Saint Luke's Health System’s Post

Is this a good story or marketing hype and froth on the cappuccino? Without the details of the study, it is very difficult to say. Why? Because the key determinant that is not mentioned is not absolute risk reduction, but relative additional risk reduction over a statin. In other words, statins have proven risk reductions for heart attack and stroke. They are now generic, which means they are cheap. So what we need to ask is: "If these obese patients with cardiovascular risks greater than 20% are put on a statin (NICE guidelines), then what extra reduction is achieved by adding in semaglutide (expensive), and is that additional risk reduction cost-effective?" This question is not answered. If I were NICE assessors, I'd guess the additional risk reduction over a statin is very small and unlikely to be cost-effective. I've been around too long in this "game" to know that the easy comparator is placebo. The real comparator is the current standard of care in cardiovascular risk reduction (statin and ACE inhibitor or ARB for hypertension). Were patients excluded in this SELECT trial if they were hypertensive and/or taking a statin? Without such forensic examination, it may be just marketing hype because it may not represent clinical management of risks. As always, the devil is in the detail. Don't get too excited just yet. I'll stick to my cocktail of 20mg atorvastatin and an ACE inhibitor, thank you - shaken, not stirred. #obesity #cardiovascularrisk #semaglutide

It was nice to give some perspective on BBC News and DailyMail.com on the recent data from the SELECT trial and how the new data on CArdiovascular risk reduction mortality of up to 20 percent with semeglutide in diabetic, obese patients with prior cardiovascular risk . It’s important to acknowledge no doubt this is a big addition to our armoury against obesity , diabetes and chronic disease management , but it is not the be all and end all, we must look at the patient holistically and use these new therapies in a stratified manner. The population health economics has not been modelled fully yet, and this is something we certainly need more understanding on the mechanism of action of the GLP-1 agonists and how cardiac protection is conferred directly so to be better guided on how the biology is really being impacted. #obesity #SELECTtrial #semaglutide #cardiovascularrisk #cardiology #CV #populationhealth #GLP1 #diabetes #precisionhealth #ozempic #wegovy https://lnkd.in/e3qrgDUx

Excellent news. Thanks again science! 🔬😊 Weight loss jab 'could reduce heart attack risk', BBC https://lnkd.in/dCHa-Mb3 #preventative #health #obesity By preventing harm before it happens this improves lives, reduces demand for overstretched health services and saves money. Win, win, win! "the drug makes people feel fuller and more satisfied, so they eat less" "An injection designed to tackle obesity could reduce the risk of heart attacks and strokes in people regardless of the amount of weight they lose while on the drug, according to a new study. Researchers looked at the effects of semaglutide - which is a prescription drug that supresses appetite and is sold under the brand names Wegovy, Ozempic and Rybelsus. They said the anti-obesity jabs could also benefit the cardiovascular health of millions of adults. Prof John Deanfield CBE, who led the team of researchers, said the generic drug could have a positive impact on blood sugar, blood pressure or inflammation, as well as direct effects on the heart muscle and vessels." UCL "After 20 weeks of being on semaglutide, 62% of patients had lost more than 5% of their bodyweight compared with 10% in a placebo group. However, the risk reduction of heart attacks, stroke or heart failure was similar in patients who lost more than 5% of their bodyweight and in those who lost less than 5%, or gained weight." "second [study], led by Prof Donna Ryan, of Pennington Biomedical Research Center in New Orleans, looked at the long-term effect of semaglutide on weight." "experts have previously warned it is not a quick fix or a replacement for eating well and exercising, and should only be offered under medical supervision." Thomas Mackintosh

New Articles in #Diabetes and #Metabolic Syndrome: #Clinical #Research/#Reviews (IMPACT FACTOR, 10, Ranked #1 Journal for Diabetes/Endo in #Asia.) 1. A paradigm shift for #cardiovascular outcome evaluation in #diabetes: Major adverse cardiovascular events (#MACE) to major adverse vascular events (#MAVE) 2. Estimated risk of cardiovascular events and long-term complications: The projected future of diabetes patients in Delhi from the DEDICOM-II survey 3. Comprehensive analysis of #dyslipidemia states associated with #fat in the #pancreas https://lnkd.in/dYaYE2W

A recent study by Aleksi V, Elise K, and Koskela TH, published in *BMC Research Notes*, highlights a concerning trend of excessive thyroid hormone use among fibromyalgia patients, particularly involving triiodothyronine (T3). T3 is believed to help alleviate fibromyalgia symptoms such as fatigue and pain due to its role in regulating metabolism and energy levels. However, this practice poses significant cardiovascular risks, including increased heart rate, arrhythmias, and a higher incidence of cardiovascular disease. The cross-sectional analysis conducted in primary healthcare settings found a notable prevalence of overprescription. Healthcare providers are urged to monitor thyroid levels closely, avoid unnecessary T3 supplementation, and conduct regular cardiovascular assessments to mitigate these risks. This study underscores the need for careful management of thyroid hormone therapy in fibromyalgia to balance symptom relief with cardiovascular health.

Great to be back after the festive season and the indulgence. Some may have missed important messages from the SURMOUNT-4 trial. Participants who switched from Tirzapetide to placebo at 36 weeks experienced 14% weight gain after a year, while those who continued on tirzapetide had a further 5.5% weight loss. Participants who switched to placebo maintained some weight loss (9.9% from study baseline) but reversed all cardiometabolic factors as waist circumference, hemoglobin A1c, fasting glucose, insulin, lipid levels, and systolic and diastolic blood pressure. This supports every reason to continue tirzapetide and similar medications. #cardiometabolic #tirzepatide

New Articles in #Diabetes and #Metabolic Syndrome: #Clinical #Research/#Reviews (IMPACT FACTOR, 10, Ranked #1 Journal for Diabetes/Endo in #Asia.) Association between #nonalcoholic fatty liver disease and #coronaryarterydisease outcomes: A #systematic #review and #metaanalysis https://lnkd.in/dYaYE2W

GLP-1s for Obesity: Your Questions Answered: Should patients combine intermittent fasting with GLP-1 agents? Are the drugs safe in kidney patients? Experts from the recent Medscape Masters event on obesity answer your questions. Medscape Medical News

🫀Cardiometabolic syndrome affects 25% of the world's adults, increasing their risk of dying from heart disease and experiencing heart attacks or strokes compared to those without the syndrome. Central adiposity is a significant factor in this increased risk. Current treatments are addressing individual risk factors such as dyslipidemia, hypertension, diabetes, and smoking to reduce cardiovascular risks. ❗️👉However, there is a growing focus on addressing cluster risk factors like high plasma insulin, intra-abdominal obesity, and prothrombotic and proinflammatory cytokines. ++ Medical AND behavioral modifications are essential in tackling this serious condition. A symposium is being held Friday Aug 23 The Texas Heart Institute to bring together medical experts, community leaders, and stakeholders to discuss the latest scientific findings and emerging interventions to address this global crisis. https://lnkd.in/gERPcSEe Joseph G. Rogers, M.D. Stephanie Coulter, MD Dr. Joe Galati Salim Virani MD Christie Ballantyne MD Shreela Sharma, PhD, RDN, LD … and more! Visit the website to see the full schedule and register for the event. Daynene Vykoukal Ren-Nessa Clarke Stella Martens Lharissa Jacobs Baylor College of Medicine TMC Helix Park

Renal Denervation: Unveiling a transformative chapter in hypertension management. The potential implications for blood pressure control are captivating, heralding a promising era in cardiovascular care. Healthcare professionals, stay tuned for the unfolding landscape of evolving therapies. #RenalDenervation #Hypertension #CardiovascularInnovation