🛣️ HDL’s Road Trip: How Reverse Cholesterol Transport Works 🫀 RCT starts as HDL extracts cholesterol from arterial foam cells (macrophage & VSMC origins) 🚚 Cholesterol rides HDL → liver via SR-B1 or transfers to VLDL/LDL via CETP 💩 Ends with fecal excretion (bile or TICE

💊 Statins & T2DM: Risk Real, but Worth the Trade-Off? 📉 JUPITER & meta-analyses confirm: 🩺 Statins slightly ↑ new-onset T2DM (HR ~1.28) in 👥 at risk of diabetes ⚖️ But benefits far outweigh risks: ✅ 39% ↓ in major CV events 📊 NNT: 134 events prevented / 54 new T2DM

🧠 Statins & Cognition: No Harm, Possible Help? 📚 ASPREE & 20+ studies show: ❌ No link between statins & cognitive decline or dementia 🧓 Statin users had no faster memory loss 🧠 Some data suggest slower decline or blunted memory loss 🧪 RCTs ongoing: STAREE & PREVENTABLE

🧓 LDL-C Still Predicts Risk at 80+: Age ≠ Immunity 📊 Copenhagen General Study (n=91,131): 🔺 LDL-C predicts MI & ASCVD across all ages — incl. 80–100 y/o 💡 NNT to prevent ASCVD over 5 yrs: • Age 80–100: 42 • Age 50–59: 345 📉 Lower LDL = lower risk, even in late life

☝️Effect of Lipid-lowering Therapies on Lp(a) Levels: A Comprehensive Meta-analysis of RCTs ☝️New evidence just published in Atherosclerosis ! 👉This comprehensive meta-analysis of 147 RCTs involving over 145,000 participants confirms that most currently available lipid-lowering

🔥 Atherosclerosis Starts Young: Time to Treat BP Like LDL New EHJ editorial: life-course blood pressure matters as much as cholesterol 🧠🫀 🧒 Even modest BP elevations in youth/adulthood = ↑ plaque later in life ⚠️ Calls for early, sustained prevention — not just midlife

☕️ Coffee O’Clock Could Shape Mortality Risk EHJ study of >170,000 US adults finds ⏰ timing of coffee matters: 🕗 Morning-only coffee = ⬇️ all-cause & CVD mortality ☕️ Afternoon/evening drinkers = ☝️ higher risk 🔍 Supports chrononutrition in CV prevention 🔗

Finerenone Reduces New-Onset Atrial Fibrillation Across the Spectrum of Cardio-Kidney-Metabolic Syndrome: The FINE-HEART Pooled Analysis The nonsteroidal MRA finerenone reduced the risk of new-onset AF/AFL across the CKM spectrum. jacc.org/doi/10.1016/j.…

🕰️ Atherosclerosis isn’t random. It’s driven by: • Particle Count → ApoB particles 🧪 • Permeability → Endothelial dysfunction (obesity ⚖️, hypertension 💓, diabetes 🩸, genetics 🧬 ) • Passage of Time → Cumulative exposure ⏳ Plaque builds silently for decades. Know

🎤 GPCE Melbourne 2025 ✅ 6 hrs on Lipids & CV Prevention ✅ 1 hr on Heart Failure ✅ Dinner deep-dive: New ASCVD therapies Don’t miss it! 👉🏼 SPEAKER50EDU to get 50% off your Session Pass. #GPCEMelbourne invt.io/1txbx00qarv #MedTwitter #CardioTwitter #meded #FOAMed

INTERHEART showed lipids cause the biggest share of MI risk 🫀(49% PAR). But the Global CV risk consortium finds quitting smoking 🚭 & controlling BP 💊 add the most years of life free of CVD or death. 🔑 Both true: lipids drive plaque, but BP & smoking hit broader diseases &

Global Effect of Cardiovascular Risk Factors on Lifetime Estimates NEJM “The absence of 5 classic risk factors at 50 was associated with more than a decade greater life expectancy than the presence of risk factors” nejm.org/doi/full/10.10…

👶➡️🧠 Pregnancy complications predict future stroke risk. 🇸🇪 Swedish study: preeclampsia, gestational hypertension, preterm birth & more link to ⬆️ long-term stroke risk—even after adjusting for shared genetics/environment. 🔦 Pregnancy history = a window into cerebrovascular

HDL: More Than Just ‘Good’ Cholesterol? New EHJ editorial revisits reverse cholesterol transport (RCT): 🫀 HDL removes cholesterol from plaques → liver → excretion ⚠️ RCT dysfunction may fuel atherosclerosis despite normal HDL levels 🔬 Future therapies may target HDL

🧬 ApoB & Lp(a): the core duo for cardiovascular risk 🔍 Sniderman, Pencina & Thanassoulis argue in @EuroHeartJ that these markers should be routine in risk assessment—beyond LDL alone. Precision prevention starts here. 🔗 doi.org/10.1093/eurhea… #CardioTwitter #MedTwitter

📊 Not all apoB particles are created equal! New @EuroHeartJ study shows CAD risk rises with apoB count, but particle type & size matter too 🧬 A more nuanced view of atherogenic lipoproteins could refine risk stratification. 🔗 doi.org/10.1093/eurhea… #CardioTwitter

💓 Heart rate lowering: friend or foe? Slowing heart rate can reduce myocardial oxygen demand—but go too far, and you risk impairing coronary perfusion, worsening heart failure, or increasing mortality in select groups. A double-edged sword: benefit depends on baseline risk,

👉  New Evidence: Lifetime Risk Starts Early 👆 A 22-year follow-up of young adults from the CARDIA study shows that cumulative exposure to apoB, LDL-P, and TRL-P between ages 18–40 significantly increases the risk of ASCVD events later in life. 📈 Each 1 SD increase in these

🎯 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