Episode notes
This week's sweep is organized around the comparator — what a treatment was actually tested against, and whether that's the comparison you face in clinic. It leads with VESALIUS-CV, the evolocumab trial in high-risk patients without a prior heart attack or stroke, covering what the twenty-five percent figure means in absolute terms, why "without prior MI or stroke" is not the same as primary prevention, the fact that only one in five patients was on ezetimibe and the 2026 guideline's decision to no longer require ezetimibe before a PCSK9 antibody, the diabetes subgroup published in JAMA, and the FDA label expansion that came before the trial. It pairs that with the VA/DoD lipid guideline synopsis in Annals, which lays out the stepwise path the trial skipped. Then a Core IM episode on triglycerides under the 2026 guideline — when to check non-HDL or apoB, a three-day carbohydrate trial, icosapent ethyl, fibrates for pancreatitis, and the new apoC-III drugs, with both open triglyceride thresholds now settled from the guideline text (apoB testing at one hundred fifty after a June correction; risk enhancer at one hundred seventy-five nonfasting or one hundred fifty fasting); the SUPER trial of supervised exercise after ACL reconstruction; the KDIGO 2026 anemia in CKD guideline in brief; and two Pediatrics in Review In Brief pieces, on diaper psoriasis and on retinoblastoma and the red reflex.