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Dive into research with our curated collection of cutting-edge medical research and peer-reviewed studies.
The Library of Medical Research
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Guidelines take years (decades) to be implemented
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A Century of Cholesterol and Coronaries
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2025: AI CT Angiography detects any plaque in up to 97% of us and suggests a PAV safety cutoff
Higher levels of lipids, earlier in life correlate with CAC development
2017: Favorable Cardiovascular Health, Compression of Morbidity, and Healthcare Costs | Circulation
Editorial: Living Longer in Good Cardiovascular Health | Circulation
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2024: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Racially Diverse Populations - PubMed (ApoB is associated with CAD risk, all-cause mortality and CV risk in a dose-dependent manner)
2007: State of the Art Paper: Beyond low-density lipoprotein cholesterol: defining the role of low-density lipoprotein heterogeneity in coronary artery disease
Clinical implications of discordance between low-density lipoprotein cholesterol and particle number
Low-Density Lipoprotein Cholesterol, Non–High-Density Lipoprotein, Apolipoprotein, or Low-Density Lipoprotein Particle: What Should Clinicians Measure? (Dr. Michael Davidson)
2009: Pro: Subfractionation testing: Advanced Lipoprotein Testing and Subfractionation Are Clinically Useful | Circulation
Con: Subractionation testing: Advanced Lipoprotein Testing and Subfractionation Are Not (Yet) Ready for Routine Clinical Use | Circulation
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LDL-C As a Quality Measure:
A woeful “29.9% of beneficiaries had their LDL-C measured within 90 days following MI hospital discharge.”
2024: Reinstating LDL-C Measurement as a Quality Metric: This Is the Way∗ | JACC: Advances
The Struggle in Achieving LDL-C Goals:
2019: Lipid treatment status and goal attainment among patients with atherosclerotic cardiovascular disease in the United States: A 2019 update - PubMed (We fail most high risk patients, in achieving LDL-C goals)
Spoiler: Barriers persist in obtaining guideline-recommended LDL-C therapies and PCSK9i continue to be underutilized
2023: Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE | Circulation (Achieved LDL-C is what drives down risk)
“Normal” LDL-C is Plenty
Very Low LDL-C: (Lower is better)
2004: Seminal White Paper by Dr.James O’Keefe: Optimal low-density lipoprotein is 50 to 70 mg/dl: lower is better and physiologically normal - PubMed
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ApoB in diverse populations: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Racially Diverse Populations
Apolipoprotein B Versus Non–High-Density Lipoprotein Cholesterol | Circulation (Allan Sniderman)
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2009 Are You Targeting Non–High-Density Lipoprotein Cholesterol?⁎ | JACC
Barriers to non-HDL cholesterol goal attainment by providers - PubMed
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2005: Apolipoprotein B Versus Non–High-Density Lipoprotein Cholesterol | Circulation (Dr. Allan Sniderman)
2011: Clinical implications of discordance between low-density lipoprotein cholesterol and particle number
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Where are we at with HDL?
Apo A-I Milano Story (how low HDL-C can be protective)
2024: Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction
NEJM Video: Quick Take Share on ApoA1 Infusions after Myocardial Infarction
Dysfunctional HDL (how high HDL-C can be harmful)
Dysfunctional High-Density Lipoprotein in Patients on Chronic Hemodialysis | JACC
High-Density Lipoproteins: From Function to Therapy
2010: Genetic causes of high and low serum HDL-cholesterol - PubMed
HDL Subfractions:
Does HDL have a role in Diabetes protection?
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Lp(a) Clinical Guidance (Risk Calculator - give it a try!)
Lp(a): A Toolkit for Health Care Professionals
2019 A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice
2024 Lipoprotein(a) association with residual risk: what has inflammation got to do with it? - PubMed
2024 Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort | JACC
2024 Lipoprotein(a): Ready for Prime Time?∗ | JACC
2024: State of the Art Review: High lipoprotein(a): Actionable strategies for risk assessment and mitigation
2025: PCSK9i and Lp(a) Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a): A Meta-Analysis and Meta-Regression of Randomized Controlled Trials | JACC: Advances
Lp(a) and statins
2022: Effect of an increase in Lp(a) following statin therapy on cardiovascular prognosis in secondary prevention population of coronary artery disease (“Severe increases in Lp(a) following statin therapy raise the risk of MACE, but a mild-to-moderate increase in Lp(a) may not affect the cardiovascular prognosis of CAD patients.”)
2022: Statin therapy and lipoprotein(a) levels: a systematic review and meta-analysis - PubMed
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Apob.app (Helps classify a lipid disorder - Give it a try1)
You need ApoB, Total Cholesterol, Triglyceride
levels
Atherogenic Triad:
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Diet and Lifestyle Guidelines:
2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk | Circulation
Mediterranean Diet:
DASH Diet:
Processed Foods: The real enemy
Ultra-Processed Food Consumption and Hypertension Risk in the REGARDS Cohort Study
Low Carb (Atkins) Diet:
A Randomized Trial of a Low-Carbohydrate Diet for Obesity | New England Journal of Medicine
Conclusion: No significant reduction in weight. Improvement in some risk factors for heart disease.
Low Carb vs Low Fat:
Accompanying Editorial and Perspective in NEJM:
Interpreting Incomplete Data in Studies of Diet and Weight Loss
Diet, Obesity, and Cardiovascular Risk | New England Journal of Medicine
Saturated Fatty Acids:
Whole Foods (Unsaturated Fats, whole grains, fruits, vegetables, Omega-3 Fatty Acids)
Optimal Diets for Prevention of Coronary Heart Disease | Cardiology | JAMA
Emerging and Controversial Diets:
(Disclaimer: As always, diet studies are fraught with lower quality evidence. Caution advised when interpreting largely observational evidence.)
Intermittent Fasting:
Poster at AHA suggesting an increase in All Cause Morality with Time-Restricted Eating:
Keto:
Effects (lack thereof) of Diet on LDL-C
“The NCEP Step 2 diet failed to lower LDL cholesterol levels in men or women with high-risk lipoprotein levels who did not engage in aerobic exercise.”
Controversial Diet Topics:
Eggs
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State of the Art Paper: Omega-3 Fatty Acids and Cardiovascular Disease: Effects on Risk Factors, Molecular Pathways, and Clinical Events | JACC
Omega-3 Fatty Acid Blood Levels | Circulation
EPA vs DHA: Omega-3 for Cardiovascular Diseases: Where Do We Stand After REDUCE-IT and STRENGTH? | Circulation
Brief abstract describing the difference in clinic trials of O3FAs: Do patients benefit from omega-3 fatty acids? - PubMed
EPA may impact inflammation via reducing oxidation of Lp(a): Abstract 16934: Eicosapentaenoic Acid Inhibits Lipoprotein(a) With Higher Rates of Oxidation Compared to Non-Modified Low-Density Lipoprotein in vitroTitle Goes Here
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Statin Safety:
2007: State of the Art Paper: Safety of Aggressive Lipid Management | JACC
Underutilization of statins:
High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. | JACC
Statins in the very old:
Statins in HIV:
Statin Therapy in People With HIV | NIH Guidelines
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Mechanism: Inhibitis Niemann–Pick C1-like 1 (NPC1L1) protein
Genetic studies in those with Inactivating Mutations in NPC1L1 and Protection from Coronary Heart Disease | New England Journal of Medicine
Cardiovascular Outcomes Trial (CVOT): IMPROVE-IT: Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes | New England Journal of Medicine
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Cardiovascular Outcomes Trial (CVOT): Impact of Bempedoic Acid on Total Cardiovascular Events: A Prespecified Analysis of the CLEAR Outcomes Randomized Clinical Trial
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Monoclonal Antibodies (mAb)Evolocumab (Repatha):
Small interfering RNA (siRNA)
Inclisiran (Leqvio)
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dal-OUTCOMES: Effects of Dalcetrapib in Patients with a Recent Acute Coronary Syndrome | New England Journal of Medicine
Obicetrapib (Learn About Obicetrapib From NewAmsterdam Pharma)
Obicetrapib: Reversing the Tide of CETP Inhibitor Disappointments | Current Atherosclerosis Reports
2025: BROADWAY Trial: Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk | New England Journal of Medicine
Future inquiries:
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APOC3 inhibitors: Familial Chylomicronemia Syndrome (FCS) and Mixed Hyperlipidemia (high NonHDL-C due to Triglyceride Rich Lipoproteins)
Olezarsen (Tryngolza):
Plozasiran (Arrowhead Pharmaceuticals)
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2011: AIM-HIGH: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy | New England Journal of Medicine
2014: HPS2-THRIVE: Effects of Extended-Release Niacin with Laropiprant in High-Risk Patients | New England Journal of Medicine
2024: How excess niacin may promote cardiovascular disease | National Institutes of Health (NIH)
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Be careful in “prescribing” plant sterols to those with ABCG5/8 mutations - they may absorb plant sterols, which are highly atherogenic.
If one is discovered to have ABCG5/8 mutation and sitosterolemia, the treatment is ezetimibe
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Combination Therapy
Rule of 6% in statins (with each doubling of statins, you only achieve an additional 6% reduction in LDL-C)
Video: Unmet Needs in Lipid Management (Dr. Eliot Brinton explains Rule of 6)
The Statin Rule of 6 - by Paul D. Thompson, MD
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Primary Prevention:
1995:WOSCOPS (West of Scotland Coronary Prevention Study Group) Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia | New England Journal of Medicine (These were essentially Heterozygous Familial Hypercholesterolemia patients with severely elevated LDL-C)
Secondary Prevention:
2001 MIRACL: Effects of Atorvastatin on Early Recurrent Ischemic Events in Acute Coronary Syndromes: The MIRACL Study: A Randomized Controlled Trial [showed early treatment (in the hospital) with statins vs placebo (you heard that right) was superior in patients coming in with heart attack (ACS)]
2004: PROVE IT-TIMI 22: Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes | New England Journal of Medicine [cool story in medicine showing that yes, early high intensity statin (atorvastatin/Lipitor) vs modest intensity statin (pravastatin/Pravachol) was superior in those coming in with heart attack (ACS) - a bit of a gift of the trial sponsor to its competitor)
2004: “A to Z”: Early Intensive vs a Delayed Conservative Simvastatin Strategy in Patients With Acute Coronary Syndromes: Phase Z of the A to Z Trial
2004: “Real World” Clinical outcomes in managed-care patients with coronary heart disease treated aggressively in lipid-lowering disease management clinics: the alliance study - PubMed
2005: “TNT”: Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease | New England Journal of Medicine
2008: Jupiter Trial: Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein | New England Journal of Medicine (some like to cite this trial as an example of the importance of hsCRP (inflammation) and the so-called “pleiotropic” effects of statins.
2009: Insights from IDEAL Trial: Total cardiovascular disease burden: comparing intensive with moderate statin therapy insights from the IDEAL (Incremental Decrease in End Points Through Aggressive Lipid Lowering) trial - PubMed
2015: IMPROVE-IT Trial: Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes | New England Journal of Medicine [Showed that even lower (LDL-C <55 mg/dL) is even better. AND, ezetimbide works as advertised - follows the Cholesterol Treatment Trialist log linear line of event reduction]
Plaque Regression (Mechanistic Studies):
IVUS (Intravascular Ultrasound) Trials
LDL-C 79 mg/dL in high intensity treatment arm vs LDL-C 110 mg/dL in modest intensity arm
High intensity statin halted progression of atheroma vs modest intensity
2006: ASTEROID: Effect of Very High-Intensity Statin Therapy on Regression of Coronary Atherosclerosis: The ASTEROID Trial | Cardiology | JAMA
1% decrease in Plaque Area Volume (PAV)
Mean LDL-C 60 mg/dL in treatment arm
2016: GLAGOV: Effect of Evolocumab on Progression of Coronary Disease in Statin-Treated Patients: The GLAGOV Randomized Clinical Trial
~Plaque regression seen in ~⅔ of patients
Mean LDL-C 37 mg/dL in treatment arm
2020: EVAPORATE CTA Plaque composition Trial: Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: final results of the EVAPORATE trial - PubMed
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2022: Statin use and risk of dementia or Alzheimer's disease: a systematic review and meta-analysis of observational studies - PubMed
Desmosterol:
2013: Alzheimer’s Disease: Brain Desmosterol Levels - PMCTitle Goes Here
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CAC Isn’t Perfect (controversies in CAC testing)
2024 Critical commentary: Coronary Atherosclerosis: Causes, Consequences, and the Passage of Time∗ | JACC: Advances
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Out of the frying pan: dietary saturated fat influences nonalcoholic fatty liver disease - PMC
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Dive into real information.
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Collection of Clinical Research
Filling the public in on the most up to date research and clinical studies, to spread information on real and current medical evidence. Learn for yourself, straight from the source.
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What's My Biological Blueprint?
Bringing understanding to what your unique genetic profile is (aka your phenotype), to further uncover what works for you and your symptoms, not just the general masses.
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Resourceful Reading Materials
Providing a collection of articles by guest doctors and medical specialists, unpacking medical concepts with rich information on further resources and next steps.
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Medical Terminology Meanings
Clarifying medical terminology and phrases so you are no longer in the dark about what is happening in your body and in learning more as you dive into research.