... since patients in trial have likely lower achieved EPA vs STRENGTH. However, dialysis patients are different and have different drivers of CV disease.
Mechanisms are uncertain. We should be open to using medicines with convincing RCTs (as with SGLT2s) despite this uncertainty. /2-fin

Some are reassured by observational epidemiology. But the recent semaglutide Alzheimer's trials did not recapitulate real world simulations. Links via Gregg Fonarow. Corrected
jamanetwork.com/journals/jam...
alz-journals.onlinelibrary.wiley.com/doi/10.1002/...
diabetesjournals.org/care/article...

Just saw this. Good review on uses of apoB testing. In my view, apoB testing has a broader role than envisioned here.
jamesstein18.substack.com/p/when-lipop...

Also believe 10 year risk paradigm of current guidelines misses opportunity for early prevention for those with elevated longer term risk.

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.

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

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