New KETO-CTA Data - Clarification and Update on Cleerly

Описание: In this talk, Dave Feldman shares new updates from the Keto-CTA study, comparing results across four independent CT imaging analyses: Cleerly, QAngio, HeartFlow, and semi-quantitative reads by expert readers. He addresses the controversies around LDL-C, ApoB, plaque progression, and regression, revealing why certain datasets conflict, and presents compelling evidence showing verified plaque regression in a subset of participants.

(* This talk was provided courtesy of Symposium for Metabolic Health 2025. https://www.lowcarbusa.org/ )

0:00 – Intro & welcome
0:34 – Disclosures & background on the Keto-CTA study
1:01 – Study design & lean mass hyper-responder criteria
1:45 – CT scans, imaging methods & data acquisition
2:10 – Semi-quantitative vs quantitative analysis explained
3:06 – Timeline of analyses & initial expectations
3:29 – First Cleerly results & early concerns
4:11 – Shared findings: baseline plaque & lack of LDL/ApoB association
5:21 – Paper publication & critics’ reactions
6:07 – Prespecified methodology: why QAngio matters
6:59 – Social media debates & misinterpretations
7:33 – The “limited contrast” argument emerges
8:33 – Breaking down claims about “all high LDL”
9:42 – Visualizing the actual LDL spread
11:01 – LDL variability: 49 mg/dL to 591 mg/dL
12:30 – Problems with the “limited exposure” critique
13:08 – Revisiting the lipid hypothesis: dose-dependent effects
14:07 – Are these the “healthiest” participants? Context & caveats
15:14 – Participant risk factors: CAC scores, A1C, glucose, hs-CRP
16:33 – Why Dave reduced public debates for a time
17:01 – Issues discovered in Cleerly’s dataset
18:13 – Introducing HeartFlow: a blinded independent analysis
19:05 – Why a fourth analysis was critical
20:02 – Record-breaking multi-analysis study design
20:34 – Preliminary results warning
21:04 – Non-calcified plaque volume % change: conflicting findings
22:00 – Absolute vs relative change: why it matters
22:28 – Total plaque volume & percent atheroma volume
23:17 – How HeartFlow & QAngio compare to reference studies
24:40 – Top-level observations & agreements
25:07 – Plaque regression: the star of the show
26:14 – Direct verification of regression by Dr. Budoff
27:00 – Red flags in Cleerly’s data: no negative values
28:33 – The “noise floor” problem explained
30:28 – Why multiple analyses were necessary
31:15 – Every imaging study shows regression — except Cleerly
32:02 – Statistical implausibility of Cleerly’s results
32:37 – Final conclusions on regression evidence
33:29 – Does regression imply safety for lean mass hyper-responders?
34:11 – No association of LDL/ApoB with plaque presentation or progression
35:02 – What’s next: study extension & Triad study
35:38 – Reflecting on six years since Keto-CTA’s conception
36:32 – Acknowledgments & closing remarks

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