Andrew J Sauer MD

My top ten tips for graduating fellows and faculty entering and continuing “early career” as I am transitioning into “mid-career”. A thread:

1/9: The MASH treatment landscape is exploding! Resmetirom recently became the first FDA-approved drug, but new meta-analyses and trials show GLP-1s (Semaglutide, Tirzepatide) and FGF21 analogs might edge it out. Let's break down the latest data. 🧵👇

The FDA has approved Wegovy HD (semaglutide 7.2 mg) for adults with obesity. In the STEP UP trial, average weight loss was about 21 percent at 72 weeks for those who stayed on treatment and 19 percent when including all participants. About one in three reached 25 percent or greater weight loss. prnewswire.com/news-releases/…

Unexpected forms of generosity: -Being early can be a form of generosity. You wait, so they don't have to. -Leaving something unsaid can be a form of generosity. You don't always need the last word. -Delivering your work on time can be a form of generosity. You make life easier for everyone downstream. -Not taking things personally can be a form of generosity. You give people the space to say things imperfectly.

Association Between Cardiovascular-Kidney-Metabolic Syndrome and Myocardial Injury After Noncardiac Surgery: A Retrospective Cohort Study Advanced CKM stages independently predicted an increased risk of MINS. These findings may improve perioperative risk assessment and guide preventive strategies. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @JACCJournals @ACCinTouch @DrMarthaGulati @hvanspall @AndrewJSauer @ShelleyZieroth @ankeetbhatt jacc.org/doi/10.1016/j.…

Recovery has a way of teaching lessons that strength alone never could. This scar is a reminder of a fall, a fractured patella, surgery, pain, limitation, and the long process of healing that follows when progress cannot be rushed. Bone healing is one thing. Rebuilding trust in your body is another. Now comes the next phase: reconstructing my legs, restoring strength, working through discomfort, and committing to become stronger and better than I was before the injury. Setbacks do not get the final word unless we let them. Adversity can diminish us, or it can refine us. I am choosing to see this as an opportunity to rise to the challenge, stay disciplined, embrace the work, and build a better version of myself than existed before the fall. Healing is not passive. It is intentional, humbling, and earned one rep at a time.

🚨 BREAKING FDA APPROVES HIGH DOSE SEMAGLUTIDE FOR OBESITY. 3x THE CURRENT HIGHEST DOSE OF 2.4 WEEKLY. 7.2MG WILL BE KNOWN AS “WEGOVY HD”. SIMILAR WEIGHT LOSS TO 15MG ZEPBOUND. $LLY $NVO $HIMS

🚨$LLY Retatrutide’s TRANSCEND-T2D-1 topline results. In just 40 weeks, participants on the max dose achieved weight loss of 15.3% (with 16.8% for the efficacy estimand). This was not an obesity trial, but just T2D. These are big numbers for a T2D (not obesity too) trial. These 40 week trials normally range between 9-11%. (Minimum starting BMI of 23.) A1C reduction was as high as 1.9% on the top two doses for the treatment-regimen estimand, and 1.9-2% for the efficacy estimand. ▪️The most common adverse events among participants treated with retatrutide (4 mg, 9 mg, 12 mg) were nausea (16.4%, 19.5%, 26.5%, respectively vs. 3.7% with placebo), diarrhea (18.7%, 26.3%, 22.8%, respectively vs. 4.5% with placebo) and vomiting (15.7%, 15.0%, 17.6%, respectively vs. 2.2% with placebo), and occurred primarily during dose escalation. ▪️Incidence of dysesthesia occurred in 4.5%, 2.3% and 4.4% (4 mg, 9 mg and 12 mg, respectively) of patients treated with retatrutide, compared to 0.0% with placebo. These dysesthesia events were generally mild, with a majority resolving during treatment. ▪️Discontinuation rates due to adverse events were 2.2%, 4.5% and 5.1% with retatrutide 4 mg, 9 mg and 12 mg, respectively, compared to 0.0% with placebo. investor.lilly.com/node/54026/pdf

GLP-1 drugs have established benefit for Type 2 diabetes. New data suggests that extends to Type 1 diabetes, with heart, vascular, and kidney protection nature.com/articles/s4159…

Heart transplantation is entering a new era — shaped by innovation, data, and clinical insight. JCF invites submissions for a dedicated Focus Issue on Innovations in Heart Transplantation. 📅 Deadline: April 10, 2026. #CallForPapers #HeartTransplantation #Cardiology

A new finding after stopping GLP-1 drugs in a large cohort with Type 2 diabetes: rapid erosion of CV benefit/protection New @bmj_latest by @zalaly @Biostayan bmjmedicine.bmj.com/content/5/1/e0… See thread: x.com/zalaly/status/…

Do GLP1s cause pancreatitis? I ran the systematic review and meta-analysis: 31 RCTs with 40,274 patients Results: Placebo — 50 cases/17433 patients GLP1 (Semaglutide or Tirzepatide) — 59 cases/22841 patients OR 0.99 (95% CI 0.67-1.45) Conclusion: There's no obvious pancreatitis safety signal in these pooled randomized data, but the overall incidence of acute pancreatitis was very very low

🚨The latest alarming look at real-world use of #GDMTworks for #HF 🇺🇸Optum database 2020-2023 -Enormous gaps in #GDMT use, across the LVEF spectrum -When initiated, usually only after a substantial delay 🤯🤯🤯 @DCRINews @JAHA_AHA ahajournals.org/doi/10.1161/JA…

The VESALIUS-CV trial is a really interesting and important trial that is very informative with regards to lipid lowering therapy and benefit. It builds on the many foundational randomized controlled trials that have come before demonstrating the benefit of LDL lowering. 🧵

Nobody is rooting for you to fail. Maybe you’ll succeed. Maybe you’ll fail. For the most part, nobody cares one way or the other. This is a good thing! The world is big and you are small, and that means you can chase your dreams with little worry for what people think.

🚨 Excited to share our latest publication in @JACCJournals - JACC: Advances! 🚨 Our study compares #Inclisiran vs #Ezetimibe in CAD + hyperlipidemia showing lower 1-year mortality, MI, and stroke with inclisiran, along with better LDL goal attainment: doi.org/10.1016/j.jaca…

Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…

Use of the preCARDIA system in patients with ADHF was feasible and well tolerated, with early exploratory signals of significantly reduced cardiac filling pressures and increased urine output. jacc.org/doi/10.1016/j.… #JACCHF #HeartFailure @RAYANYOUX

Dr. Mentz has a timely and fascinating conversation with Dr. Farr on the present and future of heart transplantation with DCD hearts at the Technology and Heart Failure Therapeutics (#THT2026) Meeting.

@venkmurthy Asymptomatic patient with high CAC was considered “may be appropriate” in the old AUC document. No longer in the 2023 document. It is a shame it was ever in there!

Use of the Electrocardiogram in Acute Myocardial Infarction | New England Journal of Medicine nejm.org/doi/full/10.10…