🏼 1.0 / 40 * 2nd event within 2 years 📉 High-V High require LDL 🥅 above + >50% reduction in LDL from baseline 🔗 #MedTwitter #MedEd #FOAMed #CardioTwitter #LDL #cholesterol @society_eas @escardio

Think of LDL like ‘pack-years’ in smoking 👉🏼 Total exposure over time matters! ⏳ Lowering LDL earlier reduces plaque burden & CV events 📉 ⏰ Prevention starts now! 🫀🔥 🔗 #Lipidology #Atherosclerosis @ACCinTouch @ESC_Journals @society_eas #MedEd #MedTwitter #FOAMed #cardiotwitter

Semaglutide (Wegovy, Ozempic) at a glance: 🎉 **STEP 1**: Achieved 14.9% weight loss in obese adults vs. 2.4% with placebo. 🌟 **STEP 2**: A 15.8% weight reduction with a 2.4mg dose in type 2 diabetes and obesity. 💪 **STEP 3**: Integrated with therapy, it resulted in 16.0% weight loss, showing synergy. 🔥 **STEP 4**: Long-term use helps maintain significant weight loss. 🔥 **STEP 5**: Over two years, weight loss was 15.2% vs. 2.6% with placebo. 🌍 **STEP 6**: Effective across demographics, with up to 13.2% loss in East Asians. 🏆 **STEP 8**: Superior to liraglutide with 15.8% vs. 6.4% weight reduction. ❤️ **SELECT**: ⤵️ Major cardiovascular events by 20% in obese with cardiovascular disease. 💓 **HFpEF Trial**: Significant improvement in heart failure with preserved ejection fraction symptoms. 🌊 **FLOW**: Demonstrated ⤵️ risk of kidney progression and cardiovascular death by 24% in type 2 diabetes with chronic kidney disease. #Obesity #Diabetes #MedTwitter #CardioTwitter #MedX #cardioX #MedEd #FOAMed @ACCinTouch @ESC_Journals @DiabetesUK @HeartOrg

Estrogen & endothelial function: A cardioprotective shield? 🫀💡 Estrogen enhances vasodilation, ⤵️ oxidative stress & inflammation & supports endothelial repair 👉🏼 🔑 factors in vascular health. Post-menopause, ⤵️ estrogen levels contribute to endothelial dysfunction, accelerating CVD risk in women 🔗 #CardioTwitter #MedTwitter #MedEd #FOAMed @society_eas @DrMarthaGulati

RT @ehj_ed: In a contemporary post-MI cohort, the risk for incident heart failure is greater than recurrent MI, even among those with norma…

RT @ESC_Journals: The year in cardiovascular medicine 2024: the top 10 papers in heart failure. Read more in #EHJ 👉

Tirzepatide (Mounjaro) at a glance 1. **SURPASS-1**: 🎉 Tirzepatide reduced HbA1c & body weight 🏋️‍♂️ vs placebo. 2. **SURPASS-2**: 🌟 Tirzepatide beat semaglutide in HbA1c & weight loss. 3. **SURPASS-3**: Tirzepatide lowered HbA1c more than insulin 💉, with weight loss. 4. **SURPASS-4**: 💖 Reduced heart risk with tirzepatide vs insulin in high-risk patients. 5. **SURPASS-5**: 🔥 Greater HbA1c drop & weight loss vs placebo with insulin. 6. **SURPASS-6**: Comparison with prandial insulin, but focused on HbA1c change. 7. **SURPASS-CVOT**: ❤️ No increased heart risk with tirzepatide vs dulaglutide. 8. **SURMOUNT-1**: 🏆 20.9% average weight loss with highest dose in obesity. 9. **SURMOUNT-2**: Tirzepatide cut weight in diabetic obesity cases 📉. 10. **SURMOUNT-3**: 21.1% more weight loss after lifestyle changes 💪. 11. **SURMOUNT-4**: Sustained weight loss with tirzepatide, regain with placebo. 12. **SUMMIT**: Reduced heart failure events & better life quality in HFpEF + obesity. 13. **SURMOUNT-OSA**: 🛌 Reduced sleep apnea severity by ~30 events/hour in obesity. 14. **SYNERGY-NASH**: 🧬 Tirzepatide resolved MASH in up to 73% of patients with liver issues. #MedTwitter #CardioTwitter #MedX #cardioX #MedEd #FOAMed @ACCinTouch @ESC_Journals

RT @ATH_Plus: Is severe hypertriglyceridemia linked to #ASCVD? Read this study on Ath Plus! ➡️ @ELS_Cardiology @soci…

RT @GoggleDocs: Statins ⤵️ CVD risk & cost-effectively improve QALYs in older adults❗️ 🔹 UK study: Statins ⤵️ CVD events by ~24% & CV deat…

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RT @HanCardiomd: #SBP and Pulse Pressure in #HeartFailure: Pooled Participant-Level Analysis of 4 Trials ( I-#PRESERVE , #TOPCAT, #PARAGON-…

🏏 Day 2 - SCG - Game on 🇦🇺 🇮🇳 With one of the fastest bowlers of all time @BrettLee_58 ‼️ #AUSvIND #SamKonstas @marnus3cricket @CricketAus @ThunderBBL @MarkHoward03

@AsennaWealth Test cricket at its best 👍🏼