Learn more about the niCVRI: niCVRI.org

Regarding dilution due to crossover: TRANSFORM is not ISCHEMIA. These are asymptomatic, older, metabolically high-risk patients—not patients already known to have moderate/severe ischemia. In ISCHEMIA, despite much more advanced disease, only 8.7% of the conservative arm underwent angiography within 6 months. At ~8% crossover, a true 20% benefit is diluted only to ~19%. Hard to imagine TRANSFORM crossover approaching 25%. Its strength is testing whether CTA can identify and treat disease earlier—before symptoms and ischemia appear. #plaquedirectedtherapy @DLBHATTMD

How to create cardiac planes using CT (or MRI). @MGHImaging @Heart_SCCT #FOAMed #FOAMrad @Learn_Things

Watch this! It was 🔥

The AI Singularity The argument goes like this: 1. Humans build an AGI. 2. The AGI becomes good at AI research. 3. It designs a smarter AI. 4. That smarter AI designs an even smarter AI. 5. The cycle repeats faster and faster. Looking at the results and capabilities from the various labs over the past few weeks I would say we are firmly in this loop now. The next 18months will be wild. Recursive self improvement will dramatically increase capability very quickly from here. Marginal costs of all models will go to ~$0.

With the lipoprotein(a) pathway to treatment challenged by the failure of the HORIZON trial, it may be time to intensify our efforts along the IL-6 inflammatory pathway. At niCVRI (@CVRF_SoCal), we are already on our way. #plaquedirectedtherapy

AliveCor has changed the paradigm of electrocardiograph recording forever. Its impact on the democratization of healthcare and dramatic reduction in the cost of services has been a major contribution. @DrDave01

Happy Birthday, Chamath. Your story is an inspiration to Americans—especially first-generation Americans like me, whose parents escaped Nazi Germany, and immigrants like you. We share a deep gratitude for this country and the opportunity it gives people to build, contribute, and lead.

I turn 50 today. This is a message to my kids but I offer it to you in case any of it rings useful. I was born in Sri Lanka in 1976 in a country that, at the time, was about to enter a decades long civil war. My father was able to get stationed at the Sri Lankan High Commission in Canada for four years in the early 80s - when some of the fighting was most severe - and which from our vantage point in Canada gave us some respite from an otherwise omnipresent conflict. He came as a diplomat but then my father filed for refugee status after four years when his life was threatened by militants. We stayed in Canada as refugees. My dad never really landed on his feet and we grew up on welfare. My mom stepped up. She did an incredible thing and put our family on her back and kept marching forward. Sometimes the steps were very small but she always tried to keep moving forward. I worked at Burger King starting at 14, giving my paycheck to my mom and dad to support our family in the role that I was assigned - earn enough to pay for our bus passes because we couldn’t afford a car. I was a loser growing up. Some friends, some good memories but mostly forgettable and lonely. I wasn’t very studious but did get my act together in my final year and got into a great university. I immigrated to the US soon after graduating and found an opportunity. Things clicked and I have been traveling a path to find myself ever since. Only in America is this possible… I worked hard, followed the rules, paid my taxes and stayed in California out of loyalty for the opportunities it has given me despite its dysfunction. I found my wife here. Had my kids here. Found my tribe here. There have been some very hard times as well - deaths, divorce, financial pain, mistakes of omission and mistakes of commission. You can’t dwell on these things - they are weights that will pull you down if you’re not careful. Learn from them. Respect them. BUT MOVE ON. To think 50 years ago I could have ever gotten a chance to meet the people I’ve met and have had the experiences I’ve had would have been mind boggling to my parents. It’s mind boggling to me now. We forget often and try to convince others it’s not true but America truly is the best country in the world. Everything and anything is possible here. I can testify. Be grateful to be here. This is the only place that gives EVERYONE a chance to live a great adventure. The first 50 years have been that for me - an incredible adventure. Notice there is nothing here about accomplishments or money. Because it doesn’t matter and it won’t matter. You will be dust in less than 100 years from now and the decision to be remembered won’t be yours so stop sweating it. It’s not in your control. So what is in your control? Be kind. Have fun. Work on something meaningful to you. Find your tribe. Try to find perspective. Find an incredible partner. Have a bunch of kids. Live an adventure. Forgive your parents - they were doing the best they could even if that wasn’t what you deserved. I will do what I can to make my next 50 years a wild ride. You should too. I love you and thank you. ❤️ 🙏🏽🙏🏽

The future of evidence-based CT post-processing is here: rigorous truthing to histology, as Elucid has accomplished, combined with detailed reporting that integrates coronary anatomy, plaque characterization, and physiology at a reasonable cost. Elucid has also developed software that moves beyond plaque characterization and physiologic assessment to help guide revascularization decisions in a clinically useful and evidence-based way. Congratulations to Elucid on the continued advancement of its software and on this important round of financing. This provides a strong platform for the company to expand its contribution to coronary imaging and precision cardiovascular care.

How a Heart Attack Begins: Plaque Rupture in Seconds

This is a very important post. We’ve done deep analysis of all the polypeptides on the progression of calcified and not classified plaque, and they can cause increased thrombosis as well as promote noncalcified plaque and rupture. This is just based on the science of what they do. All of this is about a counter culture to the problems we had during Covid and a lack of trust for those of us working in the evidence base. The distinction you’re making is very important and it’s a contribution to social media to keep all of this focused and safe. We have so many individuals promoting unsafe practices with no science. It’s the only reason I’ve decided to be in the social space to help correct these dangerous promotions @RonKarlsbergMD @RonBlankstein #plaquedirectedtherapy @davidmarcus @vkhosla

Seeing a patient referred from an outside system for CV prevention today. Can we please stop reporting coronary artery calcium scores with reference to stenosis, as shown here? 🙏🏻 @drjohnm

My gmail got hacked. I am an idiot. Glass half-empty, I am an idiot and have a mess to clean up. Glass half-full, I have heard from dozens of people I had not seen or spoken with in forever

Wow. Super cool and very valuable.