A. Michael Lincoff, MD

Interventional cardiologist and clinical researcher at the Cleveland Clinic. Professor of Medicine at Lerner College of Medicine of CWRU. Opinions my own.

[A. Michael Lincoff, MD @LincoffMichael]

@kcferdmd Of course, that CTT regression line was generated primarily by statins which also reduce CRP. And PCSK9i's fell below the line ... and don't reduce CRP. #CardsJC

[A. Michael Lincoff, MD @LincoffMichael]

@AlliBigeh Can also actually discuss nocebo effect with patients. "N of 1" trial (N Engl J Med 2020; 383:2182-2184) very illustrative - "90% of the symptom burden elicited by a statin challenge was also elicited by placebo." #CardsJC

[A. Michael Lincoff, MD @LincoffMichael]

@kcferdmd Apparent heterogeneity by primary/secondary prevention may well have been by chance. But re-emphasizes importance of treating high risk primary prevention patients, who are typically undertreated with LLT.

[A. Michael Lincoff, MD @LincoffMichael]

@goodmra1 @DrEugeneYang #CardsJC. Whether or not statin intolerance is real or nocibo effect in some patients, the bottom line is that they are not receiving the LDL-C reduction that would benefit them. No reason to believe CV benefit from BA is different in those with and without true intolerance.