Scotty Kirkpatrick M.D. @drscottyk Twitter profile

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

First day of 25th grade!! (a.k.a. 2nd year cardiology fellowship)

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Scotty Kirkpatrick M.D.

@drscottyk

3 months

Day 1 as a cardiologist back in my hometown!

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

What social media tells you to focus on: -ice baths -supplements -sauna -a new way to “detox” -lectins -anecdotes What you should actually focus on: -VO2 max -strength -Metabolic health -sleep -ApoB -Blood pressure -mental health

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

I recently started a patient on 5 mg rosuvaststin. LDL 154 -> 78. I think we underestimate how potent low dose rosuva can really be.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

“If LDL-C can be kept very low from birth, atherosclerosis will not occur.” Powerful statement from @ASPCardio .

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Weight loss is one of the most underutilized tools in a-fib: In pt's with a-fib and BMI >27, weight loss ≥10% resulted in a 6-fold greater probability of arrhythmia-free survival compared <10% weight loss.

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Scotty Kirkpatrick M.D.

@drscottyk

3 days

Why LDL <55 in secondary prevention? GLAGOV trial: in secondary prevention, 90% of non-calcified coronary lesions regressed in those who achieved an LDL less than 60.

Evolocumab and Coronary Disease Progression in Statin-Treated Patients

This randomized clinical trial compares the effects of evolocumab vs placebo on change in percent atheroma volume among adult patients with angiographic coronary disease despite treatment with...

jamanetwork.com

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Scotty Kirkpatrick M.D.

@drscottyk

3 months

Today I: Celebrated my 10 year wedding anniversary! Finished my first week as a cardiologist back in my hometown. Bought a house. Realized I’m the luckiest guy in the world.

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Scotty Kirkpatrick M.D.

@drscottyk

5 months

If my ejection fraction recovers can I stop my meds? Within 6 months, relapse occurred in 44% of patients with recovered EF who had their meds withdrawn

Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated...

Many patients deemed to have recovered from dilated cardiomyopathy will relapse following treatment withdrawal. Until robust predictors of relapse are defined, treatment should continue indefinitely.

www.thelancet.com

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

In the last few days I have seen multiple patients in their 30s/40s have a heart attack. Makes the 5AM workout a little easier to swallow. #Prevention

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

At 4 months old, I think it’s safe to say Cade was the youngest attendee at the @nationallipid scientific sessions today!

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Scotty Kirkpatrick M.D.

@drscottyk

4 months

Today was my last day of school ever! From kindergarten to 26th grade (a.k.a. last year of cardiology fellowship), thank you to all the teachers along the way who helped me get to this point, I am incredibly grateful to all of you. Now it’s time to get to work! 🩺

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

Just had an insurance company decline rosuvastatin and state the patient has to try a different statin first. Another example of an insurance company pointlessly getting in the way of patient care.

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Scotty Kirkpatrick M.D.

@drscottyk

5 months

Coronary artery calcium scan is inferior to both carotid and Ilio-femoral (and also aortic) ultrasound for identification of subclinical atherosclerosis in asymptomatic adults aged 40-54. Maybe we should use ultrasound more than CAC?! .

Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a...

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318.

pubmed.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Recently overheard someone bragging about how they were functioning on so little sleep. I’m really hoping we can culturally move past the idea that functioning on little sleep is somehow admirable. Inadequate sleep is literally one of the worst things we can do for our health.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Takotsubo’s Cardiomyopathy (broken-heart syndrome) clearly shows the acute affect our mental state can have on our heart. I think it’s only a matter of time before we discover how truly important long-term mental health is in cardiovascular disease.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Drinking sugar sweetened beverages increases LDL, insulin, inflammation, Glycated LDL, and decreases triglycerides. One of the best things we can do for patients is get them off of these drinks.

218. Guidelines: 2021 ESC Cardiovascular Prevention – Question #15 with Dr. Kim Williams

The following question refers to Section 4.3 of the 2021 ESC CV Prevention Guidelines. The question is asked by CardioNerds Academy Intern Dr. Maryam Barkhordar

podcasts.apple.com

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Scotty Kirkpatrick M.D.

@drscottyk

3 years

An alarming statistic I recently learned: 5 year mortality following a diagnosis of heart failure has been estimated to be as high as 50%. For those of us with interests in preventive cardiology, prevention needs to be more than just preventing CAD.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

It’s truly incredible how early ASCVD starts. This study of 204 autopsies ages 2-39 found: “the prevalence of fatty streaks in the coronary arteries increased with age from approximately 50% at 2-15 years of age to 85% at 21-39 years (P=0.01). “

Association between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young...

In adults, cardiovascular risk factors reinforce each other in their effect on cardiovascular events. However, information is scant on the relation of multiple risk factors to the extent of asympto...

www.nejm.org

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

Meta-analysis: By being on a high-intensity statin instead of a moderate intensity statin, it is 3.21 times more likely that the statin will prevent a cardiovascular event than cause diabetes.

Risk of Incident Diabetes With Intensive-Dose Compared With Moderate-Dose Statin Therapy

Context A recent meta-analysis demonstrated that statin therapy is associated with excess risk of developing diabetes mellitus.Objective To investigate whether intensive-dose statin therapy is...

jamanetwork.com

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

They gave me a bacon bandage for getting my flu shot. I don’t think they realized I’m into preventive cardiology😂😂

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Does particle size matter? This study using MESA data shows both small and large LDL particles are atherogenic, and that it's the particle number that matters."LDL size was not significant after accounting for LDL subclasses and risk factors"

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Scotty Kirkpatrick M.D.

@drscottyk

10 months

I recently saw a patient who lost 80 pounds and their A1C went from 9 to 6 on semaglutide. Incredible! And yet so many patients with obesity and diabetes are denied coverage by their insurance. What good is insurance if we can’t get proven life changing meds to those who need it?

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

My thoughts on the NEJM plastics study after listening to a lot of people much smarter than I

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

I recently saw a patient in their 40s with atypical chest pain. CAC zero BUT CCTA showed mid LAD moderate soft plaque with high risk features. Another reminder that CAC can be helpful but can also be falsely reassuring especially in our young patients!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Is there such a thing as too much exercise?? Incredibly comprehensive analysis on the vast benefits of exercise and the rare instances of increased patient risk of cardiovascular adverse events associated with exercise.

Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart...

www.ahajournals.org

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Spironolactone in HFrEF: 11% absolute risk reduction in mortality in just 2 years! Maximizing and optimizing GDMT can literally be the difference between life and death.

The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure | NEJM

Aldosterone is important in the pathophysiology of heart failure. In a double-blind study, we enrolled 1663 patients who had severe heart failure and a left ventricular ejection fraction of no more...

www.nejm.org

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

It’s crazy cardiac rehab isn’t used more: studies have found that cardiac rehab participation is associated with a 20-30% reduction in hospital readmission during the year after a cardiac event.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Very thankful and honored to have been accepted into the @nationallipid Lipid Scholarship Program! Can’t wait to add more tools and knowledge to my prevention toolkit!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

“Atherosclerosis is by far the greatest cause of disease, disability, death and cost. It should be the number one priority of the healthcare system.”

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Physical activity and stroke risk: highest vs lowest quartile of mean sedentary activity associated with 53% increased risk of stroke. Each 1 hour increase in low-intensity physical activity associated with 14% reduction in stroke.

Association of Sedentary Time and Physical Activity With Stroke Risk in US Adults

This cohort study assesses the associations of accelerometer-measured sedentary time and physical activity of varying intensity and duration with the risk of incident stroke among adults 45 years or...

jamanetwork.com

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

Every a-fib patient should try to: 1) Lose weight for those with BMI >27 kg/m2 2) 210 minutes of moderate-to-vigorous exercise per week 3) Stop tobacco 4) Minimize or elimination of Alcohol 5) Optimal BP 6) Screen for OSA )%20screening%20for

2023 Guideline for Diagnosis and Management of Atrial Fibrillation: Key Perspectives - American...

Thomas C. Crawford, MD, FACC

www.acc.org

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

A patient recently told me their insurance was charging them $149 a month for ezetimibe! Crazy! Thanks to @GoodRx we were able to get it for $3/month. So sad how many patients are getting financially taken advantage of for medications that should be dirt cheap.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Patient with a history of MI now on atorva 40 with LDL 82. Didn’t want to increase meds so opted for nutrition to get to target LDL goal. All he did was stop putting coconut milk in his 3-4 cups of coffee daily. Repeat LDL 61. Crazy how simple diet changes can make a big impact.

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Scotty Kirkpatrick M.D.

@drscottyk

11 months

20 yrs from now we are going to look back on this era of medicine and realize a lot of patients had unnecessary events - or worse, died - because we took too long to implement serious prevention efforts. Every adult should have a plan to lower their risk of CVD.

Prof Derek Connolly

@DrDerekConnolly

11 months

The impact of LDL-C and SBP on subclinical atherosclerosis progression was more pronounced in younger participants suggesting that the prevention of atherosclerosis and its progression could be enhanced by tighter risk factor control at younger ages

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

CAC scores can be an incredibly useful tool for ASCVD risk assessment, but it definitely isn’t perfect. Just recently I read two studies in which the CAC score was zero but patient had non-calcified plaque on CT coronary angiogram.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

What’s my risk of statin induced diabetes? JUPITER trial: in those with no risk factors for diabetes (BMI < 30, A1C <6, no metabolic syndrome, normal fasting glucose) (N=6,095), no increase in diabetes compared to placebo (HR 0.99, P= 0.99)

Cardiovascular Benefits and Diabetes Risks of Statin Therapy in Primary Prevention

As statin therapy increases risks of diabetes, the balance of benefit and risk in primary prevention for these agents has become controversial. We undertook an analysis of participants from the...

www.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

One of the most common misconceptions by patients -“My HDL is high, so my LDL being high isn’t a concern”. This shows high HDL is not protective and in many cases may be a sign of other problems: EtOH use, liver and thyroid problems, cholesterol hyper absorption, etc.

Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦

@DrMarthaGulati

7 months

High HDL is NOT protective in women: Our study from the #WISE study, led by our amazing fellow @SRanasingheMD demonstrates this U shaped curve #HDL #women #lipids See our paper in @AHJ_Open

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

I made the mistake today of talking about weight loss with a patient without first asking them about their previous weights. Turns out they had already lost 30 pounds! Don’t make the same mistake I did!!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Lifestyle works and is incredibly powerful. But meds work too. We can be pro lifestyle and pro meds when they are needed. No patient should ever be shamed for taking their medicines. They save lives.

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

“Lp( a) level should be measured at least once in all adults.” “Risk classification by Lp(a) level ranges from low (<75 nmol/L) to high (≥125 nmol/L).” “High Lp(a) levels warrant early and more-intensive risk factor management.”

Christie Ballantyne

@CBallantyneMD

6 months

A focused update to the 2019 NLA scientific statement on use of lipopr... . Updated guidance - Measured Lp(a) at least once in all adults! @nationallipid @MarlysLPA @MBBoffa @VCUDPOSChair @kcferdmd @ErinMichos @dan_soffer

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

“Atherosclerosis represents a clinical paradox: it is potentially the most preventable or treatable chronic disease, yet it remains the greatest cause of disability and death throughout the world. This does not have to be the case.”

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Scotty Kirkpatrick M.D.

@drscottyk

4 months

I recently asked one of my nephrologist colleagues this question and they completely agreed. Protein restriction in CKD is likely overall harmful - we need adequate protein for many reasons.

Ted ⚡️ Naiman

@tednaiman

4 months

Protein restriction in CKD 😭 _______ “Higher total protein intake was associated with lower mortality among participants with CKD [hazard ratio (95% confidence interval) for 1.15 and 1.35 g/kg/day versus 1.0 g/kg/day = 0.93 (0.88, 0.98) and 0.85 (0.76, 0.95), respectively].”

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

There are lots of advances coming in the fight against cardiovascular disease. But maybe the one that will have the most impact will be our ability to overcome clinical inertia and realize we need to aggressively treat CVD risk factors about 20 years sooner than we currently do.

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Scotty Kirkpatrick M.D.

@drscottyk

8 months

Time for new guidelines: “Multiple studies have shown that the guidelines wouldn’t have recommended treatment for at least 1/2 of patients who subsequently suffered MI’s including those w/ MI's before 50, those from a ⬆️risk population and those >65”.

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

"Ultra-processed food is the #1 cause of dementia". - A powerful statement from the @MayoClinic CV Board Review Course.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

No matter how you slice it , atherogenic lipid particles matter and are causal in atherosclerosis. That doesn’t mean it’s the only thing that matters or the only thing that can cause ASCVD, but to deny that LDL/ApoB is important is not based in any sound science.

Gil Carvalho MD PhD🌈

@NutritionMadeS3

2 years

"Low-density lipoprotein (LDL) indubitably contributes causally to atherosclerosis, a leading challenge to health worldwide" word.

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

“I would have taken better care of myself if I knew I was going to live this long.” A quote from a patient I recently saw. Take the time to take care of yourself, your future self will thank you!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

The Power of exercise: 12 weeks of 3x/wk 40 minute moderate intensity aerobic exercise reduced SBP by 7 points in resistant HTN. Don’t forget to Rx exercise the next time you see a pt with HTN!

Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension

This randomized clinical trial evaluates whether an aerobic exercise training intervention reduces ambulatory blood pressure among patients with resistant hypertension.

jamanetwork.com

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

There is no solid scientific evidence that very low LDL levels are harmful. This further supports the notion that in regards to LDL/ApoB, lower for longer is optimal for health and longevity.

SABOURETCardiologist

@SABOURETCardio

2 years

Low levels of #LDLc #ICH and #Safety : final pdf soon online.

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Scotty Kirkpatrick M.D.

@drscottyk

4 months

A common misconception is the thought that low LDL-C might increase risk of hemorrhagic stroke or dementia. This great review provides a summary as to why these claims are unfounded. .

LDL Cholesterol Lowering: Is There a Risk for Dementia and Hemorrhagic Stroke? - American College...

www.acc.org

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

"For each increase of 1 mg/dL of serum uric acid level, the risk of CAC progression was increased by 31%.

The association between hyperuricemia and coronary artery calcification development: A systematic...

Hyperuricemia coincides with coronary artery calcification (CAC) development, but the role of serum uric acid (SUA) as a risk factor for CAC remains unclear. The objective of this study was to gain...

www.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Oral PCSK9 inhibitor?? Great lecture by @DrMarthaGulati discussing this drug in development. Highlights: small studies and very early on, but have shown to reduce LDL-C by 65% after 14 days and lower PCSK9 by >90%. More data is needed but an exciting possibility!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

It’s estimated as many as 1.4 billion people worldwide have an elevated Lp(a). I just got my level checked, and here’s why I think you should too…

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

It’s data like this that make me think an adult who is interested in a “supplement” to benefit their long term health, should consider low dose rosuvastatin and/or ezetimibe. The subsequent lifetime risk reduction of the #1 cause of death would seem to align with their goal.

Sek Kathiresan MD

@skathire

2 years

If LDL⬇️for a long time, really hard to get heart attack Cool new evidence Some lucky people born with DNA variation that naturally lowers LDL ~50 mg/dl⬇️LDL, lifelong & risk for heart attack/death is ~50%⬇️! So, for every 1 mg/dl⬇️LDL lifelong, ~1%⬇️risk heart attack/death

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Lunch date at work with my favorite little guy ☺️

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

LDL/ApoB is causal in atherosclerosis. But this DOES NOT mean other factors don’t matter. Lots of pushback on yesterday’s tweet, so here are my thoughts 🧵

Scotty Kirkpatrick M.D.

@drscottyk

2 years

“If LDL-C can be kept very low from birth, atherosclerosis will not occur.” Powerful statement from @ASPCardio .

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

I keep telling my patients, in 10-20 years 5 mg rosuva will be OTC and there will be a craze online of influencers recommending this OTC option to lower LDL. We’ve known the benefits and safety for decades. Might as well start it now and reap the compounding benefits of time.

Erin D. Michos, M.D.

@ErinMichos

6 months

Very excited to see #TACTIC trial presented. A proof of concept that patient self selection for non prescription statin (rosuva 5) had >90% correct self selection, >98% correct use, & >35% LDL-C lowering. #ACC24 A potential mechanism to address primary prevention treatment gap!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

An inspiring heart failure statistic! At 24 months on max tolerated dose of all 4 GDMT (ARNI, BB, ARA, SGLT2i) estimated 73% RRR, 26 %ARR in all cause mortality at 24 months vs no meds!!

Association of Optimal Implementation of Sodium-Glucose Cotransporter 2 Inhibitor Therapy With...

What would the reduction be in all-cause mortality for the US population if all eligible patients with heart failure with reduced ejection fraction were prescribed sodium-glucose cotransporter 2...

www.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

We can still get coronary artery disease even if we are in excellent shape. I’ve had a couple patients who are probably in the elite cardiorespiratory fitness category and yet still got CAD. High CRF is so important, but it doesn’t mean we can ignore other risk factors!

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Scotty Kirkpatrick M.D.

@drscottyk

6 months

A woman recently told me that a few years ago she had a DEXA scan that showed she was very close to having osteopenia. She started lifting heavy weights and her bone density completely normalized! Everyone should lift weights!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Please be aware of the potential side effects of a comprehensive preventive cardiology plan. They include lower risks of: stroke, dementia, NASH, HTN, obesity, PAD, CKD, diabetes, renal & carotid artery stenosis, erectile dysfunction, fragility and poor aging😉

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

If no risk factors for diabetes, does LDL matter? Jupiter trial: in those with no DM risk factors (BMI < 30, A1C <6, no metabolic syndrome, normal fasting glucose) (N=6,095), statin was associated with a 52 % RRR in the primary endpoint.

Cardiovascular Benefits and Diabetes Risks of Statin Therapy in Primary Prevention

As statin therapy increases risks of diabetes, the balance of benefit and risk in primary prevention for these agents has become controversial. We undertook an analysis of participants from the...

www.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

It’s one thing to know your Lp(a), it’s another thing to interpret what to do with it. This graph shows how much LDL needs to be lowered to account for a given Lp(a) level. Note that the earlier you start the less aggressive you have to be.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

If anyone tells you that a common risk factor for heart disease doesn’t matter, or the opposite that only one risk factor matters, this is a HUGE 🚩. EVERYTHING matters when trying to prevent cardiovascular disease.

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Scotty Kirkpatrick M.D.

@drscottyk

7 months

Important reminder: All things being equal if you lower your small LDL particle number, you lower your risk of ASCVD events. Also, all things being equal if you lower your large LDL particle number, you lower your risk. LDL is bad, whether large or small, it raises risk.

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

Two things can be simultaneously true: 1. A low carb or even keto diet can be very helpful to some patients to improve their metabolic & overall health. 2. If ApoB rises with such a diet, lowering ApoB with tweaks to nutrition or meds would further ⬇️their risk of ASCVD.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

In light of the recent JACC study showing no protective benefit of high HDL in primary prevention. Here is a study showing High HDL (>80 mg/dL) associated with 96% ⬆️all cause mortality and 71% ⬆️ CV mortality in secondary prevention.

Association Between HDL-C Levels and Adverse Cardiovascular Outcomes

This cohort study investigates the association between very high high-density lipoprotein cholesterol (HDL-C) level and outcomes in patients with coronary artery disease.

jamanetwork.com

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

The more fit you are, the less likely you are to have a heart attack. But even if you have an MI, this study shows the higher your exercise capacity prior to first MI, the lower your risk of early death from your heart attack. Get your steps in today!

High Exercise Capacity Attenuates the Risk of Early Mortality After a First Myocardial Infarction:...

Higher baseline EC was independently associated with a lower risk of early death after a first MI.

pubmed.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Friendly reminder to be more aggressive with BP control: In the SPRINT Trial, an SBP goal of less than 120 reduced incident heart failure by 38% and mortality by 23% compared to an SBP goal of less than 140

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Think 20-30 year-olds are immune to ASCVD? Think again! In 20- 30 year-olds with risk factors, this study found a 13.1% chance of having a positive CAC score.

Predictors of coronary artery calcium among 20-30-year-olds: The Coronary Artery Calcium Consortium...

Our study demonstrates the non-negligible prevalence of CAC among very high-risk young US adults, reinforcing the critical importance of traditional risk factors in the earliest development of...

pubmed.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

An often overlooked benefit of bariatric surgery: MSK pain reduction. I recently had a patient who has now lost over 150 pounds and has had near resolution of multi joint chronic pain. This surgery can be a life-changer in so many ways for patients.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Average Tirzepatide weight loss: 5 mg ➡️ 15%, 10 mg ➡️19.5%, 15 mg ➡️ 20.9% Currently $25/mo for commercially insured patients with T2DM making this a huge win for patients.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

A reason all cardiologists should care about PAD: Even in PAD with claudication, limb-specific events are LESS common than cardiovascular events.

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

You can never be too young to think about reducing your ASCVD risk: 1/10 patients in their 20s with ZERO risk factors have sub clinical atherosclerosis. Great slide from @pnatarajanmd

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

I recently saw a patient with Lp(a) >1,000 and a history of > 10 heart attacks. Outcome data can’t come soon enough for Pelacarsen. While we wait for that, everyone please get your Lp(a) checked!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

How powerful can nutrition be in prevention? This study found a 25% calorie reduction lead to 50% reduction in inflammatory markers. Thanks to @kevinnbass as I originally found this study via his Twitter.

Long-term moderate calorie restriction inhibits inflammation without impairing cell-mediated...

Calorie restriction (CR) inhibits inflammation and slows aging in many animal species, but in rodents housed in pathogen-free facilities, CR impairs immunity against certain pathogens. However,...

pubmed.ncbi.nlm.nih.gov

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

My family and I had an amazing time at the @nationallipid Scientific Sessions in Phoenix! Thank you to the NLA Lipid Scholarship Program for having us!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Very important from ESC: “Although statins may slightly increase Lp(a) levels, treatment should not be discontinued as the cardiovascular benefits in patients with high Lp(a) far outweigh any potential risk associated with modest increases in Lp(a) levels”

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

This further supports my belief that every person at every age should be evaluated for their ASCVD risk, and have a plan to treat risk factors or prevent them from developing in the first place.

Pradeep Natarajan

@pnatarajanmd

2 years

"It is never too early to start cardiovascular disease prevention" @NatureMedicine by J. de Lemos @AnnMarieNavar @utswheart

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Improving A1C from the fourth quartile (avg 9.9) to the first quartile (avg 5.9) was associated with a 3.8 year increase in life expectancy 👀

Life Expectancy and Achieving Treatment Goals in Type 2 Diabetes - American College of Cardiology

Debabrata Mukherjee, MD, FACC

www.acc.org

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

YouTube video with 1.9 million views: -Niacin is the best way to prevent a heart attack -statins don’t prevent heart attacks If you are a physician and don’t think you need to use social media, here is an example of the garbage that gets watched when our voices aren’t present

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Even if your LDL is low, you should still check your Lp(a). “Elevated Lp(a) is a risk factor even at very low levels of low-density lipoprotein cholesterol.”

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

The data indicates that there is not such a thing as having too low LDL cholesterol. This article nicely summarizes how many fears are not routed in great data and/or are outweighed by the obvious benefits. Thanks @SABOURETCardio for sharing this!

Low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety...

Abstract. Although some observational studies suggest a potential association of low levels of low-density lipoprotein cholesterol (LDL-C) with intracerebr

academic.oup.com

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

A quality I really admire in a doctor: not being afraid to say “I don’t know”. Intellectual humility > intellectual hubris

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Whether you are a provider or a patient, everyone should watch this video. With 89 linked references this is a thorough scientific evaluation of common claims made on the internet.

Gil Carvalho MD PhD🌈

@NutritionMadeS3

2 years

We got countless requests to review the video "Your Dr. is wrong about cholesterol" by "Dr. Sten Ekberg" This week: an in-depth look at the ideas + available evidence on the topic cholesterol & mortality, LDL oxidation, insulin resistance, LDL size, statin side effects etc

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

An often overlooked treatment goal: in very/high risk ASCVD patients, both AHA/ACC and ESC recommend at least 50% LDL-C reduction irrespective of patients baseline LDL-C. LDL <70 or <55 alone may not be enough.

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Scotty Kirkpatrick M.D.

@drscottyk

3 years

A motivating statistic I learned from this episode: If by age 50, one has all of their risk factors controlled, their lifetime risk of developing ASCVD drops from 50-70% to 5%! Thanks @CardioNerds

Amit Goyal MD MAS

@AmitGoyalMD

3 years

@CardioNerds #DecipherTheGuidelines Question #2 ⃣ 🌟 @AdrianaCMares @Gurleen_Kaur96 @a_l_bailey 🎙️

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

ACC/AHA: for adults 20 to 39 years of age it is reasonable to assess ASCVD risk factors every 4-6 years. My Take away: it’s never too early to know your numbers! When was the last time you got checked?

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

I am thankful for new non-statin lipid lowering drugs as they are much needed. However, I find it troubling these meds are pushed by advertising “intolerability” of statins. They know this is nocebo effect (Samson trial). We can promote new meds without advancing false narratives

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Happy Halloween from Harry and Hedwig! 🎃

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

👀👀”Even among treated high-risk patients, 50% of such individuals discontinue their statin therapy within 6 months and by 5 years only 20% remain adherent to it.” Asking about compliance is huge!

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Wow! 50% of patients with established ASCVD were found to not be on any dose of a statin in this retrospective cohort study. We can do so much better than this!

SABOURETCardiologist

@SABOURETCardio

2 years

#LLT

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

The pooled cohort equation is a risk score. A coronary artery calcium is a disease score! Actually seeing the disease can not only change management but can motivate patients to make lifestyle changes.

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

Short-term NSAID use was associated with 43% increased risk of first CHF hospitalization in those with type 2 diabetes.

NSAIDs and Heart Failure in Patients With Type 2 Diabetes - American College of Cardiology

Debabrata Mukherjee, MD, FACC

www.acc.org

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

A great way to ruin your morning: Just watched a YouTube video with a doc saying most important thing on lipid panel to determine CV Health: #1 Tgs #2 TG:HDL ratio. And that only small LDL matters. 660k views. Sad how many people are getting misguided heart health advice.

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Scotty Kirkpatrick M.D.

@drscottyk

1 year

Patient with a STEMI who had the following risk factors: BP 130-140s, A1C 5.9, LDL 120 Many might say these numbers are “not that bad” and don’t need to be urgently addressed. Exhibit A on why we should not settle for “not that bad”.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

A sports analogy for preventive cardiology: No one would argue that ONLY offense or ONLY defense matters. They both are incredibly important. So too is BOTH our cholesterol levels and our glucose metabolism. You don’t have to pick a side 😊

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Happy Father’s Day! As we think about our family today, just a reminder that if your family has a history of heart disease please get your Lp(a) checked. It’s the most common genetically determined risk factor for heart disease that is present in 10-20% of the population.

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Scotty Kirkpatrick M.D.

@drscottyk

2 years

Me 15 years ago: Oh sweet ESPN the Magazine came! Me now: Oh sweet, the @nationallipid magazine came! Maybe I am getting older 🤓 lol

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