Sad to report that a very physically active 66 year old patient with negative nuclear 2 years ago, taken off statin with 'clean bill of health', just passed away of SCD/MI with severe 3 VD. Wife had to do CPR. Wrong test, wrong answer. Need more CAC testing in asymptomatic pts
Matthew Budoff MD
480 posts
Dr Budoff is a preventive cardiologist and Professor of Medicine at the David Geffen School of Medicine (UCLA) and principal investigator at Lundquist Institute
- This trial doesn't invalidate the lipid hypothesis, is not the final answer (Progression of soft plaque at 1 year is the final study) and is exactly as originally designed - see classic.clinicaltrials.gov/ct2/show/recor… i have no skin in the game. i am just presenting our findings
- Dr Alo, as you have published ZERO papers in your lifetime, and have no credibility in the field, calling my work dishonest is not acceptable. The change in NCPV was less than the change in PAV%, as shown in figure 1 in the paper, so if anything we put our worst foot forward.There are lots of Problems with the latest Keto- CTA study. But the reason many of us are calling it out is because of the huge promotion campaign going behind what can be best described as dishonest work. & The message that's going out to the laymen is "LDL doesn't matter on
- These lean, metabolically healthy individuals on a #ketodiet exhibited less coronary plaque and lower rates of plaque progression than I would have expected, with the majority exhibiting minimal progression and several exhibiting regression. This is interesting.
- So Honored to have been awarded the physician if the year award by the California chapter of the ACC. So many great clinicians and researchers. Truly humbled. @ACCinTouch
- Evaporate Trial presented at #escprev2021 as late breaker, showing Icosapent Ethyl can reduce Lipid Rich Necrotic Core and intraplaque hemorrhage, while increasing fibrous cap thickness on CT angiography. Understanding the mechanism is so important. @DLBHATTMD @SuvasiniL
- My most important CAC paper to date just hit: healio.com/news/cardiolog… CAC is SECONDARY RISK EQUIVALENT AT score >300 (same cohort, not comparing clinical trial patients to observational studies) @khurramn1 @RonBlankstein @ErinMichos @rblument1
- Nothing lowers risk more than a CAC of zero. see data from MESA. #Powerofzero I trust it in all asymptomatic except the young (< 40 years of age) to derisk my patients, including DM and FH @khurramn1 @rblument1 @RonBlankstein
- If anyone would like to see the presentation (won an award at WCIR), here it is:
- Very nice summary of some landmark articles in the world of coronary artery calcium in jacc.org/doi/10.1016/j.… @rblument1
- I still don't understand why colchicine continues to be disrespected - three positive outcome studies and CCTA plaque studies showing benefit, all for a 2a recommendation? sciencedirect.com/science/articl…
- Add another 54% of 11,805 patients from Denmark with LDL > 193 mg/dl also with normal CAC. NOT Everyone needs a statin, i hold therapy for CAC Zero unless DM, known ASCVD in this population with no CAC.61% Clinical FH patients with CAC Zero! Mean age 56 Loved the discussion #PowerOfZero getting more acceptance. #FactsAreFacts
- Finally, CT angiography is the preferred test in US for a majority of patients with chest pain, following the UK (NICE) and ESC 2019 Guidelines. Great editorial by @RonBlankstein @DrMarthaGulati @lesleejshaw puts this in clinical perspectiveNow out: The 2021 Multi Society Chest Pain Guideline A special thanks to the entire writing group led by @DrMarthaGulati and to the countless others who have worked on this over the past several years 👏 @ACCinTouch @AHAScience & all partner societies 👉bit.ly/3bi6nKc










