The invisible elephant....
I waited yesterday...Waited with baited breath...and then nothing but silence...
At 5 PM..Still no mention of what I consider the most important point of the REDUCE-IT trial...And that is the changes in the EPA/AA ratio...
That's really what R-I was all about...They weren't putting patients on exercise routines, they were not changing their statin dosages...They were increasing their intake of EPA...
What is wrong with these people that they can be so blind...All they could talk about was the surprising finding that the event reductions were fairly consistent over a wide range of triglyceride levels..As a former MIT student that would suggest to me something other than triglycerides was stirring the pot.
The whole trial was a double blind where the active drug was 4gms EPA Qd...Is everyone so tied into orthodox cardiology..so stuck on the lipid levels that they don't even seem to understand that what really was changed was the EPA/AA levels..and this change was what was creating the pathophysiology which result in the clinical benefits...
What these cardiologists need to understand is effects of systemic inflammation (SI) on the whole menagerie of factors that effect CVD event risk...The first thing these guys..including Bhatt, need to look at is the relationship of EPA/AA ratios to CVD event risk...before they look at trig or other lipid levels...EPA/AA ratios profoundly effect SI levels and SI levels profoundly effect sugar and other lipid levels..SI levels factor into the activity levels of insulin, FAS, and other enzymes which determine sugar and lipid levels by controlling the rate they are removed from the blood stream and stored in the adipose tissue..
Trigs, sugars and other lipids are the tail of the dog...EPA/AA ratios are the head... EPA/AA ratios are the main determiners of SI and CVD event risk is heavily effected by SI levels..In the JELIS study when they looked at CVD event risk..It lined up precisely with EPA/AA ratios and did so independent of the arm of the trial the patient was in..In a nutshell elevated SI increases CVD event risk at many different junctures..it increases insulin resistance, lowers FAS activity. increases inflammation at the endothelial juncture..increases proteolytic enzymes and effects signalling in ischemic events which increase the radius 0f cell damage, increases platelet adhesion...on and on...
But not even q mention of the changes in EPA/AA ratios from the presenters...Shameful...
":>) JL
