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Ethan J. Weiss

Sep 14, 2020 • 4 tweets • 1 min read • Read on X

Are there situations where one would want to prescribe PCSK9i in a patient on max tolerated statin and with LDLc < 70 mg/dl

If yes, what are some examples?

@ExpressScripts

Also if yes, were you aware of this from @ExpressScripts express-scripts.com/art/medicare16…

Is it fair to interpret this as meaning that there are zero circumstances where they will approve PCSK9i in a patient with LDLc < 70 mg/dl - even in a patient with multiple recurrent events?

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More from @ethanjweiss

Ethan J. Weiss

@ethanjweiss

Feb 24, 2023

A story for a Friday afternoon. Spoiler, I really don't know what to do with it.

So I have this patient. He is mid-50's & healthy aside from an ACS event a few years ago for which he was stented & is on all the right 2ndry prevention things. He is also very active

He wears an Apple Watch, & a couple of years ago the watch was telling him he had Afib. Given his CAD, this was important as it would mean adding a DOAC to his regimen which of course does not come without risk.

The watch continued to trigger frequent AF alerts and we did a Zio

He kept very careful notes and the Zio was on for a week. There was no AF at all. And the events the watch was calling fib were clearly not fib

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Ethan J. Weiss

@ethanjweiss

Jan 13, 2023

I don’t understand why people are so bothered by the fact that metabolic disease can be treated by medicines. It’s not that lifestyle solutions can’t work; they can! It’s that they don’t work for a very large number of people…

We should celebrate that more people have solutions that can work for them. Not doing so is the height of arrogance

It also seems relatively uncontroversial to acknowledge that medicines are a life-saving solution for those with hypertension who cannot control their blood pressure with lifestyle alone

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Ethan J. Weiss

@ethanjweiss

May 20, 2022

Anyone else finding it increasingly difficult to tweet anything that does not feel like it is a massive cry for attention?

I am overwhelmed by my own self-consciousness here and honestly it is a new phenomenon

I find myself writing and deleting tweets almost 100% of the time

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Ethan J. Weiss

@ethanjweiss

Apr 17, 2022

@nicknorwitz

Here’s a question for @nicknorwitz & @realDaveFeldman: if I understand, your model hypothesizes that increased ApoB in lean/athletic people on low carbohydrate or ketogenic diets does not result from either 1) saturated fat or 2) genetic variation, but rather from CHO restriction

So in the spirit of n=1 case studies, I have one for you. 52 year old male cardiologist BMI 21, exercises 6 days a week, on low SFA ketogenic diet for 4+ years with ApoB ~80 mg/dl