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Feb 22 • 4 tweets • 1 min read
Poll 1 of 4 (Please answer all four polls)

Which of these have the biggest association to heart disease?
Poll 2 of 4

What is the *second* biggest association to heart disease? (Choose a different answer from your first)
Poll 3 of 4

Which of these are the most discussed on social media in relation to heart disease?
Poll 4 of 4

Which of these are most discussed by doctors (both on and off social media) in relation to heart disease?

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More from @realDaveFeldman

Dave Feldman Profile picture
Feb 23
1/ My thoughts on being a good #Moderator

First and foremost, your top goal is to service the debate, not your own opinions.

The best moderators are those who give no clue as to where they stand on the subject because it's their express duty to leave that to participants...
2/ All your interjections in the debate should come as no surprise to anyone -- especially the participants.

In other words, clearly define the rules in advance on what you'll be enforcing, and ideally, you should announce these to the audience at the beginning as well.
3/ Thus, if someone steps out of line for these agreed upon rules and you promptly enforce them, there should be no controversy as this was expected.

A "bad call" is always a problem in any sport, the losing side feels robbed, and even the winning side feels the victory tainted.
Read 7 tweets
Dave Feldman Profile picture
Feb 13
1/ I think this is a fair question to bring forward given a severe MI can associate with reduced LDL at admission and within days of the event.

But that's also why I like this study design so much -- they exclude known CAD (coronary artery disease) at baseline...
2/ For a relevant example-- this study makes direct comparisons on symptomatic ("chest pain") patients ultimately diagnosed AMI (acute myocardial infarction, aka heart attack) vs symptomatic yet diagnosed as not having had an AMI... journals.sagepub.com/doi/full/10.41…
3/ "There were significant decreases in TC, LDL and HDL levels in both STEMI and NSTEMI patients as compared to normal subjects; however, patients with chest pain did not show any significant change in these lipids."
Read 4 tweets
Dave Feldman Profile picture
Feb 13
1/ #Study #MegaThread

A new study dropped with a trove of data I've long waited for around #CCTA/#CAC scans and #LDL #Cholesterol

✅ >23k studied (!)
✅ Largest sample of CCTA w/ ≥190 #LDL to date (!)
✅ Very uniform study population

Let's unpack...
jamanetwork.com/journals/jaman…
2/ First, be sure to check out this short thread from the lead author, @MaBMortensen.

2 quick notes:
a) While there'll be lots of data appreciated by LDL skepticism, @MaBMortensen maintains LDL-C is still "an important causal RF"
b) Usual epi caveats, etc
3/ Okay, so if you've followed me a while, you know just how incredibly thankful I am of studies that seek to avoid common risks of selection bias (Even if entirely unintended).

This study had the distinct advantage of categorically scooping its population directly...
Read 18 tweets
Dave Feldman Profile picture
Feb 6
1/ Reminder: I realize it’s the single hardest concept to get across, but for all these years I have and continue to suggest there’s a crucial case of lipoprotein profiles as often more a reflection of disease than the independent drivers of it. (ie — from 2018 re general👇)
2/ For example, I certainly know so much more on the workings of #LEM* than when I tweeted this from 2018, but does the foundation still hold up… do I think this is more relevant or less? Definitely more!

(*Obligatory mention of @nicknorwitz here and others re coming paper!)
3/ The bottom line is that while the independent causal role of lipoproteins (whether LDLp, sdLDL, oxLDL, glLDL, etc) are well worth examining. We should likewise investigate how *both* lipid profiles and CVD can be downstream of poor lipid metabolism.
Read 5 tweets
Dave Feldman Profile picture
Feb 1
1/ Hi guys! Just dropped a new interview with Bill Cromwell (@Lipoprotein) on Youtube regarding their Precision Health Report platform.

I really love their model and suggest you check it out...

(precisionhealthreports.com/oyl)

2/ They've kindly agreed to provide a coupon code "CITIZEN" for their package to help get both a discount and allow opting in your anonymized data to our OYL anonymous data pool. (Just like we do at our site)

No, there's no $$$ or compensation for us or anything like that...
3/ ... Which might seem confusing since they are technically a competitor given they offer bloodwork as well.

But hello -- @siobhan_huggins and I are *always* game for *everyone* finding what works for them. And seriously, I think this platform is a strong step forward.
Read 5 tweets
Dave Feldman Profile picture
Feb 1
I'm incredibly honored at @nicknorwitz's offer for a transplant -- so blessed to have such a good friend they'd donate their own...

- eyebrows! 😂

Okay, but seriously, let's talk about disappearing eyebrows and how it can potentially signal reasons of concern...
2/ Occasionally I get a doctor (often a Dermatologist) ask if I've checked for hypothyroidism given it can be associated with loss of the outer eyebrow.

However, this is usually resolved when they see my eyebrows up close given it doesn't follow the same pattern... Image
3/ Often there is a pronounced pinching or abrupt halt in the pattern of spread. But to be sure, this is more of what I hear from them. I haven't researched much on it given I already knew this pattern was common in my family-- but this study was helpful👇 ncbi.nlm.nih.gov/pmc/articles/P…
Read 6 tweets

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