Ep:385 REPLACE STATINS WITH THIS FDA-APPROVED PLAQUE STABILIZER

Summary

Dr. Rob Cvis discusses the underutilized drug colchicine as a powerful anti-inflammatory for cardiovascular disease, which the FDA has approved to be more effective than statins in reducing risk. He emphasizes its benefits for secondary prevention, particularly in patients with high CRP levels, and suggests it as a safer and cost-effective alternative to statins, potentially in combination with low-dose aspirin, for reducing inflammation and vascular events.

Takeaways

• 👨‍⚕️ Dr. Rob is discussing the underutilization of colchicine compared to statins for cardiovascular disease, despite its proven effectiveness.
• 💊 Colchicine, known for treating gout, has been FDA-approved for its higher risk reduction in cardiovascular disease compared to statins.
• 🧬 Colchicine's history dates back to 1500 BC, originally used for joint inflammation and is derived from a plant.
• 🔍 The drug works as a powerful anti-inflammatory, which is crucial in addressing the root cause of cardiovascular issues rather than just the symptoms.
• 💡 Dr. David Nebert, an electrophysiology cardiologist, highlighted the benefits of colchicine for secondary prevention in patients with existing cardiovascular disease.
• 📉 High-sensitivity C-reactive protein (hsCRP) levels are a significant indicator of inflammation and cardiovascular risk, where colchicine can be beneficial.
• 💲 The low cost and less aggressive marketing of colchicine may contribute to its lesser-known status compared to statins.
• 🛑 For patients with a history of heart attack, stroke, or significant plaque burden, colchicine should be considered as a serious medication option.
• 🚫 The script suggests that colchicine might be a replacement for statins rather than used in conjunction due to its anti-inflammatory properties.
• 📚 A study published in the Journal of the American College of Cardiology emphasizes the predictive power of hsCRP over LDL cholesterol for cardiovascular events.
• 📉 FDA approval in June 2023 recognized colchicine's role in reducing the risk of major adverse cardiovascular events, including in patients with atrial fibrillation.

Q & A

Who is Dr. Rob Cvis and what is his area of expertise?

Dr. Rob Cvis is a specialist in lipidology and cardiology, often referred to as the 'carb addiction Doc'. He focuses on the effects of carbohydrates on health and the role of various treatments in managing cardiovascular diseases.

What is the main point of the video regarding the use of Statins by cardiologists?

The video suggests that cardiologists often insist on prescribing Statins for cardiovascular disease, despite the availability of other drugs like colchicine that may be more effective at reducing the risk of cardiovascular events.

What is colchicine and how is it typically used?

Colchicine is a drug that has been used for centuries and is typically prescribed for conditions like gout and inflammation. It is derived from a plant and was known as early as 1500 BC.

Why does Dr. Cvis believe colchicine is more effective than Statins for certain cardiovascular conditions?

Dr. Cvis believes colchicine is more effective because it is a powerful anti-inflammatory that significantly reduces vascular inflammation, which is a primary factor in cardiovascular diseases. The FDA has approved colchicine for reducing coronary artery disease risk at a level greater than Statins.

What is the role of inflammation in cardiovascular disease as discussed in the video?

Inflammation is presented as a key factor in cardiovascular disease. It is suggested that by reducing inflammation, particularly in the blood vessels, the risk of cardiovascular events can be significantly lowered.

How does colchicine work in relation to atherosclerotic cardiovascular disease?

Colchicine works by reducing the activation of white blood cells, decreasing their aggressive function, and reducing their adhesion to plaques, which are a major component of atherosclerosis.

What is the significance of C-reactive protein (CRP) in the context of the video?

CRP is highlighted as a marker of inflammation that is more predictive of cardiovascular death than LDL cholesterol. Elevated CRP levels are an indication for considering colchicine as a treatment option.

What is the FDA's stance on the use of colchicine for cardiovascular disease?

The FDA has approved the use of low-dose colchicine to reduce the risk of major adverse cardiovascular events, including heart attack, stroke, and cardiovascular death in patients with established atherosclerotic disease.

Why does Dr. Cvis suggest that colchicine could be a better alternative to Statins for some patients?

Dr. Cvis suggests that colchicine could be a better alternative due to its anti-inflammatory properties, its effectiveness in reducing cardiovascular risk, and its lower cost compared to Statins.

What is the recommended dosage of colchicine according to Dr. David Nebert, as mentioned in the video?

Dr. David Nebert recommends a low dose of 0.5 mg of colchicine for patients with elevated CRP levels and a history of cardiovascular disease, as part of a secondary prevention strategy.

How does Dr. Cvis view the combination of low-dose aspirin and colchicine for certain patients?

Dr. Cvis sees the combination of low-dose aspirin and colchicine as a potentially healthier and more effective alternative to Statins, especially for patients with a history of cardiovascular events and ongoing inflammation.