#191 Lipids Update with Erin Michos MD


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By The Curbsiders Inc., Matthew Watto MD, Stuart Brigham MD, and Paul Williams MD. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”!

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  • Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli
  • Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
  • Infographic: Beth “Garbs” Garbitelli
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP
  • Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Erin Michos MD MHS

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps
  • 00:00:00 Intro
  • 00:01:52 Getting to know Dr. Erin Michos
  • 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel
  • 00:11:50 Digging into ASCVD Risk Calculator
  • 00:16:12 Who should get 10 year ASCVD Risk assessment and what are the categories?
  • 00:18:13 How Dr. Michos discusses healthy lifestyle and “Primordial Prevention”
  • 00:19:42 What are “Risk Enhancing Factors”?
  • 00:22:36 Who should get biomarker testing vs CAC scoring?
  • 00:29:35 How Dr. Michos discusses statin therapy with her patients
  • 00:32:18 How to address risks of side effects
  • 00:37:57 Primary vs Secondary Prevention
  • 00:39:40 “What should my cholesterol be?”
  • 00:42:03 How often to follow-up labs?
  • 00:46:00 Differences between stain intensity
  • 00:47:57 How to manage side effects
  • 00:52:05 PCSK9 inhibitor discussion
  • 00:55:06 Aspirin, Fibrates and Icosapent Ethyl
  • 01:02:13 High Risk vs Stable ASCVD
  • 01:06:50 Take home points and the future
  • 01:10:50 Outtro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.


Listeners will feel comfortable managing both primary and secondary prevention for ASCVD among different patient scenarios.

Learning objectives

After listening to this episode listeners will…

  1. Recognize the different risk levels and further ways to hone risk-stratification.
  2. Describe primary prevention management including how to discuss lifestyle changes, statins, and managing common statin-related complaints.
  3. Recognize the importance of lipid reduction for secondary prevention and different medications to achieve this.

Dr Erin Michos reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.


Michos E, Devgun J, Garbitelli B, Chiu C, Berk J, Williams PK, Watto MF. “#191 Lipids Update with Erin Michos MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. January 20, 2020.

213 episodes