DrBecher

🫀🔥 LDL is down. Therapy is optimal. And yet… plaque is still growing. Report from the presentation of the HURRICANE study at the ECR2026 Proud to be part of this study that sheds more light into a very hot contemporary topic. That’s the uncomfortable reality highlighted by new data presented at ECR 2026. 👉 Statins were working. 👉 Guidelines were followed. 👉 LDL was controlled. And still: 📈 Atherosclerosis progressed. 💡 This is the blind spot we’ve been ignoring: 👉 Residual cardiovascular risk Driven by: ✔️ Inflammation ✔️ Metabolic factors ✔️ Genetics 👉 Things LDL alone does NOT capture 🚀 Enter Photon-Counting CT (PCCT) For the first time, we can: ✔ Quantify plaque volume ✔ Differentiate plaque components ✔ Track progression over time 👉 Not just detect disease… 👉 Measure its evolution ⚠️ And this is where it gets disruptive: Patients who are “well-controlled” on paper may still be: 👉 biologically active 👉 progressing silently 🧠 This changes the entire paradigm: ❌ Treat LDL → assume success ➡️ becomes ✅ Treat disease → verify with imaging 🎯 Clinical implication We may need to move from: Lipid targets ➡️ to Plaque targets From: Surrogate biomarkers ➡️ to Direct disease measurement 🚨 Bottom line Statins treat risk. 👉 PCCT shows reality. And sometimes… they don’t match. ⚡ The future is not: “Did we lower cholesterol?” It’s: 👉 “Did we actually stop the disease?”

The LPA gene has an IL-6 response element, meaning when IL-6 levels go up and reach the liver, more Lp(a) is made. There are drugs in development for both lp(a) and IL-6, what does this mean for interpreting results? Here is a succinct summary of the salient issues: academic.oup.com/eurjpc/advance….

Why are 100% of eligible patients with HFrEF w/o CI or intolerance not receiving quadruple GDMT in 2026? ARNI+BB+MRA+SGLT2i ➡️ 75% ⬇️ all-cause ☠️ (26% ARR, NNT=4, 24 months) 85% ⬇️ HF 🏨 (33% ARR, NNT=3, 24 months) Extend median survival by 7-11 years 💊 Cost $78/month

The RETRY protocol for radial artery occlusion recanalization, based on ultrasound-guided distal radial access and DCB angioplasty, is feasible, safe, and associated with excellent technical success and favorable short-term patency. jacc.org/doi/10.1016/j.…

That's right. Inflammation is the big miss for getting ahead of coronary artery disease scientificamerican.com/article/new-ev… My review of this big shift erictopol.substack.com/p/the-big-shif…

Elon Musk thinks the entire education system is built on a broken assumption. That every student should learn the same thing. At the same speed. In the same order. At the same time. Musk: “Everyone goes through from like 5th grade to 6th grade to 7th grade like it’s an assembly line. But people are not objects on an assembly line.” The model was designed for a factory economy. Standardized inputs. Predictable outputs. That economy is gone. The assembly line is gone. But the education system still runs on its logic. A student who masters algebra in two weeks sits through eight more weeks because the calendar says so. A student who struggles gets dragged forward because the schedule doesn’t wait. Neither is being served. Both are being processed. Musk: “Allow people to progress at the fastest pace that they can or are interested in, in each subject.” AI doesn’t teach a classroom. It teaches a student. One at a time. Every time. It skips what a student already knows. It finds where they’re stuck and approaches it from a different angle. It adjusts in real time. Not at the end of a semester when the damage is already done. A student obsessed with basketball learns fractions through shooting percentages. A student who builds in Minecraft learns geometry through architecture. The subject doesn’t change. The entry point does. No teacher with thirty students can do this. Not because they lack skill. Because the math doesn’t work. AI doesn’t have that constraint. Musk: “You do not need to tell your kid to play video games. They will play video games on autopilot all day. So if you can make it interactive and engaging, then you can make education far more compelling.” The brain isn’t broken. The format is. Kids learn complex systems and strategic thinking for hours voluntarily. Then walk into a classroom and can’t focus for twenty minutes. That’s not a discipline problem. That’s a design problem. Musk: “A university education is often unnecessary. You probably learn the vast majority of what you’re going to learn there in the first two years. And most of it is from your classmates.” Four years. Six figures of debt. And the real value comes from the people sitting next to you. Not the institution charging you. The degree doesn’t certify knowledge. It certifies endurance. Musk: “If the goal is to start a company, I would say no point in finishing college.” The system was built to train employees. If you’re not trying to be one, it has nothing left to offer you. Every lecture. Every textbook. Every curriculum. Now available instantly. Personalized to any learner. Adapted to any pace. The question isn’t whether the old model survives. It’s how long we keep forcing students through it while the replacement already exists.

Re-entry of Artemis II crew captured by the astronaut in International Space Station

📢DK Crush like you’ve never seen it before! Episode 1⃣ of this series on "How to perform DK-Crush for left main bifurcation stenting" now online 📺pcronline.com/Cases-resource… In this episode, learn about: 🟣Multi-modality simulation to unveil the hidden parts & small obstacles that can result in complications 🟣Angioscopy directly inside the coronary artery to provide a better understanding of 3D stent configuration In-depth commentary and perspective and perspective provided by @GoranEBC & William Wijns. @twj1974 @NievesGonzalo1 @BURZOTTA_F @M_Lesiak @gabor_gt @RhianEDavies1 @esbrilakis @VisibleHeartLab #interventionalcardiology #CardioEd #EuroPCR

"We are a mirror, reflecting you." Artemis II mission specialist Jeremy Hansen discusses ways that the crew worked together and supported each other throughout their lunar mission.

Hello, Moon. It’s great to be back. Here’s a taste of what the Artemis II astronauts photographed during their flight around the Moon. Check out more photos from the mission: nasa.gov/artemis-ii-mul…

Imperdible mensaje de Chistina Koch tras su vuelta del espacio. Oratoria 10/10. Contenido 10/10. Emoción 10/10. Gente que sí ♥️

Skipping breakfast is associated with depression and anxiety, according to a new study ⚠️

A Little trick to save the radial access for an arterial line after #PCI, thanks to @GianlucaCampo78 for the idea!

Welcome home Reid, Victor, Christina, and Jeremy! 🫶 The Artemis II astronauts have splashed down at 8:07pm ET (0007 UTC April 11), bringing their historic 10-day mission around the Moon to an end.

🚨 | Misión Artemis II: Se ha publicado un video del ingreso de la tripulación a la atmósfera terrestre, increíble 👏🏼

In STEMI with large thrombus burden, a combined strategy using a stent retriever and continuous aspiration achieved complete thrombus removal after failure of aspiration alone. #STEMI eurointervention.pcronline.com/article/stent-… @QuentinChatela2 @RoffiMarco

Genetics Predict Weight Loss & Side Effects Of GLP1 RA Drugs 1️⃣ Not everyone loses the same weight on GLP-1 drugs and this variation might start at the genetic level. 2️⃣ To understand why, a large GWAS of 27,885 people on GLP-1 drugs analyzed weight loss and side effects. 3️⃣ It found that a variant in the GLP1R gene was linked to greater weight loss, each copy giving ~0.76 kg extra loss. 4️⃣ Interestingly, the same biology also influenced side effects: 1) GLP1R variants → more nausea/vomiting (often linked with higher weight loss) 2) GIPR variants → higher vomiting risk (especially with tirzepatide) 5️⃣ Together, this shows that response to GLP-1 drugs isn’t random, your genetics partly determines both results and side effects, opening the door to personalized treatment. nature.com/articles/s4158… @DrNadolsky @DrKarlNadolsky @NutritionMadeS3 @drmatthewnagra @BevTchangMD @MichaelAlbertMD

AI to detect risk of heart failure 5 years ahead of symptoms via CT scan epicardial fat tissue jacc.org/doi/10.1016/j.… @JACCJournals

the oral wegovy launch has had a rocket ship like trajectory, but will oforglipron cause a flattening? taking some predictions… because i have no clue but im fascinated by what’s going to happen next

💊GLP-1 drugs like Ozempic and Wegovy have far-reaching health benefits beyond weight loss. In a new nationwide cohort study, researchers from Beth Israel Deaconess Medical Center are adding one more to that list: Prevention of ulcers in the gut! 🔗: ow.ly/8yez50YBJUs