Discover and read the best of Twitter Threads about #ascvd
Most recents (20)
1a) Welcome to a live-tweeted, #accredited #tweetorial from @nationallipid #NLA23 in #Atlanta on advances in #hyperlipidemia management #LLT. Our expert returning faculty is Pam R. Taub, MD @PamTaubMD #cardiologist from @UCSDHealth 
1b) Dr. Taub is a clinician/scientist and is a frequent contributor to our #accredited programs. She is the founding director of the Step Family Foundation Cardiac Rehabilitation and Wellness Center at #UCSD.
#FOAMed #cardiotwitter @MedTweetorials #MedEd #lipids
#FOAMed #cardiotwitter @MedTweetorials #MedEd #lipids
2) This program is supported by an educational grant from Esperion Therapeutics & is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/. Earn 0.75 hr 🆓CE/#CME by following this 🧵!
1/ #Metabolism, #lipids, and #ASCVD
#megathread🧵🧵🧵
Okay, I want to revisit and breakdown my position on this crucial topic and the challenges in communicating it.
⚠️ Get comfortable, as this could get long.
Ready? Let's go...
#megathread🧵🧵🧵
Okay, I want to revisit and breakdown my position on this crucial topic and the challenges in communicating it.
⚠️ Get comfortable, as this could get long.
Ready? Let's go...
2/ First, it's worth reviewing why there's a high level of confidence low density lipoproteins (LDLs) drive atherosclerotic cardiovascular disease (ASCVD)
For an excellent, lay-person video, I recommend @NutritionMadeS3's from a couple years ago 👇
For an excellent, lay-person video, I recommend @NutritionMadeS3's from a couple years ago 👇
3/ Also in the name of arguably the most cited meta-analysis for the Lipid Hypothesis to date:
"Low-density Lipoproteins cause atherosclerotic cardiovascular disease"
This meta combines lines from genetic, observational, and interventional studies.
pubmed.ncbi.nlm.nih.gov/28444290/
"Low-density Lipoproteins cause atherosclerotic cardiovascular disease"
This meta combines lines from genetic, observational, and interventional studies.
pubmed.ncbi.nlm.nih.gov/28444290/
PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) inhibitors have changed the landscape of cardiology forever.
This is a Tweetorial🧵on why.
And it starts in 1999, with a French family named HC2.
This is a Tweetorial🧵on why.
And it starts in 1999, with a French family named HC2.
At the time Varret and colleagues were evaluating familial hypercholesterolemia (FH) in a French pedigree.
Most known FH at the time exhibited mutations in APOB or LDLR genes. In the HC2 pedigree, neither of these genes were affected. But a third area was…
Most known FH at the time exhibited mutations in APOB or LDLR genes. In the HC2 pedigree, neither of these genes were affected. But a third area was…
Fast forward to 2003. Abifadel and Varret discover mutations to a gene in this area called PSCK9.
PCSK9 encodes a newly discovered protease expressed in the liver and found to be important to cholesterol metabolism.
And mutations here could lead to some pretty wild stuff. How?
PCSK9 encodes a newly discovered protease expressed in the liver and found to be important to cholesterol metabolism.
And mutations here could lead to some pretty wild stuff. How?
1/🚨New Episode🚨
Aspirin for Primary Prevention: #MindtheGap Segment
What do current ACC and USPSTF guidelines say about daily low-dose #aspirin for the primary prevention of #cardiovascular disease?
🎧: apple.co/3VPRCV4
Sponsor: bit.ly/TCChoZ
Aspirin for Primary Prevention: #MindtheGap Segment
What do current ACC and USPSTF guidelines say about daily low-dose #aspirin for the primary prevention of #cardiovascular disease?
🎧: apple.co/3VPRCV4
Sponsor: bit.ly/TCChoZ
2/Throwback to medical school pathophysiology!
Remember how the #atherosclerotic process takes place in blood vessels? 🫀
Now, where does #aspirin exert its effect during this cascade? 🤔
Remember how the #atherosclerotic process takes place in blood vessels? 🫀
Now, where does #aspirin exert its effect during this cascade? 🤔
3/What do the most recent #RCTs inform us about the use of aspirin for primary prevention ⁉️
ASCEND, ARRIVE, ASPREE!
#CoreIMJournalClub 📕
ASCEND, ARRIVE, ASPREE!
#CoreIMJournalClub 📕
1) Welcome to this new #accredited #tweetorial on “Strategies to Apply Current Clinical Trial Data for SGLT2i to Reduce the Progression of CKD,” authored by our ⭐️tweetorialist Edgar V. Lerma 🇵🇭 @edgarvlermamd
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
3) Faculty disclosures and statement of accreditation are provided at ckd-ce.com/disclosures/. Please FOLLOW @ckd_ce (& @cardiomet_CE!) so you don't miss ANY of our unique serialized #tweetorials, always 🆓, always from expert authors! Prior programs at ckd-ce.com/category/dkd/ .
1) Welcome to a new #accredited (0.75h CE/#CME) #tweetorial on challenging case presentations for pts with #cardiometabolic disease, #CaReMe #FOAMed.
Our expert author is Claire Davies. @claireyrivs is a specialist diabetes & endocrinology #pharmacist working in Gateshead in 🇬🇧.
Our expert author is Claire Davies. @claireyrivs is a specialist diabetes & endocrinology #pharmacist working in Gateshead in 🇬🇧.
2) She is a member of UKCPA Diabetes & Endocrinology committee @UKCPADiabetes & works across #diabetes, #endocrinology, & emergency/acute care in Secondary Care. She is currently involved in development of regional guidelines & education to support medicines optimisation for PLWD
3a) This program is intended for healthcare professionals and is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company.
1a) Welcome to one of our favorite events on the @academiccme #accredited #tweetorial feeds: a takeover of our programming from @GoggleDocs! The focus of this tweetorial is data from #ADA2022 on #SGLT2i beyond cardiac disease. Our expert author is @GoggleDocs' @drpatrickholmes.
1b) Check out our other #ADA2022 recap #tweetorial by new @GoggleDocs family member @Ines_VFonseca who focused on the cardiac data presented: ckd-ce.com/dkd13_ada22a/
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
Join us tomorrow for the launch of a new #accredited #tweetorial on the primary care management of #hyperlipidemia covering the relationship between #LDL_C & major #CV events, CV risk categories, recommended LDL-C treatment goals, & oral therapeutic options for lipid-lowering
1) Welcome to a new #tweetorial on the primary care management of #hyperlipidemia. Our returning @cardiomet_CE expert author is dedicated #SoMe education advocate Kevin Fernando, FRCGP FRCP Edin, FAcadMEd MSc Diabetes @drkevinfernando
2a) This is the next instalment of @cardiomet_CE's 10-part #tweetorial foundational series on #lipid management! It is accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists.
#FOAMed @MedTweetorials #cardiotwitter
#FOAMed @MedTweetorials #cardiotwitter
1/ Interesting thread via @NutritionMadeS3. I invite everyone to read through his before reading the remaining of mine here below…
2/ naturally, you’re discussing a topic that’s very near and dear to my research, @NutritionMadeS3. I’m certainly very interested in metabolic health as it relates to lipid profiles — particularly the “triad” of high LDLc, high HDLc, and low TG. (See mdpi.com/2218-1989/12/5…)
1/ I'd love to take an opportunity to expand on this important topic, and if I may, suggest something important to watch for with some newly emerging data.
To @MichaelMindrum point, I too believe the #ApoB will demonstrate higher association with #ASCVD than #LDL #Cholesterol..
To @MichaelMindrum point, I too believe the #ApoB will demonstrate higher association with #ASCVD than #LDL #Cholesterol..
2/ But to be sure, ApoB can be best represented as:
(1) Non-LDL ApoB lipoproteins
- and -
(2) LDL ApoB lipoproteins
The first category is predominantly chylomicrons, VLDL, and IDL -- which associate very highly with ASCVD.
(1) Non-LDL ApoB lipoproteins
- and -
(2) LDL ApoB lipoproteins
The first category is predominantly chylomicrons, VLDL, and IDL -- which associate very highly with ASCVD.
3/ You can think of category (1) as "Triglyceride Rich Lipoproteins" (TRL, aka "remnants") and category (2) as "Triglyceride Poor Lipoproteins" (TPL)
The population of #LMHRs have extremely high levels of ApoB. But this pattern is a mix of very *low* TRL and very high TPL.
The population of #LMHRs have extremely high levels of ApoB. But this pattern is a mix of very *low* TRL and very high TPL.
1) Welcome to a new #accredited #tweetorial on Clinical and Laboratory Manifestations of #DKD in #T2D: From Early Identification to Monitoring Management. Your expert author is @edgarvlermamd.
2a) This activity is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers. It is accredited for #physicians #physicianassistants #nurses #NPs #pharmacists. Check out @cardiomet_ce for more🆓CE/#CME.
2b) Past programs are still eligible for credit & can be found at cardiometabolic-ce.com. Faculty disclosures are at cardiometabolic-ce.com/disclosures/.
#FOAMed #medtwitter #diabetesmanagement #kidneydisease #diabetickidneydisease #diabetes @goKDIGO @MedTweetorials @nephondemand
#FOAMed #medtwitter #diabetesmanagement #kidneydisease #diabetickidneydisease #diabetes @goKDIGO @MedTweetorials @nephondemand
1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Cardiologist’s Perspective! Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies
2) @GiuseppeGalati_ is at San Raffaele Research Hospital, Milan 🇮🇹 @SanRaffaeleMI. This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
3) @cardiomet_CE is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, & Chiesi. Earn credit from archived programs at cardiometabolic-ce.com. Disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !
So you've heard a lot of stuff, you've read a lot, maybe you listened to our podcast @cardionerds on it, and yet something is still missing.
TRIGLYCERIDES NEED A TWEETORIAL!
Let’s get right into it with 2 big points to start
TRIGLYCERIDES NEED A TWEETORIAL!
Let’s get right into it with 2 big points to start
#1: Lipids are insoluble in water. You’ve likely seen in this in science class or making salad dressing
What this means is that cholesterol and TG need to be transported with proteins in the body. So we add proteins + lipids and boom, we’ve got lipoproteins (LDL, ILD, VLDL, etc)
What this means is that cholesterol and TG need to be transported with proteins in the body. So we add proteins + lipids and boom, we’ve got lipoproteins (LDL, ILD, VLDL, etc)
#2: The key to this TG story is Very Low-Density Lipoprotein (VLDL). VLDL is made by the liver of proteins, cholesterol, and TG
The ratio of TG to cholesterol depends on the size of the particle, with VLDL getting smaller as adipose and muscle pull TG out of circulating VLDL
The ratio of TG to cholesterol depends on the size of the particle, with VLDL getting smaller as adipose and muscle pull TG out of circulating VLDL
9) Many risk factors modulate the propensity of LDL-C to traverse the endothelium and enter the arterial intima. See 🔓academic.oup.com/eurheartj/arti….
10) It now appears that the passage of #LDL into the #intima is not a merely passive process whereby the concentration in blood & the permeability of the endothelium determine LDL accumulation.
11) It’s #Transcytosis (an active process), through a vesicular pathway involving #caveolae, scavenger receptors (#SRB1) and activin like receptor kinase 1 (#ALK1). Hence for a given blood level of LDL-C the amount of atherosclerosis is variable.
1) Welcome to an #accredited #tweetorial on the role of ⬆️ #LDL-C levels in the pathogenesis & pathophysiology of #ASCVD. I am Kausik Ray MD FRCP @profkausikray, Professor of Public Health & Cardiologist @imperialcollege London AND President of European Atherosclerosis Society
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at cardiometabolic-ce.com/disclosures/.
3) #Atherosclerosis starts in childhood, progresses in fits and spurts and presents in middle to late life in the form of major adverse cardiovascular events #MACE.
1) Welcome to @cardiomet_CE's new series on #lipid management! This is a 10-#tweetorial program, all #accredited, that will cover it all. Our first expert author is Paul Thompson MD @PaulDThompsonMD, esteemed #cardiologist from @hartfordhosp @UConn Med & now @MGHHeartHealth !
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at cardiometabolic-ce.com/disclosures/.
3) @PaulDThompsonMD took on education re mechanisms & use of ezetimibe & bempedoic acid. He proposes a case: 45 ♂️ w/history of inferior wall #MI treated with primary angioplasty.
@ASPCardio Statement led by @DBelardoMD & myself w/ @ErinMichos @RonBlankstein @rblument1 @kcferdmd @KCKlatt @pnatarajanmd @DrOstfeld @KoushikReddyMD @deirdre_tobias @KevinH_PhD Practical Evidence-Based Approaches to Nutritional Modifications to ⬇️ #ASCVD
bit.ly/3tRD0XP
bit.ly/3tRD0XP
Recommendations to ⬇️ #ASCVD with Nutrition:
1. Primary and Secondary Prevention of ASCVD: A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein & fatty fish is optimal for the prevention of ASCVD
🥕🥬🥦🫑🥒🍅🧅🧄🥔🐟🍉🍒🍏🍊🍇🍋🍎🌶️🍈🍐🌿🌱
1. Primary and Secondary Prevention of ASCVD: A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein & fatty fish is optimal for the prevention of ASCVD
🥕🥬🥦🫑🥒🍅🧅🧄🥔🐟🍉🍒🍏🍊🍇🍋🍎🌶️🍈🍐🌿🌱
2. Hyperlipidemia: Replacing saturated fat with polyunsaturated and monounsaturated fat, reducing dietary cholesterol intake, and increasing intake of fiber rich foods, can all lead to a ⬇️ in LDL-C and apoB.
1) Welcome to @cardiomet_CE's series on #lipid management! This is a 10-#tweetorial program, all #accredited, that will cover IT ALL. The expert author for this module is Robert Giugliano MD @ @rgiugliano, renowned #cardiologist from @BrighamWomens & @harvardmed !
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at cardiometabolic-ce.com/disclosures/.
3) @rgiugliano is going to discuss care of patients taking #statins who still have residual atherosclerotic cardiovascular disease #ASCVD risk.
#JACCCardioOnc #Tweetorial: Along the spectrum of cancer Tx, #YeSCCT has a lot to offer regarding identifying subclinical #ASCVD, excluding obstructive #cvCAD in cardiotoxicity when appropriate. #CardioOnc, as a field, can gain from incorporating CCT in practice.
🧵1/
🧵1/
#YeSCCT may identify subclinical #ASCVD in cancer patients & survivors. Reviewing previous non-gated thoracic CT scans for CAC may help identify subclinical #cvCAD and start prompt preventive Tx.
#JACCCardioOnc #CardioOnc #MedTwitter #CardioTwitter
2/
#JACCCardioOnc #CardioOnc #MedTwitter #CardioTwitter
2/
Several clinical scenarios in the context of cardiotoxicity may require ruling out obstructive #cvCAD. Cancer pts tend to have ⬆️ risk of complications from invasive procedures➡️ thrombocytopenia & hypercoagulable states. #YeSCCT may derive significant benefit. #JACCCardioOnc
3/
3/
Join here tomorrow for the launch of a new accredited tweetorial on the expanding role of #SGLT2i in CV disease! Earn 0.5 CE/CME credits: physicians, nurses, pharmacists! Expert faculty @mvaduganathan. #medtwitter @academiccme #diabetesmanagement @endocrinenetwrk
1) Welcome to a Tweetorial on #SGLT2i & CV health. “Flozinators of the world, unite!” Accredited for 0.50h by @academiccme: #physicians, #nurses, #pharmacists. I am @mvaduganathan . . .
. . . and this educational activity, which is intended for healthcare providers, is supported by grants from Abbott, AstraZeneca, Bayer, Chiesi, and NovoNordisk.
