🚨🚨🚨🚨🚨🚨🚨🚨 BREAKING: Matthew Budoff MD has now presented the matched analysis for: KETO (#LMHRstudy) vs Control (#MiHeart) -🙏Please RT🙏- METHODS – 80 Participants of #LMHRstudy fell within #MiHeart age range and were then matched 1:1 for age, gender, race, diabetes mellitus, hyperlipidemia, hypertension, and past smoking to asymptomatic subjects... from the #MiHeart cohort. PRIMARY ANALYSIS – High resolution heart scans (#CCTA) allowing for primary analysis of Total Plaque Score (TPS), Total Stenosis Score (TSS) and Segment Involvement Score (SIS) RESULTS The matched mean age was 55.5 years, with mean #LDL cholesterol of 272 mg/dL (max LDL-C 591) mg/dl and mean 4.7 years duration on a ketogenic diet. 🚨 There was no significant difference in coronary plaque burden of #LMHRstudy (mean LDL-C 272) cohort as compared to #MiHeart controls (mean LDL 123 mg/dl); nb: pre-KETO LDL-C in KETO group was 122 mg/dl 🚨 There was no significant difference in CAC (median and IQR) [0 (0,56)] versus [1 (0, 49)], p = 0.520 🚨 No relationship of LDL-C elevations and plaque ⚠️ This analysis is on baseline scans and the study is still ongoing for second CCTA completion in our cohort by February of 2024. And as always, please continue to work with your doctor. - I will have my own video reaction and thoughts in the coming hours. 🙏🙏🙏 to everyone -- and I mean everyone -- who helped us get to this pivotal milestone. 🙏🙏🙏show more

@BudoffMd I can now report stats consistent with the hypothesis that @realDaveFeldman is, in fact, the devil How dare he rise to the challenge and publish papers and help produce an #LMHRstudy without an MD! How dare he chase his curiosity with integrity and an open-mind! The horror!

@BudoffMd 😂

Super interesting. It's early days, and a small cohort, but I feel that this line of work promises to teach us something new about the relationship between LDL-cholesterol/apo B-containing particles and ASCVD. Even though it's just the baseline data, given that participants were on keto, supposedly with similarly high LDL-cholesterol, for almost 5 years, one would have expected at least a small detectable difference in the amount of plaque. It's these unexpected findings that sometimes teach us the most, so I will be following publications and future follow-ups of this or similar cohorts closely. The longitudinal data with changes in plaque and CAC scores will be very interesting. Definitely looks like a good effort, and I know firsthand how tricky it can be to obtain funding for something that tests an against-the-grain hypothesis like this. Congrats, @realDaveFeldman, @BudoffMd, and team. On the flip side, I was just about to publish a 45-min video about blood lipids and ASCVD risk. This new finding will now necessitate a bit of a revision ...

Hi @mario_kratz -- First, sorry to hear about disrupting the planned video, I know you take a lot of time and care in putting them together (I've watched many). But of course, you also know I couldn't have discussed until released (yourself being in the craft). Second -- if you don't mind my asking, (and there's no wrong answer to this, btw) have these data impacted your own personal opinion on what you were going to share in the planned video?

@BudoffMd I've been waiting almost 25 years for a study such as this. Just what's been needed looking at CV risk, proper imaging (CAC, CTCA) and ketogenic diets. Kudos to @realDaveFeldman @BudoffMd @nicknorwitz @khurramn1 @Agatston_Center and many others...

@BudoffMd Hmm, so 4.7 yrs of sky high LDL levels didn't result in more coronary plaque compared with control participants with less than half the LDL level. Surprise, surprise! Maybe high LDL doesn't confer the risks we were told, at least for LMHRs (like me).

@BudoffMd Thanks for sharing Dave. When will the paper be published? Looking forward to reading it

@BudoffMd Abstract will be published in Metabolism. The full paper is submitted, but as you know, that's not a predictable process with regard to timing – but hopefully it will be out soon.

@BudoffMd the next q about "ascertainment bias" the whole claim is that high LDL, in and of itself, causes atherosclerosis. when it doesn't, they just waive it away with "well the people are just healthy." Exactly! That's the point.

@BudoffMd I’m interested in anything that would be considered a confounder in that it should also likewise be considered a means of treatment for those with diseases associated with high LDL and ASCVD (ie monogenetic FH)