Wouldn’t a change in Lifestyle be more effective? Specially, switching to a Whole-Food Plant-based diet, regular exercise, no smoking, minimal alcohol? Per the research of Ornish, Esselstyn, Barnard, et al. Or, at least a “true” mediteranean-diet?
Also, wouldn’t a high-dose statin, plus possibly PCSK9 inhibitors be effective in turning soft-plaque into hard-plaque, which is stable?
Yes, recommendations for lifestyle modifications and use of high-intensity statins, PCSK9 blockers is what we do now. There's more in detection of risk and treatment to offer and build on.
There is some work being done to test other anti-inflammatory agents in cardiovascular disease. Check out www.cardiolrx.com, which has 2 Phase II trials nearing completion (in recurrent pericarditis and acute myocarditis).
Excellent synopsis of the data. I couldn't agree with you more regarding the role of inflammation and CVD! I have developed a non-invasive technology that measures endothelial dysfunction and feel that it could be valuable in serially monitoring the effects of anti-inflammatory treatments for CVD whether that be medication or lifestyle changes. What are your thoughts? The company website is: www.cordex.systems. Please feel free to email me through the site. Thank you.
“ At 2 year follow-up the primary outcome (death, target vessel heart attack or revascularization) occurred in 3.4% of the medical therapy group compared with 0.4% in. the interaction group, a significant 46% reduction (P=0.003).” I don’t understand where the 46% value came from.
Thanks for this. Wondering what relationship/benefit you think this may have in post-COVID hyper inflammatory conditions?
Excellent, thank you for this post Dr. Topol!
Wouldn’t a change in Lifestyle be more effective? Specially, switching to a Whole-Food Plant-based diet, regular exercise, no smoking, minimal alcohol? Per the research of Ornish, Esselstyn, Barnard, et al. Or, at least a “true” mediteranean-diet?
Also, wouldn’t a high-dose statin, plus possibly PCSK9 inhibitors be effective in turning soft-plaque into hard-plaque, which is stable?
Yes, recommendations for lifestyle modifications and use of high-intensity statins, PCSK9 blockers is what we do now. There's more in detection of risk and treatment to offer and build on.
There is some work being done to test other anti-inflammatory agents in cardiovascular disease. Check out www.cardiolrx.com, which has 2 Phase II trials nearing completion (in recurrent pericarditis and acute myocarditis).
Excellent synopsis of the data. I couldn't agree with you more regarding the role of inflammation and CVD! I have developed a non-invasive technology that measures endothelial dysfunction and feel that it could be valuable in serially monitoring the effects of anti-inflammatory treatments for CVD whether that be medication or lifestyle changes. What are your thoughts? The company website is: www.cordex.systems. Please feel free to email me through the site. Thank you.
“ At 2 year follow-up the primary outcome (death, target vessel heart attack or revascularization) occurred in 3.4% of the medical therapy group compared with 0.4% in. the interaction group, a significant 46% reduction (P=0.003).” I don’t understand where the 46% value came from.
In the paper" At 2 years, the primary outcome occurred in
three (0·4%) patients in the preventive percutaneous
coronary intervention group and in 27 (3·4%) patients in
the optimal medical therapy group (absolute difference
–3·0 percentage points [95% CI –4·4 to –1·8]; p=0·0003;
table 2 and figure 2). I can't post the Table here but it's right in there
From 27 to 3 is an 89% reduction (not 46%).