This presentation was scheduled for February 2016 but It had to be canceled or postponed because of a bout of shingles. It was meant to convey my understanding of the most prominent cause for coronary artery disease gleaned from my greater than 40 years of clinical cardiology practice, whom the vast majority were post age 65 and Medicare beneficiaries. From this experience I am able to identify by extrapolating backwards to age 20 and identify those at risk cardiac events.

Today we try to instruct internists to identify at risk patients prospectively i.e. to identify those at risk starting around age 40 by using (in my opinion) various flawed risk calculators which yield probabilities or chance. If one should be included or excluded from risk and suffer an event, once that event occurs that event is a 100% for that individual whether the patient was treated with a Statin or not.

The vast majority of my patients had FCH (Familial Combined hyperlipidemia) which included significant triglyceride abnormalities. Today's risk calculators only indirectly and incompletely consider Remnant Lipoproteins (the major undesirable lipoprotein causing the greatest cardiovascular disease events) which may or may not be able to be identified by triglycerides.

There is strong emphasis on the statins as the KING of cardiovascular disease prevention by those having a vested interest (the Pharmaceutical companies who control the trials and there academicians)  However, the statins are significantly incomplete treatment for FCH

Watch how the Statins and other medications addressing LDL cholesterol alone compare to more vigorous treatment of LDL cholesterol