Kush Agrawal, MD, FACC, RPVI

Well, this sucks. My original account @RealKushAgrawal got hacked. @TwitterSupport remains utterly useless.

@DamnDRoseTweets And locked in.

Clocked in

Drop a 💙 if you love the Obamas

Class and grace. #HappyBlackHistoryMonth 🖤

The only way I view my President and First Lady 🤎🙂‍↔️

RETWEET if you stand with the Obamas against Trump’s racist attacks!

🧠💊 Supplements vs. Statins: what actually lowers LDL-C? A reality check from a randomized trial Many patients turn to “natural” supplements for cholesterol control—but do they work? This well-designed randomized clinical trial provides a clear, evidence-based answer. 👇 🔬 Study design In the SPORT trial, adults without known ASCVD but with elevated LDL-C and increased 10-year cardiovascular risk were randomized for 28 days to: Rosuvastatin 5 mg/day Placebo Six popular supplements: fish oil, cinnamon, garlic, turmeric, plant sterols, or red yeast rice Primary endpoint: % change in LDL-C. 📉 Key results Rosuvastatin reduced LDL-C by ~38%, far outperforming placebo and all supplements. None of the supplements lowered LDL-C more than placebo. Garlic was associated with a numerical increase in LDL-C. Statins also improved total cholesterol and triglycerides; supplements did not. Adverse events were low and similar across all groups. 📊 Why this matters Despite massive public use and strong marketing claims, commonly used supplements: ❌ Do not meaningfully lower LDL-C ❌ Do not improve inflammatory markers (hsCRP) ❌ Do not match even low-dose statin efficacy Meanwhile, 5 mg of rosuvastatin—a modest, guideline-supported dose—delivered consistent, clinically meaningful lipid reductions in every treated patient. ⚠️ The bigger picture This study doesn’t just compare pills—it highlights a communication gap: Supplements are perceived as “safer” and “equally effective” Evidence says otherwise 📌 Bottom line If the goal is LDL-C reduction and cardiovascular risk modification, supplements are not substitutes for statins. Clear data, simple message: evidence beats marketing. 🫀📚 A must-read for clinicians navigating lipid discussions—and for patients deciding where “natural” ends and effective begins.

@FCademartiri @minhaskh Wow. Earth shattering advice.

🫀🩺 Life after PCI: what really matters once the stent is in This 2025 JACC: Advances state-of-the-art review reframes post–PCI care around a simple but powerful message: the procedure is only the beginning. Long-term outcomes depend far more on patient management than on the stent itself . 🔑 Three pillars of post-PCI care The authors organize optimal management around three core principles: 1️⃣ Lifestyle modification & risk factor control 2️⃣ Secondary prevention pharmacotherapy 3️⃣ Selective—not routine—monitoring for restenosis 🏃‍♂️🥗 Lifestyle first (and forever) Post-PCI care must aggressively target: smoking cessation 🚭 (initiate in hospital, not later) regular physical activity (≥150 min/week) heart-healthy diets (Mediterranean-style favored) blood pressure, diabetes, lipid, and weight control Cardiac rehabilitation is strongly recommended—it improves survival, quality of life, and adherence, yet remains underused. 💊 Medical therapy: balance ischemia vs bleeding Modern PCI management has shifted toward simpler, safer antithrombotic strategies: Stable CAD: short DAPT (1–3 months) → single antiplatelet therapy ACS: 12 months DAPT, with growing support for de-escalation AF or anticoagulation needs: dual therapy beats triple therapy High-intensity statins are mandatory, with LDL-C targets <55 mg/dL in very high-risk patients. Adjuncts like ezetimibe, PCSK9 inhibitors, GLP-1 agonists, and even low-dose colchicine may play expanding roles. 🔍 Restenosis: don’t hunt what isn’t there With modern drug-eluting stents, restenosis rates are <5%. Evidence is clear: ❌ Routine stress testing or angiography in asymptomatic patients ✅ Symptom-driven, risk-based evaluation only Trials like POST-PCI show routine surveillance increases procedures—not outcomes. 🧠 The real takeaway PCI fixes a lesion. Outcomes are driven by prevention, not metal. 📌 The stent treats the artery. Long-term care treats the patient.

Damn.

@chranababy17 amazing.

Over the course of a lifetime, we face only a few moments where the decisions we make and the actions we take will shape our history for years to come.  This is one of them.

@yasmeenrajpoot0 @RivianTrackr Too many

@DeepBlueDoc21 @RivianTrackr One year, and still the same welcome. What’s your favorite feature?

Rivian just launched a sleek new 'Dark' variant of their Cargo Crossbars for the R1T and R1S! 🖤 Both the Silver and Dark options are available for $650. Keep an eye on the Rivian Gear Shop for restocks! Read more: riviantrackr.com/news/rivian-ad…

Will you support Gov. Gavin Newsom for President in 2028? 🖐🏽

If Barack Obama could run again, would you vote for @BarackObama? Yea or Nay???

In 2023, the U.S. spent approximately $1.35 trillion on healthcare administration. That's more than we spent on: Physician salaries (~$350B) Nursing salaries (~$335B) Retail prescription drugs (~$450B) Imaging, lab tests, EHRs, and outpatient procedures combined Even capital investment in hospitals and equipment. Btw, Physicians account for 8-9% of overall healthcare costs by comparison.

They never leave Congress because the grift is too good. Chuck Grassley: 91 Eleanor Norton: 88 Hal Rogers: 87 Maxine Waters: 87 Steny Hoyer: 86 Nancy Pelosi: 85 Jim Clyburn: 85 Mitch McConnell: 83 Bernie Sanders: 83 Etc Congress ends up being a corrupt taxpayer nursing home.

The average age of a U.S. Senator is 64. The average age of a U.S. House Rep is 57. The average age in America is 39. These people squatting in seats for decades can’t accurately relate to, or represent, the needs of Americans. We need term limits.

@mjfree Nasty Nero

“I hope that Benjamin Netanyahu burns in HELL” - Irish MP