I didn't want to cover this because this is a critical question that comes up a
whole lot. People are looking at calcium scores versus CIMT and that whole
conundrum of "Wait a minute, my calcium got worse, so I'm worse off, right?" And
we keep saying, no, we want that... we want soft plaque to calcify. This is the
actual... this is an actual study that shows that. So these are two plaques.
They're basically comparable. This one... you can't see quite as well because
that's... which one's soft and which one's hard? Somebody in here knows? The right
one is hard. That's calcium, that white stuff is calcium. Radiolucent... and what is
that radiolucent? This, no, I can't remember those terms. The white is calcified.
So if you look at it, you can actually... it's not just subjective. They actually
quantify it using those little bubbles and some technology. Here's what happens.
The guys with the calcified, it still did have a couple of events. But those are
the guys that had soft plaque (29 events in 112 cases). There's the guys that had hard plaque (4 in 103). So
that's why we keep saying we want you here, and lifestyle will get you here. We don't
want you there. Do you understand what this is? Life table analysis. It's the
probability of having an event. Every time somebody in the study in the
population has an event, the population goes down. So each one of these drops is
an event. And this solid line is the people that had the soft (echolucent) plaque.
The same lifestyle. His lifestyle. Well, that I mean we know that from some other
studies. This study won't tell us that. But you know they've been studies where
they compare medication to lifestyle. Hit the head. Moderate the lifestyle. Winds
out every time. So there's nothing that I or any other doctor can do that will
impact your health and future like youth like the decisions you make all day,
every day. How much you sleep, how good your sleep is, how you protect that sleep,
how you do the boring stuff that helps you sleep, have how many carbs you eat,
what your BMI is, how heavy you are. That's called a
Kaplan-Meier life table analysis. So what that is is you've got two populations.
You got a study population.
You got a study population that's got...
they have clear plaque. Let's go back up. They have clear plaque.
This is important for what we're doing today and for a major reason the most of
you came here. The question again is is calcified plaque really that much safer?
Because all I hear is the higher my calcium score, the worse off I am. And
what they did... this is a study where they took people, and they measured... they
classified them into two different areas. This is somebody with
a calcified plaque (right). That's what it looks like on your IMT. You're not likely to
see a whole bunch of other people's I am teased but I can tell you it's out
there. It's clear. And we look for progression from this to this. This is
soft plaque (left). That's calcified plaque (right). Any questions about that concept? This
is soft plaque, and that's... and this is again if she said well how do
you know that you can get certain gradations. You do get certain gradations.
We do have quantification systems for grading. How much quantifying how
much plaque there is now. So they took the two populations 112 in the solid
line echolucent. And is that confusing you? The term "echolucent"? Because it
confused me. These are the guys that had soft plaque on statins. They had
hard plaque. But this isn't a gun and it stands have impact this issue. But this
has got nothing to do with whether you got statins. This has got to do with
whether you've got soft or hard plaque. This... of the guys with hard plaque/calcified
plaque did have some. They can't... they had a couple of events early on. So yeah.
Which is what you'd expect actually. Lends some validity to what these
guys are telling the truth and not... making something up.
This is the hundred. So this is what... 112... wait, and it's sort of like a
double negative and I keep getting confused on trying to use the term
"echolucent." Listen, I'm not going to try. These are the guys that had soft plaque (solid line). These are
the guys... they had a hard plaue, calcified plaque (broken line). Well, you can assume even more so
that they were probably doing some stuff in terms of their lifestyle. I mean it's
clear... it's clear lifestyle has a bigger... a 30-pound weight loss, you can't
match with any kind of statin. A 15-, 20- pound weight loss, you can't match with
any kind of statin. Fat mass in and of itself drives inflammation, drives
softening of plaque. Yes, statins do impact. If there's no
question. But is it all statin? No. I mean that's part of the... that's part of the
difference between what you'll get here versus what you'll get out in the
standard community. They'll look very quickly for a whole bunch of reasons to
put you on statin that I wouldn't put you on a statin.
The Louisville event was an incredible success. Many people didn't know that
that was our first attempt to coordinate the whole thing ourselves. And it was
better than we had had hoped. A lot of focus, and people saying, you know what, I
know that we can deal with this together as a group. There are other people that
I'm meeting here at this event that are doing the same things I'm doing and with
success. I don't have to be a doctor to know all this stuff. We are going to go
ahead and have another one on February 28th in the Hyatt Regency Grand
Cypress in Orlando.