BITESIZE: Two LDL Trials. Two Different Results.

Should LDL be treated? In this episode of Metabolic Mind, Dr. Bret Scher explains why the better question is who may benefit from LDL lowering, how aggressively it should be treated, and what outcomes matter most to the individual patient.Dr. Scher reviews two major trials that studied aggressive LDL lowering in very different populations. VESALIUS-CV looked at high-risk patients with serious vascular disease and found that adding a PCSK9 inhibitor reduced both cardiovascular events and all-cause mortality. STAREE studied older adults without known cardiovascular disease and found fewer cardiac events with statin therapy, while overall survival and hospitalizations did not change. Disability-free survival also showed no differenceHe covers:Why LDL treatment depends on the person, not just the numberWhat VESALIUS-CV found in high-risk patients with vascular diseaseWhy STAREE tells a different story in older adults without known heart diseaseThe difference between reducing cardiac events and extending lifeWhy vascular disease should shape how aggressively LDL is treatedHow age, frailty, cognition, cancer risk, and independence affect the risk-benefit conversationWhy LDL may need a different discussion for someone using ketogenic therapyHow metabolic health, insulin resistance, and direct evidence of vascular disease fit into the decisionThese trials illustrate why LDL treatment should be individualized with a healthcare provider. For some patients, aggressive lowering may save lives. For others, the benefits may be smaller or less connected to the outcomes they care about most.🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.#LDL #CardiovascularHealth #MetabolicMind #MetabolicHealthExpert Featured:Bret Scher, MD - Baszucki Group Medical Director & Host of the Metabolic Mind Podcasthttps://www.linkedin.com/in/bret-scher-08baaa102/https://www.instagram.com/drscher858/?hl=enhttps://x.com/bschermdResources Mentioned:Effects of Evolocumab on Mortality Outcomes in Patients Without Previous Myocardial Infarction or Stroke: A Prespecified Analysis of the VESALIUS-CV Randomized Clinical Trialhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.082436Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adultshttps://www.nejm.org/doi/10.1056/NEJMoa2607314https://youtube.com/playlist?list=PLzWI83-NWCL5V7N6MjywX5QbkVn9Svi3q&si=oKVT518X1u0rUcMkFree CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits: https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a n