Prompt Cast
Insights into Cardiovascular Disease and Lipidology with Dr. Tom Dayspring
TLDR Dr. Tom Dayspring discusses the role of atherogenic lipoproteins, ApoB concentration, and HDL functionality in cardiovascular disease risk assessment and evolving therapies, highlighting the importance of triglyceride levels in lipoproteins and the potential benefits of high dose EPA for reducing residual risk in high-risk individuals.
Timestamped Summary
00:00
The episode features Dr. Tom Dayspring discussing recent insights into cardiovascular disease and lipidology, focusing on atherogenic lipoproteins, risk assessment, and evolving therapies.
07:11
Atherogenic lipoproteins play a crucial role in the pathogenesis of cardiovascular disease, with emerging emphasis on factors such as triglycerides and lipoprotein little A.
14:49
ApoB concentration, particularly LDL particles, plays a significant role in cardiovascular disease risk compared to other lipoproteins.
22:23
The role of ApoB-bearing particles in cardiovascular disease is complex and multifactorial, influenced by factors such as particle number, endothelial function, and particle quality.
29:58
Cholesterol levels in the plasma do not necessarily reflect the total amount of cholesterol in the body, as the majority is contained within cell membranes and steroidal producing tissue.
37:25
The history of cholesterol subfractionation highlights the importance of HDL cholesterol, which is often mistakenly labeled as "good cholesterol," but its metric is considered useless in assessing cardiovascular risk.
44:34
The current metrics for assessing HDL cholesterol are inadequate, and there is a lack of understanding regarding the functionality and complexity of HDL particles.
51:48
Research on HDL functionality is ongoing, but current HDL metrics are not worth the investment, while LP Little A is a significant genetic driver of atherosclerosis that warrants further exploration.
58:55
The function of APOA may involve scavenging oxidized lipid moieties, particularly on LP little A particles, which could potentially be harmful, with metrics available to measure these oxidized lipids.
01:06:04
Large clinical trials are needed to assess the efficacy and safety of APO little a synthesis modulator drugs for coronary artery disease.
01:13:40
Triglyceride levels in lipoproteins, particularly LDL, can provide valuable information about cardiovascular risk, insulin resistance, and inflammatory markers.
01:21:14
Statin therapy remains a key approach in lipid lowering, with limited innovation due to cost considerations and focus on developing therapies targeting atherogenic lipoproteins.
01:28:15
Lipitor is a potent statin, but considerations like drug interactions and lipophilicity may influence the choice between Lipitor and other statins like Crestor, with varying recommendations on statin dosing based on LDL reduction and APOB levels.
01:35:19
Benpadoic acid and Zetamide can be co-prescribed to lower LDL cholesterol and APOB levels, offering a new option for statin-intolerant individuals or those requiring triple LDL-lowering therapy.
01:42:17
High dose EPA showed almost a 30% residual risk reduction in high-risk individuals with cardiovascular disease or diabetes who were already on statins, leading to a shift towards using omega-3s at higher doses.
01:49:29
Studies have shown that taking four grams of EPA can lead to improved plaque appearance, despite a significant reduction in residual risk, indicating potential benefits for cardiovascular health.
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Health & Fitness
