Welcome to the CardioNerds Lipid Series Page!
The CardioNerds Lipid series is a comprehensive series led by series co-chairs Dr. Rick Ferraro, cardiology fellow at The Johns Hopkins Hospital and Dr. Tommy Das, cardiology fellow at The Cleveland Clinic and produced in collaboration with the American Society For Preventive Cardiology (ASPC).
CardioNerds Academy Chief Fellows Dr. Rick Ferraro (FIT, Johns Hopkins) and Dr. Tommy Das (FIT, Cleveland Clinic) join Academy fellow Dr. Jessie Holtzman (soon, chief resident at UCSF internal medicine residency) to learn all about LDL physiology and function from Dr. Peter Toth!
Low-density lipoprotein cholesterol (LDL-C) has been well established as a risk factor for atherosclerotic cardiovascular disease with an ever growing armamentarium of medications to lower LDL-C plasma levels. Yet, LDL-C also plays a number of key physiologic roles across mammalian species, such as cell membrane formation, bile acid synthesis, and steroid hormone production. In this episode, we discuss the definitions of high, normal, low, and ultra-low LDL-C, what functional assays are used to measure LDL-C, and what is considered the safe lower-limit of LDL-C, if there is one at all. Drawing upon experience from rare genetic conditions including abetalipoproteinemia and loss-of-function variants of the PCSK9 gene, we glean pearls that clarify the risks and benefits of low LDL-C.
CardioNerds Dr. Rick Ferraro, Director of the #CardsJC Journal Club and cardiology fellow at Johns Hopkins and Dr. Tommy Das, Program Director of the CardioNerds Academy and cardiology fellow at Cleveland Clinic join Academy fellow and episode lead Dr. Julie Power, chief fellow at the University of Minnesota to learn all about the link between LDL-C and cardiovascular events and disparities in care from Dr. Keith Ferdinand, Professor of Medicine and Chair in Preventative Cardiology at Tulane University School of Medicine.
As we’ve learned in prior episodes, LDL-C plays a key role in lipid pathophysiology. But how does it lead to cardiovascular events? LDL-C directly leads to plaque expansion and deposition in the arterial intima. Increasing levels of LDL-C are directly related to worsening plaque burden, a principle exhibited powerfully by the dose-dependent nature of coronary atherosclerosis in patients with underlying mutations leading to LDL-C elevation, such as familial hypercholesterolemia.
Importantly, the treatment of atherosclerosis and implementation of lipid-lowering therapies are not uniform, with significant disparities throughout the community. The message is clear: Reducing LDL-C is of paramount significance in the prevention and treatment of coronary atherosclerosis and ensuring equitable access to care is critical to addressing the societal burden of cardiovascular disease and improving the health of our communities.
There is no CME associated with this episode. To get free CME from other CardioNerds episodes, please visit VCU Health here.
Relevant disclosure: Dr. Ferdinand reported severing as a consultant for Medtronic, Amgen, and Novartis.
CardioNerds Dr. Rick Ferraro, Director of the #CardsJC Journal Club and cardiology fellow at Johns Hopkins, and Dr. Tommy Das, Program Director of the CardioNerds Academy and cardiology fellow at Cleveland Clinic, learn all about the clinical application of the ASCVD primary and secondary prevention guidelines in terms of lifestyle modifications and lipid lowering strategies from Dr. Allison Bailey, Editor-in-Chief of the ACCEL Audio Journal and Advanced Heart Failure and Transplant Cardiologist at Centennial Heart. Dr. Baily was a co-author on the 2018 ACC/AHA Guideline on the Management of Blood Cholesterol.
In this episode we will learn about the current guidelines for primary prevention of ASCVD, the evidence for specific dietary changes in improving cardiovascular outcomes, the current guidelines for secondary prevention of ASCVD, how successful are clinicians and patients in meeting LDL-C recommendations, and what the recent SAMSON trial teaches us about statin intolerance.
Lipid Related CardioNerds Episodes
Lipid Series Co-Chairs!
Dr. Rick Ferraro is midwest raised, spent two years as a Teach For America Corps member teaching science in Milwaukee before heading to medical school at Weill Cornell Medicine in NYC. Current senior resident at the Osler Medical Residency program and will begin cardiology fellowship at Johns Hopkins Hospital in 2021. Completed intern year under the incredible leadership of Dr. Amit Goyal. Interested in cardiovascular prevention and imaging
Dr. Tommy Das is an internal medicine resident in the Osler Program at Johns Hopkins and rising cardiology fellow at The Cleveland Clinic. He is a native of Houston, TX, and completed medical school at UT Southwestern School of Medicine. He is part of the inaugural Medical Education Pathway for IM Residents at Johns Hopkins, and is passionate about the interplay between MedEd and Cardiology. His interests range from teaching hands-on bedside skills to interventional cardiology research to the pursuit of perfect pecan pie.
Meet Our Guests!
Dr. Peter Toth is the Director of Preventive Cardiology at CGH Medical Center in Sterling, IL, and Professor of Clinical Family and Community Medicine at the University of Illinois College of Medicine in Peoria, and adjunct associate professor of medicine, Johns Hopkins University School of Medicine. He received his medical degree from Wayne State University School of Medicine in Detroit, MI, and PhD in Biochemistry from Michigan State University in East Lansing. He has written extensively on the topic of lipids and is Co-Editor of twenty textbooks in preventive cardiology, diabetes, hypertension, and lipidology. Additionally, Dr. Toth is the President of the American Society of Preventive Cardiology, past President of the National Lipid Association, as well as incoming chair of the American Heart Association’s Council on Lipoproteins, Lipid Metabolism, and Thrombosis.
Keith C Ferdinand, MD, is Professor of Medicine at the Tulane University School of Medicine and the Tulane Heart and Vascular Institute in New Orleans, Louisiana. He was previously Professor of Clinical Pharmacology at Xavier University, New Orleans and Clinical Professor of Medicine at Emory University, Atlanta, Georgia. Dr. Ferdinand received his medical degree from the Howard University College of Medicine in Washington, DC. He is board-certified in internal medicine and cardiovascular disease, certified in the subspecialty of nuclear cardiology, and a specialist in clinical hypertension certified by the American Society of Hypertension.
Dr. Julie Power @JuliettePower44 is a cheif cardiology fellow at the University of Minnesota. She completed medical school at Drexel University in Philadelphia followed by residency training at Allegheny General Hospital in Pittsburgh where she also served a Chief Resident. In addition to a continued involvement in medical education, Julie plans to pursue additional training in interventional cardiology after her general cardiology fellowship. In her free time, she enjoys spending time with family and friends, including exploring Minnesota with her boyfriend, Steve.
Alison L. Bailey @a_l_bailey is a General Cardiologist in Chattanooga, TN. She completed her medical training (all of it!) at the University of Kentucky and has been using what she learned there for the last 20 years. She loves ALL of cardiology, but spends most of her clinical time in prevention and heart failure. She believes that Food is Medicine and is passionate about helping her community find healthier ways to live. She has been involved in medical education throughout her career as a chief resident, chief fellow and Cardiology Fellowship program director. She currently serves as the Editor-in-Chief of ACCEL and thinks the most important contribution any of us can make is to elevate medical education. She believes in the mission of CardioNerds wholeheartedly. She enjoys cooking, reality TV and hanging out with Max, her favorite son.