Hi Dave — thank you for the kind words on our NATURE-CT publication. You asked a fair question: how would Keto-CTA look if we only looked at the people with CAC ≤ 100, just like we did in NATURE-CT? Any comparison using the original KETO-CTA data is no longer valid. The paper was formally retracted by JACC Advances at the authors’ own request. The retraction notice is here: jacc.org/doi/10.1016/j.jacad… Even setting the retraction aside, the plaque progression rates in the keto/LMHR group were much higher than the healthy rates we reported in NATURE-CT: ~18.9 mm³ median NCPV increase vs ~4.9 mm³ annualized in NATURE-CT. This faster plaque progression is the adverse effect directly linked to the very high ApoB/LDL-C levels caused by the keto diet. The public should be warned that this is likely a dangerous approach, especially for those who show rapid plaque progression as defined by OUR study. Standard of care guidelines from the ACC and AHA recommend lowering ApoB and LDL-C to reduce heart disease risk. They advise against allowing sustained high levels like those seen in keto dieters. Caution is essential. We can now define and treat rapid progressors even before calcium is present, as documented in our First-in-Human paper: jacc.org/doi/10.1016/j.jacca… This is further supported by performing serial imaging—an approach we first described in 2013 in Atherosclerosis: atherosclerosis-journal.com/… We subsequently confirmed this over 13 years using current technology in our 2022 paper on serial analysis of coronary artery disease progression by AI-assisted coronary CT angiography: pubmed.ncbi.nlm.nih.gov/3643… We all agree that baseline plaque strongly predicts future plaque. But decades of research also show that sustained high ApoB/LDL-C drives atherosclerosis progression. In this group who chose the keto diet often against "standard of evidence advise", close lipid monitoring and careful risk assessment are essential. Keto is likely harmful to arteries for most people, even if some tolerate it well. Looking forward to continuing open discussion. Best Ron Karlsberg MD FACP FAHA FACC MSCCT (Lead author, NATURE-CT)@realDaveFeldman @DLBHATTMD @MichaelAlbertMD @CMichaelGibson @RonBlankstein @chamath @ethanjweiss

Don't miss your chance to boost your expertise in cardiovascular CT! Join us for the 18th Annual SCCT Board Review Course. Register now: scct.org/page/BoardReviewVir…

And it may very well be one of the pathways for the mitigation and eradication of CAD x.com/RonKarlsbergMD/status/…

This will be an interesting pathway, first for those who fail other approaches: x.com/RonKarlsbergMD/status/…

@BudoffMd @ChinnaiyanMD @DrKelleyBranch @damini_dey @RonKarlsbergMD @MichaelCoordsMD

On my way to Miami to meet 200 fellows for what promises to be a fantastic learning experience. Looking forward to the energy, and discussions ahead 😎

One of my NIH grant reviews came back last year with comments clearly LLM-generated. The PMIDs cited against the proposal were hallucinated. The papers did not exist. The score still counted toward the funding decision.

A man spends 50 years teaching at MIT. He knows his time is running out. So he records one last lecture — everything he knows, distilled into a single hour. He died 5 months later. This is that lecture. The most important hour you'll watch this week. 👇 Bookmark it for later

First time at #EuroPCR @PCRonline a dedicated Physiology Course. Physiology is becoming available in every case—#CCTCA, angio or invasive. Understanding the fundamentals is key to interpretation and decision-making. FFR is not only an index; it is a concept. Join us on Monday 18 in Paris. #Physiology #FFR Don't miss it pcronline.com/Courses/EuroPC…

The American Heart Association mourns the passing of the legendary cardiologist Eugene Braunwald, M.D., widely recognized as one of the most influential figures in the history of cardiovascular medicine. Over seven decades, his work reshaped the understanding and treatment of heart disease, leading many to call him the father of modern cardiology. Braunwald was a lifelong contributor to the American Heart Association, helping advance its research and scientific mission, and was honored with some of the Association’s highest honors for his lasting influence on cardiovascular care and research. His influence extended well beyond his own discoveries, as generations of Association‑supported investigators, clinicians and academic leaders were trained by Braunwald or guided by the clinical trial standards and mentorship models he helped establish. newsroom.heart.org/news/amer…

This post and others sparked a lot of questions about cholesterol, which were answered to answer to help clear the air and address the misinformation that often scares our patients. For a general discussion about cholesterol, here’s an easy-to-read study that may be helpful: sciencefocus.com/the-human-b… @ShelleeC

#SCCT2026 will bring you 4 days of outstanding scientific sessions from world-class speakers, with an exhibit hall showcasing the latest #YesCCT technology. ow.ly/bKgb50YCnFO