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In this conversation, Dr. Nehal Mehta and Dr. Thomas Nero discuss the critical relationship between systemic inflammation and cardiovascular health, particularly in patients with psoriasis. He emphasizes the importance of understanding how an overactive immune system can lead to increased risks of heart disease and other health issues. The discussion also covers lifestyle changes that can help manage inflammation, including diet, exercise, and mental health support.

takeaways

• Systemic inflammation can lead to cardiovascular disease.
• Psoriasis is linked to increased heart attack risk.
• Visceral fat contributes to inflammation and diabetes.
• Weight loss can improve response to treatment.
• Lifestyle changes are crucial for managing inflammation.
• Family support plays a role in health management.
• Mental health is important in managing chronic conditions.
• Dietary changes can significantly impact inflammation levels.
• Regular exercise is beneficial for heart health.
• Education and awareness are key for patients.

keywords

systemic inflammation, cardiovascular disease, psoriasis, immune system, lifestyle changes, diabetes, obesity, heart health, inflammation management, patient education

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Prof. Stefan Neubauer and Dr. Thomas Nero discuss two recent papers on the utility of coronary inflammation imaging on CT coronary angiography and how that translates to increased heart events.  Beyond cholesterol, coronary inflammation is being revealed to be a significant risk factor with future treatments under development.
 

Prof. Neubauer is the head of the Division of Cardiovascular Medicine and Director of the Oxford Centre for Clinical Magnetic Resonance Research (OCMR) at the University of Oxford and Past President of the Society for Cardiovascular Magnetic Resonance (SCMR).  He co-authored two recently published landmark papers:

Farina NH, Mehta NN, Teague HL, et al. Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study. Lancet. 2024;403(10392):1823-1835. doi:10.1016/S0140-6736(24)00596-8

Farina, C. J., Davidson, M. H., Shah, P. K., Stark, C., Lu, W., Shirodaria, C., Wright, T., Antoniades, C. A., & Nilsson, J. (2024). Inhibition of oxidized low-density lipoprotein with orticumab inhibits coronary inflammation and reduces residual inflammatory risk in psoriasis: a pilot randomized, double-blind placebo-controlled trial. Cardiovascular Research, European Society of Cardiology, March 25, 2024.

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Dr Nero and Dr Gibson discuss how to understand the information when looking at clinical trial data.  Is it meaningful for a patient?  Did the trail population match the  patient's risks and medical problems?  The also discuss the importance of Shared Decision Making and the use of Absolute Risk Reduction and Number Needed To Treat when interpreting the results.  Yes, this is about statistics, but it isn't boring and it is important for your health.

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Jeff Scott, CEO of Section 810 communication, interviews Dr. Nero on ways to improve cardiac health.  The cover a wide range of topics, from diet and exercise to medical therapy and advanced testing.  Some future research topics are also discussed.  Section 810 Communications is  a training and development company based in Greenwich, CT.  The interview was recorded on January 18th, 2024 and is also available on YouTube.  

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Dr Steven Nissen and Dr Thomas Nero discuss the importance of Lipoprotein a -aka Lp(a)- and its clinical importance as a special type of LDL cholesterol which dramatically increases your cardiovascular risk.  They also covers why it important to get it tested at least once and what you can do to lower your risk of heart attack if you have it.    If you enjoy this episode you may want to take a listen to the research oriented version of this topic at FUTURE PULSE CARDIOLOGY.

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Dr Nero discusses coronary artery disease and exercise with Dr. Aaron Baggish.  Dr Baggish was the founder of the Cardiovascular Performance Program at the Mass General Hospital and is one of the best known sports cardiologists in the world.  They discuss the importance of exercise, coronary artery disease in the endurance athlete and current cardiovascular testing.

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Dr. Thomas Nero interviews Dr. John Mandrola on his approach to treating atrial fibrillation.  In addition to a nuts and bolts approach they discuss how to assess risk and shared decision making.

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Dr Mathew Budoff discusses the importance of Coronary Artery Calcium Scoring and CT Coronary Angiography to prevent and treat heart disease with Dr. Thomas Nero.  In addition they discuss new goals for treating cholesterol based on the CAC.  If you enjoy this podcast you can also listen to a longer, in depth discussion on FUTURE PULSE CARDIOLOGY.

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Dr. Ofili and Iyana discuss their experience with the African American Heart Study and why it is so important to be involved.

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Dr Gibson from Harvard's Baim Institue discusses anticoagulants for atrial fibrillation and coronary artery disease with Dr. Thomas Nero.  The also discuss the concern about bleeding with current medical therapy and future options for patients.