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The Proof · September 22, 2025 · 72m
Why Heart Disease Happens Even When You're Doing Everything Right
Vascular medicine specialist Dr. Dan Soffer explains why people with 'perfect' risk factors still have heart attacks — the role of Lp(a), residual inflammatory risk, and the limitations of standard risk assessment.
This summary was generated from show notes and public descriptions, not from a full transcript review. Details may contain inaccuracies.
Highlights
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Standard risk calculators miss 50% of heart attacks — they don't capture Lp(a), family history depth, or inflammatory markers
Soffer: the standard 10-year cardiovascular risk calculators (ASCVD, Framingham) use only age, sex, cholesterol, blood pressure, diabetes, and smoking. They miss Lp(a), hsCRP, coronary calcium, and detailed family history — resulting in 50% of heart attacks occurring in people classified as 'low risk.'•
Residual inflammatory risk persists even after LDL is optimized — hsCRP is the missing biomarker
Soffer: even after aggressively lowering LDL cholesterol with statins, 60-70% of cardiovascular events remain. Much of this residual risk is driven by inflammation, measurable by hsCRP. The CANTOS trial showed that reducing inflammation without lowering LDL reduces cardiovascular events.Was this useful?