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The Skeptical Cardiologist's avatar

Ryan,

Similar to you, my eldest daughter excelled in med school and chose primary care. Great primary care doctors like you and her are essential to quality health care but they are in short supply and at greater risk of burn-out due to many factors.

Here's my post on the MESA app (https://theskepticalcardiologist.com/wp-admin/post.php?post=36905&action=edit&calypsoify=1)

It allows a calculation without the CAC score and it includes family history!

In the example I describe a 64 year old with a 175 score goes from 4.7% to 8% risk

Dr P

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The Skeptical Cardiologist's avatar

Gerry,

Fortunately, we have some great options for patients like you who are at high ASCVD risk but have significant intolerance to statins.

Ezetimibe has an excellent side effect profile and has shown improved outcomes.

The PCSK9 inhibitors are very effective with good outcome data and minimal side effects.

Yesterday, we heard at the ACC that bempedoic acid lower MAC in stat in-intolerant high risk patients.

All of these drugs, by the way, work by one method or another to lower apo B and LDL levels.

Dr. P

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