If a patient presents with ST elevation on an EKG and symptoms of a heart attack (STEMI), activate the cath lab immediately, as the standard of care is to open the artery within an hour to save heart muscle and lives.
If you have a stent, ensure you take your prescribed blood-thinning medication like Plavix daily, especially in the initial months, as it is critical to prevent life-threatening stent thrombosis.
For stable angina, prioritize optimized medical therapy to manage symptoms before considering a stent. Stents are useful if medicines are ineffective or cause intolerable side effects, but they don’t typically extend life in stable angina.
If considering growth hormone, understand that while it may improve lean muscle mass and fat mass for aesthetic or performance goals, there is no evidence it promotes longevity and may even decrease it.
If following a ketogenic diet or fasting, utilize a ketone biomarker measurement (e.g., with a device like Keyto) as a real-time guide to reinforce behavioral changes and improve adherence, as scale weight is a lagging indicator.
For asymptomatic individuals, a coronary artery calcium (CAC) score is most informative in two scenarios: if you are young (under 45-50) and have any calcification, or if you are older (over 70) and have a score of zero, as these results can significantly guide the aggressiveness of medical therapy.
When considering a CT angiogram (CTA) for asymptomatic patients, evaluate their psychological disposition. For anxious patients, seeing plaque on a CTA might cause significant distress and sleeplessness, which could outweigh the clinical benefit of the information.
As a clinician, reconsider the routine ordering of HeartFlow analysis with CT angiograms for stable angina patients, as current data from trials like Orbita suggest it may not add significant value to management beyond the anatomical information from the CTA itself.
Adopt an ’evidence-informed’ approach to medicine, recognizing that clinical trials provide data on averages, but individual patient decisions often require judgment and art, especially in areas like prevention where direct trial data may be lacking.
Maintain scientific humility by acknowledging that ‘all facts have a half-life’ and scientific truth is constantly refined. Be open to being wrong and view unexpected results as opportunities for learning and discovery.
Recognize that understanding science and critical thinking is essential to avoid being ‘overrun with propaganda and nonsense.’ Actively seek to improve your scientific literacy, regardless of your profession.
As scientists and educators, strive to communicate scientific concepts in an interesting and exciting way without oversimplifying, to engage a broader audience and foster scientific literacy.
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Physicians and those interested in clinical trials should download the ‘Journal Club’ app, which provides comprehensive summaries and details of clinical trials, serving as a valuable resource for staying informed.
Utilize Twitter as a tool to curate scientific information and research from experts in adjacent fields, helping to stay updated on developments outside one’s immediate specialization.