Dr. Gero 0xAki█a v2 (🦄,🌿,👻) Will Brink Thomas Dayspring John Kastelein Dr. Michael Sagner, MD William Cromwell, MD Pablo Corral MD Artificially lowering cholesterol, i,e with statins or PCSK9i, INCREASES risk of strokes, heart attacks, by inhibiting reverse cholesterol transport, and dementia, amongst other things. Cardiologist Dr Nadir Ali explains in here youtube.com/watch?v=niz4n1…
Owais A Khawaja, MD MPH FACC FSCAI Matthew Budoff MD Would you not adjust the statin dose to high intensity statin (or add PCSK9i) if CAC is not 0?
How important is Lp(a) in the development of #aorticvalvestenosis ? Don’t miss Dr Benoît Arsenault’s review on #PCSK9 Forum of cutting-edge research and implications for screening and treatment >> ow.ly/SoSn50OUFbE
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Benoit Arsenault
In PACMAN-AMI, the PCSK9i alirocumab led to significant regression of non-obstructive lesions at 1 year compared to placebo on top of rosuvastatin. New research shows that this effect did not translate into significant improvement in coronary physiology. eurointervention.pcronline.com/article/impact…
Christian Faaborg Andersen MD CardioNerds Richard Ferraro Alaa Diab, MD Dinu V. Balanescu, M.D. Amit Goyal MD MAS Colin Blumenthal, MD MS Daniel Ambinder, MD Patrick Zakka, MD Gurleen Kaur, MD Ahmed Ghoneem, MD MSc Don't forget to replete vitamin D before just giving up on a statin or doing complex switches. Also the recommendation to try a fibrate or cholestyramine instead of a PCSK9i is kind of 'meh'. Why give a nearly-useless drug simply for the sake of minimally changing a lab value?
Larronde Esteban But, if I remember other simil. prob. longer studies w PCSK9I , ⬇️ LDLc goal achiev. was better 4 MACE in cca. monotonic way, down to the bottom.
others Im sure know more :
Maciej Banach Pablo Corral MD Thomas Dayspring William Cromwell, MD Gil Carvalho MD PhD🌈 Prof Kausik Ray John Kastelein et al
Larronde Esteban Dont see any 'but' here :)
uncomparable contexts/papers. prim prev 4 years/decades vs post-MI sec prev cca 2y only- follow up, even here HRR of 0,7 cca is great as add on th w pcsk9I. I'd not expect cca. 40 vs 20mg/dl goal LDLc in only 2y in such context to bring signif diff.🤷♂️
Christian Faaborg Andersen MD Richard Ferraro Daniel Ambinder, MD Gurleen Kaur, MD Alaa Diab, MD Akiva Rosenzveig Eunice Dugan, MD Cali Clark, DO MBA Rachel Goodman Hamza Patel, MD Craig Beam On the topic of alternative agents and bempedoic acid; it is interesting to see how many providers reach for fibrates over BA if PCSK9i and ezetimibe have been exhausted.
Note; CVD reduction with gemfibrozil was 34% in HELSINKI and 24% in VA-HIT, whereas BA showed 13%. Thoughts?
Mike Rea, IDEA Pharma And of course access (assuming payers end up having to cover this indication). Wouldn't be surprised to see similar situation to PCSK9i where companies pay large rebates to secure sole preferred status dividing up the market, especially the big payers.
Shashi Iyengar | Diabetes Remission with Low Carb being scientific It can certainly increase risk. Artificially lowering cholesterol, i,e with statins or PCSK9i, INCREASES risk of strokes, heart attacks, by inhibiting reverse cholesterol transport, and dementia, amongst other things. Cardiologist Dr Nadir Ali explains above
Owais A Khawaja, MD MPH FACC FSCAI Matthew Budoff MD If there is coronary calcium, there is plaque/cad. Thus its not about primary prevention, but plaque stabilization. I go high intensity statin +/- PCSK9i. All the best
It appears that there is no short term benefit of starting PCSK9i early in the ACS.
Abstract 11354: Role of PCSK9 Inhibitors in Acute Coronary Syndromes - A Pilot Study | Circulation ahajournals.org/doi/abs/10.116…
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Methi 🇵🇸 🌹 being scientific This means that using pcsk9i low lower LDL & LP(a) can cause cancers?
Ben Ogorek Howard Luks MD 2. called Reverse Cholesterol Transport. Foam cells are formed when reverse cholesterol transport is inhibited, such as when statins or PCSK9i are taken.
There is indeed a clear mechanism, but it is