vialroom
Fortnightly digest · 2025-09-08 → 2025-09-21

cardiovascular outcomes, and what the room does with an endpoint

A cardiovascular outcomes trial got a proper reading in the bloodwork channel, which by now is where the room does its careful work. The interesting argument was not about the result but about what a member with no cardiovascular disease should take from a secondary-prevention population. The honest answer, arrived at slowly, is not very much.

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What happened

  • SELECT in NEJM 2023 was read for its population as much as its endpoint, and the distinction did most of the work in the conversation.
  • A secondary-prevention result does not transfer cleanly to a member with no established disease, which several people wanted it to.
  • apoB versus LDL cholesterol came up again and this time produced a practical suggestion, which is to track whichever one you can get repeatedly.
  • STEP 2 in Lancet 2021 was brought in by a member with type 2 diabetes who wanted the trial that actually studied people like them.
  • Two members posted twelve-month lipid panels side by side and the difference in what improved was a useful corrective to any single story.

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