Dr Ford Brewer - PrevMed I Was Wrong About Stents - Ford Brewer MD MPH
Sep 16, 2024
Explore the shifting perspectives on heart disease risk and the controversial use of stents. Hear about advanced diagnostic techniques that reveal the nuances of vulnerable plaque in arteries. Learn about misleading nutritional claims that fuel health myths, and the complex relationship between dietary habits and heart health. Dive into the debate on stent efficacy, especially regarding their long-term benefits versus lifestyle changes. Uncover the differences between plaque types and the importance of informed health choices for better patient outcomes.
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Relative Vs Absolute Risk Matters
- The PREVENT study suggests IVUS/OCT-guided stenting of vulnerable plaque may reduce events compared with medical therapy alone.
- Relative risk improvements can look large even when absolute risk reductions are small.
Soft Plaque Predicts Events More Than Blockage
- Vulnerable (soft) plaque matters more than percent stenosis for predicting heart attacks.
- IVUS and OCT can identify thin-cap fibroatheromas that standard flow measures miss.
Prioritize Metabolic Health First
- Don't rely on stents alone to protect you from heart attacks; prioritize metabolic health first.
- Control diet, detect insulin resistance, and treat metabolic disease proactively instead of depending on procedures.