Dr. Pam R. Taub talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting. In part 6 of this Exclusive Interview, Dr. Taub discusses calcium scores and starting patients on PCSK9.
Dr. Pam R. Taub, MD, FACC is a board-certified cardiologist who focuses on general and preventive cardiology. As a general cardiologist, she works with patients to diagnose and prevent heart disease, as well as manage conditions such as hypertension (high blood pressure), diabetes, coronary artery disease, or heart failure. Her own research—focused on how epicatechin (a compound found in dark chocolate) can improve mitochondrial structure and exercise capacity in patients with heart failure and diabetes—has received funding from the National Institutes of Health and the American College of Cardiology, and has resulted in multiple publications in top journals. She is also developing and testing new biomarkers (blood tests) to predict cardiovascular risk, as well as studying the mechanisms of statin-related muscle complaints and decreases in exercise capacity and using epicatechin to treat them.
Transcript of this video segment:
Steve: So what about the calcium score? Is there any reason to check the calcium scores? Most doctors don’t do that. Is there a benefit to that?
Dr. Taub: Well, coronary calcium scoring has been shown in study after study to be very predictive of outcomes. It’s another test that you can use to risk stratify somebody. Somebody who has a high calcium score you want to be more aggressive with in managing their lipids versus somebody that does not. It’s another tool. Sometimes I’ll use it but usually the biomarkers that I check give me enough information.
Steve: So in the new drugs the PCSK9s, how do you start a patient on it? Do you just give them the first shot and they walk out the door, and they come back in two weeks?
Dr. Taub: That’s a good question, because they are relatively new drugs, you have to go through a pretty extensive approval process from the insurance company. You have to document the patients have tried different statins. What doses of statins, you have to document what their LDL is. Once the drug is approved by the insurance company, what we’ll typically do is we’ll ask the patient to come in for their first injection so our nurse can walk them through it. It’s actually very simple, the needle is a very small gauge needle. Most patients say they can’t even feel it. We do walk them through the first injection. The companies also provide nurses to come to the patient’s home to walk them through the first injection. After the first injection, patients usually feel very comfortable injecting themselves and it’s once every two weeks.
Steve: When can you expect to see results?
Dr. Taub: I’ve seen amazing results in 3 months, when I check their next lipid profile.
To view other segments in this video series:
Part 1: A Cardiologist’s Perspective on Diabetes
Part 2: New Cholesterol Drugs PCSK9 Inhibitors
Part 3: PCSK9 Side Effects
Part 4: Working with Diabetes Patients
Part 5: Advice on Treatment Methods
Part 6: Starting on PCSK9s
Part 7: Recommending New Drugs
Part 8: Results of Using New Drugs