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Fipco @fipco.bsky.social · 20d

Probably yes, for example lixisenatide - short half-life GLP-1ra dosed once a day was not superior to placebo on MACE (ELIXA). Real world data has some value, but results are all over the place. IMO CVOTs suggest both semaglutide and tirzepatide are good options for secondary prevention.

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Fipco @fipco.bsky.social · 29d

• start prevention earlier (than current guidelines suggest)
• measure apoB

Editorial by Angela Pirillo and Alberico Catapano #cardiosky
academic.oup.com/eurheartj/ad...

Fipco @fipco.bsky.social · 29d

ICER organization draft: Semaglutide and tirzepatide for obesity are cost effective. For context, a 2014 ACC/AHA task force suggested a less than $50k per QALY threshold as "high value". #cardiosky icer.org/assessment/o...

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Fipco @fipco.bsky.social · Sep 8

Key take home: current risk models understate clinical & economic benefit of long term bp/lipid lowering.

Link to slides corserahealth.com/assets/pdfs/...

Fipco @fipco.bsky.social · Sep 8

NATURE-Legacy study compares MR/genetically modeled life long LDL-C and blood pressure lowering (HR 0.32) to short term effects in the HOPE-3 trial (HR 0.71). By Brian Ference, et al. /1 #ESCCongress2025 #cardiosky

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Fipco @fipco.bsky.social · Sep 2

"This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P." Analysis of UK Biobank data by Elizabeth Epstein, et al. #cardiosky pubmed.ncbi.nlm.nih.gov/40887080/

Apolipoprotein B outperforms low density lipoprotein particle number as a marker of cardiovascular risk in the UK Biobank - PubMed

This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P. Notably, risk was already elevated at as little...

pubmed.ncbi.nlm.nih.gov

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Fipco @fipco.bsky.social · Aug 21

Statin eligibility with PREVENT vs PCE 10 year risk at various thresholds by Sadiya Kahn, et al.
jamanetwork.com/journals/jam...

Fipco @fipco.bsky.social · Aug 19

Lp(a) testing is highly cost effective (cost saving) in this study by Morton, et al. Applies to US and various other countries. #cardiosky #lpa #cea
www.sciencedirect.com/science/arti...

Lp(a) testing for the primary prevention of cardiovascular disease in high-income countries: a cost-effectiveness analysis

Cost-effectiveness of Lipoprotein(a) [Lp(a)] testing is not established. We aimed to evaluate the cost-effectiveness of Lp(a) testing in the cardiovas…

www.sciencedirect.com

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Fipco @fipco.bsky.social · Aug 19

Somewhat lukewarm view of colchicine in this editorial. "the CLEAR SYNERGY results have brought considerable clinical equipoise for the prescription of colchicine to reduce ASCVD risk" pubmed.ncbi.nlm.nih.gov/40825059/

Colchicine: Evidence to Treat or Equipoise? - PubMed

Colchicine: Evidence to Treat or Equipoise?

pubmed.ncbi.nlm.nih.gov

Reposted by Fipco

Daniel Drucker @danieljdrucker.bsky.social · Aug 15

From #T2D to #obesity #CVD #OSA and now #MASH The expanding benefits of GLP-1 medicines www.novonordisk.com/news-and-med...

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Reposted by Fipco

Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc @christosargyrop.bsky.social · Aug 15

This "living" guideline document will unlive many people with diabetes if applied.

Why are guideline ppl addicted to sulfunylureas/nsulin/metformin ?

Those are useful to lower A1c from stratospheric levels, but if we are thinking hard outcomes improvement, the answer is #flozin & #glp1

#fail

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Reposted by Fipco

Daniel Drucker @danieljdrucker.bsky.social · Aug 7

Orforglipron notches double digit #weightloss investor.lilly.com/news-release...

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Daniel Drucker @danieljdrucker.bsky.social · Jul 31

SURPASS CVOT #T2D #Tirzepatide Non inferior but numerically superior for some endpoints #CVD investor.lilly.com/news-release...

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Fipco @fipco.bsky.social · Jul 19

Select other populations comparing PREVENT and PCE /2
• pubmed.ncbi.nlm.nih.gov/40615687/ VA-mostly male
• pubmed.ncbi.nlm.nih.gov/40560603/ Sutter
• pubmed.ncbi.nlm.nih.gov/40510258/ UK Biobank (ex-US)
• pubmed.ncbi.nlm.nih.gov/39921505/ Kaiser
• www.jacc.org/doi/10.1016/... Rochester

Performance of the American Heart Association's PREVENT risk score for cardiovascular risk prediction in a multiethnic population - PubMed

The Predicting Risk of Cardiovascular EVENTS (PREVENT) equations, created and endorsed by the American Heart Association, provide cardiovascular risk estimates for the general population, but have not...

pubmed.ncbi.nlm.nih.gov

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Fipco @fipco.bsky.social · Jul 19

Looking below the surface... PREVENT equations seem better calibrated vs PCE in other studies compared to recent JACC study. VA, Kaiser, UK Biobank (ex-US), and others. /1

bsky.app/profile/fipc...

Fipco @fipco.bsky.social · Jul 14

On the surface, in this dataset of 240k, the PCE calibration seems closer to actual than PREVENT. Excerpt S-Table 45.
bsky.app/profile/pnat...

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Fipco @fipco.bsky.social · Jul 14

On the surface, in this dataset of 240k, the PCE calibration seems closer to actual than PREVENT. Excerpt S-Table 45.
bsky.app/profile/pnat...

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Fipco @fipco.bsky.social · Jul 11

DAPA-HF

Fipco @fipco.bsky.social · Jul 11

In Norway🇳🇴, 4 years after DAPA-HF, 85% of those with reduced ejection fraction heart failure get an SGLT2i. In the US🇺🇸, it's under 30%. #gdmt #flozins #cardiosky
www.hcplive.com/view/study-h...

onlinelibrary.wiley.com/doi/10.1002/...

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Daniel Drucker @danieljdrucker.bsky.social · Jun 20

A detailed look at dosing, efficacy and tolerability for Amycretin www.thelancet.com/journals/lan... #weightloss #obesity

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Fipco @fipco.bsky.social · Jun 20

Good interview with @danieljdrucker.bsky.social on obesity medicines. I clicked the translate button since hablo muy poco español elpais.com/salud-y-bien...

Daniel Drucker, padre de Ozempic: “No tenemos datos suficientes para usarlo en personas sanas, yo no vendo los fármacos”

El investigador canadiense acaba de recibir el Premio Fronteras del Conocimiento por su papel en los fármacos antiobesidad, aunque es conservador sobre su uso

elpais.com

Fipco @fipco.bsky.social · Jun 17

Three views on GIP agonism and antagonism. Thread with 3 links. #obesity #cardiosky bsky.app/profile/dani...

Daniel Drucker @danieljdrucker.bsky.social · Jun 16

As we head to the 2025 @amdiabetesassn.bsky.social GIP biology will be part of the conversation. Here Samms and Sloop summarize the compelling scientific story of Tirzepatide and the case for GIPR co-agonism #Diabetes #Weightloss #obesity diabetesjournals.org/diabetes/art...

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Fipco @fipco.bsky.social · Jun 11

Systemic review of discordance studies by Daniel Sehayek, et al. finds apoB generally outperforms LDL-C and non-HDL-C. (prior post of recent study adds to this evidence) #cardiosky

www.lipidjournal.com/article/S193...

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Fipco @fipco.bsky.social · Jun 11

Converting mean apoB and LDL-C values to population percentiles (using NHANES) shows risk tracks with apoB. (ASCVD % from Figure 1) Results similar for non-HDL-C. /2-fin

Fipco @fipco.bsky.social · Jun 11

Mid-sized 🇬🇷discordance study (n=3042, 20 year follow-up) favors apoB over traditional lipid measures. By Giannakopoulou et al. /1 #cardiosky pubmed.ncbi.nlm.nih.gov/40386959/

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Fipco @fipco.bsky.social · Jun 9

Merck's enlicitide, an oral PCSK9i, meets LDL-C and other endpoints in 2 phase 3 trials. Details to come. "There were no clinically meaningful differences in incidences of AEs and SAEs in either trial" #cardiosky
www.merck.com/news/merck-a...

bsky.app/profile/fipc...

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