Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?

Thank you Dr. Pearson.

The Skeptical Cardiologist

The skeptical cardiologist has been utilizing coronary artery calcium (CAC) scans to help decide which patients are at high risk for heart attacks, and sudden cardiac death for the last decade. As I first described in 2014, (see here) those with higher than expected calcium scores warrant more aggressive treatment and those with lower scores less aggrressive treatment.

Although , as I have discussed previously, CAC is not the “mammography of the heart” it is incredibly helpful in sorting out personalized cardiovascular risk. We use standard risk factors like lipids, smoking, age, gender and diabetes to stratify individuals according to their 10 year risk of atherosclerotic cardiovascular disease (ASCVD) but many apparent low risk individuals (often due to inherited familial risk) drop dead from ASCVD and many apparent high risk individuals don’t need statin therapy.

Previously, major guidelines from organizations like the AHA and the ACC did not recommend…

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5 Classifications of Diabetes Proposed

  1. Severe autoimmune diabetes (formerly type 1 diabetes): affected 6% of patients in the derivation cohort; characteristics include early-onset disease, relatively low BMI, and GADA-positive
  2. Severe insulin-deficient diabetes: 18% of patients; GADA-negative but similar to cluster 1; lowest HOMA2-B scores
  3. Severe insulin-resistant diabetes: 15%; higher HOMA2-IR scores
  4. Mild obesity-related diabetes: 22%; obese, but not insulin resistant
  5. Mild age-related diabetes: 39%; older than other clusters, but largely similar to cluster 4

Quoted from  NEJM Journal Watch.

 

First They Came For My White Coat – America’s War on Doctors

Source: First They Came For My White Coat – America’s War on Doctors | American Council on Science and Health

If you decide to spend ten minutes or so to read this article please take an additional 5 minutes to read the comments section.  Keep an open mind and always remember there are two sides to every story.

Untreated sleep apnea shown to raise metabolic and cardiovascular stress — ScienceDaily

Sleep apnea, left untreated for even a few days, can increase blood sugar and fat levels, stress hormones and blood pressure, according to a new study of sleeping subjects. A report of the study’s findings, published in the August issue of The Journal of Clinical Endocrinology & Metabolism, adds further support for the consistent use of continuous positive airway pressure (CPAP), a machine that increases air pressure in the throat to keep the airway open during sleep.

Jun emphasized that the study was limited by studying people with severe OSA and obesity, thus limiting the ability to apply the findings to all OSA patients. The researchers also did not compare CPAP use to a sham CPAP control group to exclude a potential placebo effect

Source: Untreated sleep apnea shown to raise metabolic and cardiovascular stress — ScienceDaily