Peter Carey

Consultant Physician STSFT. Honorary Clinical Lecturer UoSMS. Self confessed Lipid Geek. “GIM Plebster”. Views expressed are my own.

[Peter Carey @drpecarey]

Went to a talk on Shakespeare on Friday evening. I had always assumed that the 4th wall came into being with the advent of cinema (and the screen forming a physical barrier). Surprised to learn that it actually preceded this and was first suggested by Denis Diderot in 1758!

[Dr Alo, DO, FACC @MohammedAlo]

Non-Hdl-C: Lower Sooner, Longer Better After Heart Attack

The ESC/EAS 2021 guidelines recommend starting with statins and adding non-statin therapies to reach lipid goals, but this approach may delay lipid control in high-risk MI patients, who often aren't on lipid-lowering therapy before their MI.

This is the first study to examine the impact of timing and magnitude of non-HDL-C reduction after MI on MACE, mortality, and non-fatal MI.

5 Key Points From The Study

1️⃣ Study Overview: 56,262 MI patients were evaluated for major adverse cardiovascular events (MACE), death, and non-fatal MI, with non-HDL-C levels assessed at admission, 2 months, and 1 year.

2️⃣ MACE Risk: Patients in the lowest quartile of non-HDL-C at 1 year had a significantly reduced risk of MACE compared to those in the highest quartile (HR 0.76).

3️⃣ Consistency Across Outcomes: Similar risk reductions were observed across all outcomes. Patients achieving both early and sustained non-HDL-C targets had the lowest risk (HR 0.80).

4️⃣ Early and Sustained Targets: The best outcomes were seen in patients who achieved target non-HDL-C levels within 2 months post-MI and maintained them at 1 year.

5️⃣ Lipid Reduction: From a lipid perspective, in the context of patients with a MI, if the “destination” is to lower the risk of MACE, then the journey is via reductions in atherogenic lipids to attenuate, stabilize, and in some instances reverse the atherosclerosis process over time.

These findings challenge the current stepwise approach for cholesterol lowering after MI which inevitably results in delaying goal attainment and possible harm.

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[Nicky @NickyJohnsonNY]

Wishing you a terrific Tuesday from North Yorkshire 😊 take a pew and enjoy the view 😉

[Dr Tony Goldstone @goldstone_tony]

High earner in the NHS? Increment this year?

You *need* to understand both of these graphs 👇
Dont end up #PayingToWork

[Tim Street @Tims_Pants]

https://t.co/lMO6MRBFbI

That was unexpected. #Diabetes #DOC

[Filipino Nurses Association UK @filipinonurseuk]

@filipinonurseuk strongly condemns the recent racist attacks on our dedicated Filipino nurses in Sunderland. Our community has been an integral part of the NHS since 1969. We are united against racism and will continue to support our colleagues.
#StopRacism

[Aled Roberts 🏴󠁧󠁢󠁷󠁬󠁳󠁿🇦🇹 @capaled]

This is how to remember the tragedy in Southport not what has happened in Sunderland with the burning of a police station

[Lewis Atkinson MP @LewisAtkinson]

I am appalled by the disorder in the centre of Sunderland tonight.

Our city is not represented by a tiny minority causing trouble.

@northumbriapol have my full support as they respond to criminal thuggery and work to protect all the communities of our city.

Tomorrow the people of Sunderland will come together and continue to build the bright future that we have - a future where every community of our city feels safe and prospers.

[Peter Carey @drpecarey]

So depressing to see the news from Sunderland. Not representative of the majority of people from the city.

[Health Innovation NENC @HI_NENC]

The Northern Lipid Forum returns for 2024! Join this event to hear lectures on #CVD prevention in the North East and North Cumbria.

📅 17th October 2024
⏰ 18:00-21:00
📍 Delta Hotels by Marriott, Newcastle Gateshead, NE11 9XF

Register 👉 https://t.co/LtLlIvUDX5

[Shivani Misra @ShivaniM_KC]

One of the consultants who has been a key figure in our department for years and years, who is passionate about endocrine training and education and generally someone you would seek advice from for pretty much anything, retired today.

When I became a consultant in 2017, I used to have lunch with him pretty much every day. He invited me to join the other older male consultants when I started so I did. He did endo, I did diabetes so we’d discuss clinical stuff generically, but lunch was the highlight of my day. We’d laugh and talk about politics, sport, memes even - pretty much anything. It helped me brake the ice with all the consultants.

That lunch became the anchor point of my day. People don’t realise how isolating it is when you first become a consultant. The camaraderie that emerged from those lunches was like a warm blanket,

His leaving feels like the end of something. I think it’s really tough when big characters in the department leave. It feels physically empty. I guess other people step up, eventually.

Anyway, I’m in Singapore right now but I rang him to say bye and he was just leaving the building so that at least feels special.

I’m going to meet him and his wife for dinner in a few weeks so of course gone but still good friends.

Anyway. Someone important to me professionally and personally retired today and he is a very special and inspiring endocrinologist.

Also this is why consultants need office space. Consultants have a team but are often isolated from their peers. Lunch time chats and coffee with other consultants is mentally relaxing and a real tonic.

[Ian Ridley 💙 @IanRidley1]

I covered #England under 10 managers, including some caretakers, very august names and figures among them. Not one of them achieved what #GarethSouthgate has, some with potentially exceptional sides in 98, 06 and 10.
(Venables might have, but couldn't swallow his pride and do a Euro 96 'audition', though it was really the FA suits fault for insisting he did.)
Worth remembering too, that England failed to qualify for a Euros and three World Cups in the 70s, 80s and 90s.
Not only is Southgate's record of achievement quite brilliant, he did it with enlightenment, by developing and empowering young men, showcasing them as shining representatives of a diverse and - largely - tolerant nation, partly bolstering a nation's self-esteem in some dark years and ridding the national team of a world-weariness.
There are those who called him woke. He certainly woke English football. The 'Dear England' letter was a masterstroke.
There were mistakes, moments he missed, opportunities that slipped through his fingers. He will surely reflect on them more than anybody.
They are not for today, nor does today belong to those who have been vilifying this most honourable, articulate and steadfast of men for perceived failures that really aren't.
Today is for him to be assured that those who have any realistic sense of English football's history and standing, and who appreciate a return to being able to hold heads high, are humbly grateful for his eight years of inspired, yeoman service.

[Peter Carey @drpecarey]

@trishgreenhalgh I would expect no less!

[Bridget Phillipson @bphillipsonMP]

It’s a good week for St. Robert’s alumni ❤️🤍

[Peter Carey @drpecarey]

@trishgreenhalgh Unless someone deletes it!

[Peter Carey @drpecarey]

@trishgreenhalgh Oh Trish you tease. We all know that what happens on the Independent SAGE WhatsApp group stays on the Independent SAGE WhatsApp group

[Leon Mann MBE @Leon_Mann]

Can all the racists who posted after the Euros final at Wembley please take note…

Every single one of our penalty takers just now has Black heritage.

🦁🦁🦁

🖤🖤🖤🖤🖤

[Peter Carey @drpecarey]

@PippaCrerar Is he now the third Cabinet member from Sunderland??

[Jake Humphrey @mrjakehumphrey]

We win penalty shoot outs with this manager.

We regularly make semi-finals and finals with this manager.

Gareth has transformed the belief of @England

Now let’s back him…

[Peter Carey @drpecarey]

@PMCallaghan @bphillipsonMP @jreynoldsMP Love it!😊