Cardionerds: A Cardiology Podcast

375. Beyond the Boards: Foundations of Cardiovascular Prevention with Dr. Stephen Kopecky

18 snips
Jun 6, 2024
CardioNerds host Dr. Stephen Kopecky, a cardiovascular prevention expert, discussing risk assessment beyond standard calculators, optimizing cholesterol levels, and managing statin intolerance. They explore guidelines for LDL goals based on risk factors, addressing side effects, and future interventions for personalized cardiovascular prevention.
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INSIGHT

Beyond The Pooled Cohort Equation

  • The pooled cohort equation underestimates risk in some patients because it excludes important risk enhancers.
  • Risk enhancers include family history, ethnicity (like South Asian ancestry), chronic inflammation conditions, and female-specific factors such as preeclampsia.
ADVICE

When To Check Lp(a) and ApoB

  • Check lipoprotein(a) in patients with family history of premature ASCVD to assess increased risk.
  • Use apolipoprotein B testing especially when triglycerides exceed 200 or when LDL calculation is inaccurate.
ADVICE

Coronary Calcium Scoring Guidance

  • Consider coronary artery calcium (CAC) scoring to better stratify risk when ASCVD risk score is low but risk enhancers exist.
  • Counsel patients about implications of positive or zero CAC to avoid false reassurance or complacency.
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