American College of Cardiology (ACC) Meeting Updates 2026

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Announcer 0:00

Welcome to the MedEvidence Monday Morning Radio Show, hosted by Kevin Geddings of WSOS and Augustine Radio, and powered by ENCORE Research Group. Each Monday morning, Dr. Michael Koren calls in to bring you the latest medical updates with a insightful discussions. MedEvidence is where we help you navigate the real truth behind medical research, both a clinical and research perspective. So sit back, relax, and get ready to learn about the truth behind the data in medicine and healthcare. This is MedEvidence!

Kevin Geddings 0:31

Dr. Michael Koren joining us live in the studio line and we appreciate him taking time out of his day because he's very busy today, well, all days, but todat he's in New Orleans, at the American College of Cardiologisty meeting, which is a big deal in the world of heart health, correct?

Dr. Michael Koren 0:47

Yeah, so we have two major U.S. medical meetings for cardiologists. One is called the American Heart Association meeting, which typically happens in November, which I think I spoke with you at here in New Orleans. And just coincidentally, this meeting is also in New Orleans, and this is the other big meeting called the American College of Cardiology. So I am here doing my thing in New Orleans, going to different meetings and learning what is the latest and greatest in my field.

Kevin Geddings 1:15

Yeah. And indeed, there's some headlines coming out of that conference in New Orleans, and you'll be seeing that in the news over the next couple of days as well. But a lot of talk about, you know, cholesterol and the parameters of determining whether or not you have cholesterol that should be addressed in some way with medication and the like, right? Some changes to that.

Dr. Michael Koren 1:32

Yeah, so periodically leaders in the cardiology community get together and they put out guidelines. And the guidelines are important because they're the information that gears doctors in terms of their approach and problems in cardiology and other medical problems, of course. And they're also important because this is what insurers will pay for. This kind of sets the policy for the country. So the lipid guidelines, cholesterol guidelines, were just changed this week. And that's been a big focus of discussion here at the meeting in New Orleans. And the bottom line about these guidelines is that they're not changing that much from the previous version. But they're making it very clear that we believe that lower is better when it comes to cholesterol, faster is better, getting down to your goal as quickly as possible, and using these medications when necessary as soon as possible, meaning earlier in your life. And then simpler is better. So again, take-home message is faster is better, lower is better, and simpler is better.

Kevin Geddings 2:35

There you go. And indeed, uh you all have some ongoing studies that folks can participate in, one dealing with gene editing and some of these issues, right?

Dr. Michael Koren 2:44

Yeah, so that's a interesting new technology that's also been something we've talked about here at the meetings in New Orleans. And just for people that aren't familiar, gene editing is not changing your chromosome so that your kids get a new gene, but it's actually targeting a certain organ, in this case, the liver, and it's changing the expression of genes in that organ alone. So we're about to start studies that are just absolutely mind-blowing, where we can get a medicine just to the liver and change the way the liver expresses its its genetic components such that it doesn't make a bad protein called PCS K9. And we we have other drugs in the market that block PCSK9, but imagine, Kevin, having a treatment that you just take once, once in your life, and it corrects the gene in your liver that's producing this bad protein. So this is some stuff we're doing now. And uh for people who have a cholesterol problem that comes from genetics, like familial hypercholesterolemia or FH, they would be really good candidates to look into this program. So again, PCSK9 is the name of this bad protein that causes cholesterol problems, and we have a treatment now that may be a one-time treatment that corrects the problem.

GLP-1 Plus Amylin For Weight

Kevin Geddings 4:02

Yeah, there you go. And speaking of some interesting studies, I know it doesn't have to do necessarily with heart issues, but there's a really interesting GLP1 with an add-on study that's getting ready to enroll. Isn't it right, Dr. Koren?

Who Should Join These Trials

Dr. Michael Koren 4:14

Yeah, it is. Thanks for bringing that up. So everybody is kind of familiar with Ozempic and Mounjaro GLP1 drug, and that type of drug is is working on a hormone system called incretins. Incretins. And these are hormones that signal between your gut and your brain such that your brain knows that you should stop eating. These are satiety signals. And the GLP1s have been very successful. But GLP1s causes vomiting sometimes because they're triggered in a major way by eating. And they're not triggered by just your baseline state. But there's another type of incretin called amylin. And amylin is a hormone pathway that is active all the time. So the thought processes in the studies that we're doing is if you combine combine a GLP1 with an amylin drug, then you may have the best of both worlds. You may uh get uh get satiated or full earlier when you're eating, but you may also have less food noise because of this baseline amylin effect. So we're doing studies right now looking at how to use these type of medications to help people curb their appetite and hopefully lose weight.

Kevin Geddings 5:28

Yeah. Uh Dr. Koren, going back to the gene editing piece, that that particular study, who would be someone out there driving around listening to us right now who should consider participating in that trial?

Dr. Michael Koren 5:40

If you know of a very strong family history of high cholesterol, if you have been diagnosed with familial hypercholemia or FH, you'd be a great candidate. And if you had complications of high cholesterol like bypass surgery or heart attack, you'd be a great candidate to be studied further. So again, if you're driving out there and you've been told that you have familial hypercholesterolemia or you have an LDL cholesterol that's well north of 200, and I think there's a good chance that we'll be able to help you, even if we don't get you involved in the genetic study, we can help you in other ways.

Kevin Geddings 6:13

That's Dr. Michael Koren, medical doctor, cardiologist, and research scientist. And also just before we let you go on that topic, too, just because we mentioned that GLP1 uh study, I would think someone who has been on Ozempic or Zepbound or one of these meds and they haven't had a whole lot of success.

Dr. Michael Koren 6:28

Yeah, that's great. That's a great point. And in fact, you're you're alluding to one of the specific programs that we're looking at, which is to help people that got stuck at some level with GLP1s. So, for example, you're overweight, the GLP one helped in the beginning, and you're down 10% body weight from baseline, but you can't get past that. Yeah. Well, that type of person would be a great candidate for the research work that we're doing now. So thank you for bringing that up.

Kevin Geddings 6:56

Yeah. What is and and not to steal too much of your time, but I I do hear that from a lot of our listeners, just people that you come in contact with, that people seem to be plateauing on these drugs, on these GLP1s, at least some people. What what what do you think is causing that?

Dr. Michael Koren 7:10

Well, that that's why this whole amylin hypothesis is so interesting. So the GLP 1s, again, work triggered by meals. And and and they'll make you feel after a sh a little small amount of eating that you you've had enough, your satire signal is triggered and and that's one way to reduce your caloric intakes. But if you're still eating for stress reasons or other things, you may just substitute the your pattern of eating such that you're eating more frequently. And amylin receptor agonists will have the effect of bringing the that food noise down, curbing your appetite. So again, it's this thought that a combination of two different mechanisms of satiety or curbing your appetite may be the most effective way of dealing with things. So again, to answer your question, everybody's a little bit different. Some people have a tremendous response to GLP1s and can lose 20% more of their body weight, but others don't. And there are reasons behind that. And there's another system that we can help trigger the issue of people that get stuck at a certain level after they've been taking a GLP 1.

Kevin Geddings 8:20

Absolutely. And Dr. Koren, I know you're off to yet another meeting in New Orleans. What's what's a good uh interesting topic for the next session you have to go to? Something something sexy, right?

Dr. Michael Koren 8:31

I don't know if you consider any of this stuff sexy, but uh there's uh there's also things that we're working on in congestive heart failure, and I'm I'm excited to go to a meeting for that. Where this there's so much talk around gene therapy now, and gene therapy is gonna be not just for cholesterol issues, but it's also gonna be for weak heart muscle. It's gonna be for people that have a condition called hypertrophic cardiomyopathy or a very thick dysfunctional heart muscle. We're we're looking at that. We're now looking at these extended type of uh gene expression studies for hypertension. So people are having trouble with high blood pressure. We're working on that. So it's really quite remarkable. Um there's been an explosion, quite frankly, of understanding of genetics and how they affect our health on a day-to-day basis. And we now have solutions for some of these genetic problems. So again, it it's just absolutely mind-blowing some of the things that we're doing and how elegant these scientific mechanisms are to deal with these issues. Getting back to your point about appetite suppression, we know GLP 1s work. We know in some people they work better than others. We know there are other incretins or systems that affect appetite. And but what we don't know is if we combine two of these mechanisms, does it work better than each one alone? And that's the question that we're gonna answer in research, and and people can benefit by being part of it.

Kevin Geddings 10:02

Dr. Michael Koren, uh, be safe out there in New Orleans, and we'll look forward to having you back home soon.

Wrap Up And How To Learn More

Dr. Michael Koren 10:08

Same here. Have a great week, Kevin.

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