本期AMA节目，Peter深入探讨了动脉粥样硬化性心血管疾病（ASCVD），这是发达国家头号杀手。Peter强调了理解ASCVD的重要性，因为它普遍存在且不可避免。节目详细介绍了动脉粥样硬化的发展过程，包括它如何在很小年龄就开始，以及胆固醇的作用。此外，讨论了ASCVD的致病因素，这些因素决定了预防策略。节目还涉及血液检查中的重要指标和生物标志物，以及用于确定动脉损伤程度的诊断测试，如冠状动脉钙化积分（CAC）和CT血管造影。最后，Peter概述了理解和解读钙化积分的关键，并总结了关于预防的要点。

❤️‍🩹 ASCVD的早期发展：Peter强调了在生命早期理解动脉粥样硬化的重要性。他解释了ASCVD的普遍性和不可避免性，及其在发达国家中的高发病率。

🩸 胆固醇与ASCVD：节目深入探讨了胆固醇在ASCVD中的作用。Peter解释了胆固醇如何参与动脉粥样硬化的发展，以及其与ASCVD风险之间的关系。

⏳ ASCVD的发展过程：Peter详细描述了ASCVD的发展过程，分为几个阶段，涵盖了从早期病变到晚期动脉粥样硬化的各个环节。他提到了不同年龄组的尸检中发现的冠状动脉病变。

🧪 诊断性测试与生物标志物：节目讨论了用于评估动脉损伤程度的诊断测试，如CAC、CTA和CIMT，以及血液检查中用于识别ASCVD生物标志物的实验室指标。

🔑 预防的关键：Peter强调了预防ASCVD的关键要点，包括理解和解读CAC评分，以及基于风险因素采取的干预措施。他还讨论了关于预防的要点，为听众提供了实用的建议。

View the Show Notes Page for This Episode

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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of atherosclerotic cardiovascular disease (ASCVD)—the number one killer in the developed world. Peter argues for the importance of paying attention to and understanding ASCVD given its ubiquity and inevitability. He goes into great detail about the development of atherosclerosis and how it can take hold at a very early age, the role of cholesterol, and the causal factors of ASCVD that determine prevention strategies. Additionally, he discusses the important metrics and biomarkers found in blood work, as well as diagnostic tests such as coronary artery calcium scores (CAC) and CT angiograms which help to determine the level of arterial damage present. Finally, Peter lays out the keys to understanding and interpreting calcium scores before wrapping up the conversation with his key takeaways regarding prevention.

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We discuss:

• The importance of understanding atherosclerosis early in life [2:15];
• Defining atherosclerotic cardiovascular disease (ASCVD), its causes, and the role of cholesterol [9:00];
• The process of developing ASCVD, part 1 [15:00]; 
• The process of developing ASCVD, part 2 [24:00];
• The process of developing ASCVD, part 3 [32:45];
• How early in life ASCVD can start to develop [40:30];
• Case studies of atherosclerosis and figures showing real pathology [43:00];
• Coronary artery lesions present in autopsies of different age groups [49:15];
• The causal factors of ASCVD that determine prevention strategies [52:15];
• Labs to identify biomarkers of ASCVD ]59:00];
• Diagnostic tests to determine the level of arterial damage present—CAC, CTA, CIMT, and more [1:00:30]
• Keys to understanding and interpreting a CAC score and/or CTA results [1:05:15];
• Is there a risk from cholesterol levels being too low? [1:13:00];
• Key takeaways regarding prevention [1:15:45];
• More.

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