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The Peter Attia Drive

May 6, 2019

In this episode, Ethan Weiss, Hopkins trained preventative cardiologist at UCSF, discusses two topics that on the surface may seem unrelated which is cardiovascular disease, and the role of growth hormone and IGF in disease. Ethan provides a masterclass in everything from acute coronary syndrome to all of the complex nuances around stent placement, as well as how calcium scores and results from CT angiograms shape his treatment of patients. He also shares how his idea to study the sex differences in blood clotting as it relates to coronary disease lead him to pursue the field of endocrinology, and specifically what he found with respect to the effect of growth hormone and IGF on the liver, the brain, and overall human longevity. 

We discuss:

  • Mutual love for hockey [7:15];
  • Ethan’s background and interest in cardiology [13:15];
  • Clinical definitions of a heart attack, clotting, and plaque: What causes the acute event? [24:15];
  • Defining coronary disease and myocardial infarction: The evolving nomenclature [32:00]; 
  • What happens when someone comes to the ER with a STEMI (ST elevation myocardial infarction)? [47:15];
  • Stents [54:45];
  • Treatment protocol for both acute and chronic coronary artery disease: History, controversy, and important distinctions [1:06:30];
  • Using stents to treat stable angina: What we learned from the COURAGE AND ORBITA trials [1:15:30];
  • The “art” of longevity: The challenge of preventative medicine and understanding risk [1:31:45];
  • Understanding CAC scores, and CT angiogram results [1:40:15];
  • How sex differences in clotting and heart disease got Ethan interested in growth hormone and IGF [2:01:00];
  • Impact of growth hormone on the liver [2:07:00];
  • Growth hormone and insulin sensitivity [2:18:00];
  • The role of GH and IGF on chronic disease and cancer [2:23:30];
  • Will taking growth hormone promote longevity? [2:32:30];
  • GH and IGF as a treatment for early stage dementia? [2:34:30];
  • What happens to IGF while fasting and what about fasting improves longevity?  [2:35:15];
  • The importance of becoming scientifically literate and making science more exciting for future generations [2:38:30];
  • Ethan’s new company: Keyto [2:43:45]; and
  • More.

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