Jeff Sternlicht: A Heart Attack Should Not Be the Starting Line
Jeff Sternlicht, Emergency Physician and Medical Director at Vituity, shared a post on LinkedIn:
“The plaque that causes tomorrow’s heart attack is already there today.
Yet we divide cardiovascular prevention into two categories:
- Primary prevention before the first event.
- Secondary prevention after it.
Those labels are useful. But atherosclerosis does not suddenly become more real after a heart attack.
A new prespecified VESALIUS-CV analysis presented at ESC 2026 makes that point difficult to ignore.
Among more than 12,000 high-risk adults without a prior heart attack or stroke, adding evolocumab reduced the risk of a first heart attack by 36%. Five-year incidence fell from 4.1% to 2.7%.
This does not mean everyone with minimal plaque needs a PCSK9 inhibitor.
It does mean we should not wait for the first event before treating established disease seriously.
Risk factors estimate who may develop atherosclerosis. Imaging can show us who already has it.
Once plaque is present, the goal is to change its trajectory before it causes harm.
A heart attack should not be the event that finally convinces us the plaque was dangerous.”
Other posts featuring Jeff Sternlicht on Hemostasis Today.
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Sep 19, 2026, 00:48Mahmoud Mehawed: Heparin vs Warfarin vs DOACs Understanding the Key Differences
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Sep 18, 2026, 17:48Ronak H. Mistry: Updated ASH Guidelines Bring New Focus to Iron Deficiency
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Sep 18, 2026, 17:32Hassan Kawtharany: New Ferritin Cutoffs for the Diagnosis of Iron Deficiency With or Without Anemia