adssx
#1664
That’s not how I understood the study. I thought it was: in one group we do the usual (so nothing unless you have a stratospheric LDL) and in the other one we use the CAC to start a statin earlier. But that’s not very clear and you might be right.
1 Like
Liz Parrish has done the PCSK9 gene therapy. I think about 5 years ago.
Get a mail box in a state where your fav Dr can do Telemedicine and a burner phone from that state 
but don’t tell anyone
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LaraPo
#1667
Which AI tool did you use for that? I want to try it for my list of medications.
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mccoy
#1669
DeepseeK = 0 US$
DrOracle = 10 US$ per month. Do you find this AI significantly better than Deepseek and worth the price (which si not exorbitant anyhow)?
No, do not subscribe. Free AIs such as Grok, ChatGPT, DeepSeek, and OpenEvidence are very good. You can always use more than one to get a consensus.
I always ask for references in the query and then check them with PubMed.
IMO, OpenEvidence is excellent and always provides references.
You can get OpenEvidence for free. You just have to convince them you are in the medical field.
researcher, etc. They will take your word for it.
5 Likes
mccoy
#1671
Thanks. In the meantime, I’ve started to use the Deepthink (R1) function of Deepseek. It’s pretty impressive. I’ve also submitted the same question to Deepseek and another AI. Some aspects of the answers overlap, others are different sometimes building up a more complete picture.
I’m going and try Openevidence, if the issue is serious enough, I’m going to ask the same question to 3 different AIs, and learn their behaviour. It is clear that this new tool requires some learning time for the users at first.
2 Likes
Remarkable effects of intravenous atorvastatin in rats with acute MI
Cardioprotection during myocardial infarction in diabetic cardiomyopathy
Diabetic patients are at an increased risk of diabetic cardiomyopathy (DCM) and acute myocardial infarction (AMI). Protecting the heart against AMI is more challenging in DCM than non-diabetic hearts. We investigated whether intravenous atorvastatin administration during AMI exerts cardioprotection in DCM as seen in non-diabetic hearts.
Sprague-Dawley rats were divided into streptozotocin-induced DCM and normoglycemic-control groups. Our model of DCM rats exhibited interstitial fibrosis and cardiac dysfunction at 5 weeks. At this time point, all animals underwent AMI-induction (coronary ligation for 45min), receiving intravenous atorvastatin or vehicle during ischemia. Animals were reperfused and sacrificed 24h later for myocardial infarct size analysis and cardiac tissue sampling. Echocardiography was performed.
DCM vehicle rats had larger infarcts than normoglycemic vehicle-treated animals at comparable area-at-risk. Intravenous atorvastatin reduced infarct size and preserved systolic function in both groups. In comparison to vehicle animals, intravenous atorvastatin inhibited RhoA membrane translocation, induced AMPK phosphorylation, prevented apoptosis execution and improved cardiac remodelling in the infarcted heart of both groups whereas innate immune cell infiltration was further reduced in intravenous atorvastatin-treated DCM animals.
The proven cardioprotective effectiveness of this intravenous statin formulation in the presence of DCM warrants its further development into a clinically therapeutic option.
https://diabetesjournals.org/diabetes/article/doi/10.2337/db24-0510/157977/Cardioprotection-during-myocardial-infarction-in
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Cannabis Is Interfering With the Heart
New research suggests clinicians should warn patients about the potential of cannabis to harm cardiovascular health. But how big a risk cannabis presents depends on the amount used and how much stock should be placed in observational studies.
The link between cannabinoids and cardiovascular disease, which used to be limited to evidence from preclinical studies, case reports, and case series, is now evident in epidemiological studies, researchers from Stanford reported in a recent paper in Nature Reviews Cardiology.
A large-scale US study from 2024 relied on survey data from more than 430,000 respondents and found the 4% of respondents who reported using cannabis daily had a 49% increased risk for myocardial infarction and a twofold increased risk for stroke. The added risk from cannabis was similar among those who also smoked tobacco and those who never used tobacco.
https://www.medscape.com/viewarticle/cannabis-interfering-heart-2025a10006c2
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So smoking cannabis is just as unhealthy as smoking tobacco.
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You mean repeatedly and deliberately inhaling burned plants and paper into your lungs isn’t a good idea? Who ever could have known!
Pretty interesting. This is my exact research field, pretty much, and I spent a lot of hours looking at rat MI models and echo, haha. I will point out that lots of things can show these massive changes in cardiac function rats, but don’t translate to humans. But this paper is cool that they actually used mice with a form of DCM. Ok, it’s induced in a “fake” way using a drug to poison the pancreas, but it’s still an upgrade over the young healthy rodents used in most studies.
I can definitely believe the results. We know Atorvastatin has a ton of diverse effects, not just for lipid lowering.
They used 2.5mg/kg intravenous. Converting rat to human, we divide by 6.2, which is 0.4 mg/kg, or 28mg for a 70kg human. That’s a very normal dose for oral consumption and would be very easy to implement. However, I am not aware of any atorvastatin formulated for IV administration.
A previous study from the same group (Intravenous Statin Administration During Myocardial Infarction Compared With Oral Post-Infarct Administration - PubMed) did compare oral versus intravenous, and found that IV was more effective, no surprise. And the bolus seems to be key, since daily oral Atorvastatin post-MI was less effective. That points to some sort of acute cardioprotection.
The authors have patents for IV atorvastatin, so clearly they’re incentivized to show that IV is better. However, the obvious question in my mind is whether you could overcome it just by using a bigger oral dose. Like, going to 80mg, or even 150mg, as an acute single dose post-MI would be nothing too crazy or risky IMO.
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NY is coming on to the interstate medical compact - so long as they pass legislation that has been introduced. Then it is easy to get a license - it’s just a few, but no paperwork.
1 Like
New Evidence on the benefits of statins for CVD prevention in older adults with CKD
Using a new-user study design and target trial emulation framework with intention-to-treat as the primary analysis, the authors observed a significant protective association of statins with CVD and mortality outcomes for those newly prescribed a statin compared with those who were not. For the composite of CVD events (myocardial infarctions, heart failure, or stroke), the hazard ratio (HR) was 0·94 (95% CI 0·89–0·99) in the group aged 75–84 years and 0·88 (0·79–0·99) in the group aged 85 years and older. For all-cause mortality, the HR was 0·87 (95% CI 0·82–0·91) in the group aged 75–84 years and 0·89 (0·81–0·98) in the group aged 85 years and older. The results of a per-protocol analysis showed a stronger protective association for both CVD and mortality outcomes for those who were prescribed a statin, at all age groups.
Open access:
https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(25)00017-0/fulltext
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Tim
#1678
Because of its association with CVD, CKD, morbidity, and mortality, uric acid should be monitored closely and treated aggressively. The normal range of uric acid in the blood is between 3.5 and 7.2 mg/dl. But normal is not normal for some people. Some people could have an attack of gout at 6.0 or lower. There is a school of thought that says gout may be asymptomatic at levels as low as 5. Asymptomatic at the joints but still corroding your system.
The same school of thought indicates that those at risk for major diseases should probably start on a low dose of allopurinol or febuxostat. Both work the same way and both get mostly good reviews. Uric acid should be treated like blood pressure, where lower is generally better.
AnUser
#1679
Butter, tallow, and full fat milk is back.
Sigh.
You reap what you sow, and it’s going to be a grim one.
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AnUser
#1680
“Plaque calcification (CAC=>1) is advanced disease” – A. Sniderman.
Doesn’t look like a fun time.
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Wait, what happened in 2010?! From lowest mortality a hockey stick rocketing up, super sharp reversal! Also very contrary to expectation, for many decades (1984 - 2011) women were substantially more likely to die from CVD?! Odd.
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adssx
#1682
In 2013 strict guidelines for LDL were eliminated by the ACC/AHA.
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Why did things change in 2010?
Marat Fudim, MD, an associate professor in the Duke Department of Medicine and lead author of the study published April 24 in JAMA Cardiology, points to widespread obesity and rising rates of diabetes and hypertension putting more people at risk for heart failure.8 May 2024
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