The LDL Cumulative Exposure Hypothesis The longer your arteries are exposed to high LDL-C, the ⬆️ the risk of atherosclerosis. 📈 🔬 Early & sustained LDL lowering = lifelong CV benefit. 🔗 https://t.co/7piLFHXT2T #CardioTwitter #MedTwitter #FOAMed #MedED @ACCinTouch

🧬🫀 The CARDIA study Shows that cumulative exposure to apoB & LDL particles in young adults strongly predicts later ASCVD. 👉 No “safe” LDL threshold identified - risk keeps falling the lower & longer LDL/apoB is controlled. Early prevention = lifelong protection. 🔗

🧬🫀 Adipose tissue isn’t just bystander 👉🏼 it’s a driver of atherosclerosis. 🔥 Perivascular adipose tissue (PVAT) dysfunction fuels endothelial injury, inflammation & plaques. 💊 Targeting adipose health (e.g. SGLT2i, PPARγ) gives CV benefits beyond glucose/lipid control. 📊

🧑‍⚕️💊 New evidence in type 1 diabetes - an emulation study Statin initiation was linked to lower 10-yr all-cause mortality & major CVD in >20k UK adults 🇬🇧 ✅ Benefits strongest in women, ≥40y, high LDL-C, higher CV risk ⚠️ Very low adverse effects (slight ↑ liver

Some great slides from #Guidelines discussion on triglycerides reduction. Check them out. 📉 Not all TG-lowering therapies equal CV benefit. •Statins: ↓TG 15–26% ✅ CV benefit •Fibrates: ↓TG ~26% ❌ no clear CV benefit •High-dose icosapent ethyl (EPA): ↓TG 20% ✅ CV

Beta blockers were routinely given to patients after a heart attack. 2 new randomized trials show conflicting results for patients with an ejection fraction of >40% #ESC2025 @NEJM https://t.co/QMxTbwmlaZ https://t.co/jzeoh8bhbC

https://t.co/NCHmqCGhp3 “Novo Nordisk’s Wegovy® cuts risk of heart attack, stroke or death by 57% compared to tirzepatide in real-world study of people with obesity and cardiovascular disease” #STEER #ESC2025 Waiting SurmountCVOT and SURPASS CVOT

#ESC2025 by night #GPCEBrisbane by day 2 days, 6 talks, all Lipids and CV risk @RACGP @atheroaussie

Lp(a) - its time for primetime 🎥 #MedTwitter #cardiotwitter #MedEd #foamed @escardio #ESC2025 @BNordestgaard

ESC / EAS Focused update 🔥 takes 1️⃣ The ⤴️ the risk the ⤵️ the LDL 2️⃣ Factor Bempedoic acid into combo Rx 3️⃣ Lp(a) > 105 nmol/L 👉🏼 Risk enhancer 🔗 https://t.co/CNXFnMLU1l #MedTwitter #FOAMed #MedEd #CardioTwitter #ESC2025 @escardio @society_eas @RACGP @Drlipid

#ESCCongress2025 @escardio and @society_eas update on 2019 guidelines for dyslipidemia management. Note extreme risk peofile, intensification of LDL lowering Rx in ACS and add-on EZE, , use of Vascrpa in hypertrgl and statins in HIV regardless of LDLc levels @Drlipid @AmarPut

🩸 Not all LDL is equal! Small dense LDL-C (sdLDL-C) 🧬—and its ratios—predict carotid plaque 🫀 risk better than LDL-C or non-HDL-C. This study shows sdLDL-C metrics add key risk info for prevention 💡 Full study 👉 https://t.co/uo6V8acL2E #JACCAsia #cvPrev #cvLipids #ACCIntl

👶💊 Statins in pregnancy 🇳🇴 805k pregnancies (2005–2018) 📊 No ↑ risk of any, major, or minor congenital malformations with 1st-trimester statin use ✅ Statins unlikely to be major teratogens 🫀 For women at high CV risk (ie HoFH), benefits likely outweigh potential risks

Everyone should have their Lp(a) tested Once in their life @RACGP @RACGPPresident @Mark_Butler_MP @society_eas #MedTwitter #MedEd #cardiotwitter #FoamEd 🔗

Chronic kidney disease 👉🏼 alters lipid metabolism ⚖️ 🧪 ↓HDL, ↑TG, ↑oxidized & small dense LDL, ↑remnant cholesterol. ✅ Statins±ezetimibe lower CV risk in stage 3–4 CKD ⚠️ Benefit less clear on dialysis 💊 #MedEd #MedTwitter #CardioTwitter #FOAMed @ACCinTouch 🔗

Pleased to share our latest Interaspire paper on global lipid goal attainment . Still poor globally. Better with combo Tx. Non-HDL and apoB goals shouldn’t be applied when TG is low/ normal . I.e they should be lower https://t.co/fW54LRKUBT

🧂💊 Aldosterone: the overlooked villain? New @EuroHeartJ review highlights why early use of aldosterone-targeted therapies (like MRAs and finerenone) may be 🔑 in resistant hypertension and CKD. Time to rethink timing—not just target. #CardioTwitter #MedTwitter #MedEd #FOAMed

LDL-C & CV risk w/ CAC = 0 Even in symptomatic patients with zero coronary calcification, higher LDL-C was still linked to ↑ ASCVD events over ~4.2 years. 🚫🧱🔥 Reinforces that lifelong LDL-C management is vital 👉🏼 calcification status doesn’t negate risk. #CardioTwitter

🎯 Precision Lipidology Enters the RNA Era Small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) are reshaping lipid management by targeting mRNA degradation at the source. 👉Inclisiran targets PCSK9 → ↓LDL-C 👉Volanesorsen, Olezarsen, Plozasiran target