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Welcome back to the CardioNerds Cardiovascular Prevention Series, where we are continuing our discussion of Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs). This class of medications is becoming a household name, not only for their implications for weight loss but also for their effect on cardiovascular disease. CardioNerds Dr. Ty Sweeney (CardioNerds Academy Faculty Member and incoming Cardiology Fellow at Boston Medical Center), Dr. Rick Ferraro (CardioNerds Academy House Faculty and Cardiology Fellow at Johns Hopkins Hospital), and special guest Dr. Franck Azobou (Cardiology Fellow at UT Southwestern) sat down with Dr. Darren McGuire (Cardiologist at UT Southwestern and Senior Editor of Diabetes and Vascular Disease Research) to discuss important trial data on GLP-1 RAs in patients with heart disease, as well as recent professional society guidelines on their use. Show notes were drafted by Dr. Ty Sweeney. Audio editing was performed by CardioNerds Intern student Dr. Diane Masket. If you haven’t already, be sure to check out CardioNerds episode #350 where we discuss the basics and mechanism of action of GLP-1 RAs with Dr. Dennis Bruemmer. This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Novo Nordisk. See below for continuing medical education credit. Claim CME for this episode HERE. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - GLP-1 Agonists: Diving into the Data Patients with diabetes and clinical atherosclerotic cardiovascular disease (ASCVD) or who are at high risk of ASCVD benefit from treatment with a GLP-1 RA. For persons with sufficient ASCVD risk and type 2 diabetes, GLP-1 RAs and SGLT2 inhibitors can, and often should, be used in combination. "Just like we don’t consider ‘and/or’ for the four pillars of guideline-directed medical therapy for heart failure with reduced ejection fraction, we shouldn’t parcel out these two therapeutic options...it should be both.” Setting expectations with your patients regarding injection practices, side effects, and expected benefits can go a long way toward improving the patient experience with GLP-1 RAs. Utilize a multidisciplinary approach when caring for patients on GLP-1 RAs. Build a team with your patient’s primary care provider, endocrinologist, clinical pharmacist, and nurse. “This is really a cardiologist issue. These are no longer endocrinology or primary care drugs. We need to be prescribing them ourselves just like we did back in the nineties when we took over the statin prescriptions from the endocrinology domain...we need to lead the way.” Show notes - GLP-1 Agonists: Diving into the Data For which patients are GLP-1 RAs recommended to reduce the risk of major cardiac events? For patients with type 2 diabetes and ASCVD, starting a GLP-1 RA carries a Class 1, Level of Evidence A recommendation in the most recent ESC and ACC guidelines. For patients without diabetes or clinical ASCVD with an estimated 10-year risk of CVD exceeding 10%, consideration of starting a GLP-1 RA carries a Class 2b, Level of Evidence C recommendation to reduce CV risk. The STEP-HFpEF trial showed that among patients with obesity and HFpEF, once-weekly semaglutide may be beneficial in terms of weight loss and quality of life. The results of the FIGHT and LIVE trials question the utility and safety of liraglutide in treating patients with advanced HFrEF. Of the over 17,000 patients enrolled in the SELECT trial, about 25% had heart failure, of which about one-third had HFrEF. Stay tuned for sub-analyses from that trial for more info! Can we still prescribe GLP-1 Ras in patients with well-controlled T2DM?

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Keto Clean’s journey on Shark Tank was nothing short of transformational. The innovative keto-friendly product caught the attention of the sharks and captivated viewers across the nation. From pitching their product to negotiating with the sharks, Keto Clean’s founders faced challenges and triumphs that ultimately led to their success on the show. In this article, we will delve into the details of Keto Clean’s time on Shark Tank and explore how they emerged victorious in the competitive world of entrepreneurship.

The Pitch

When Keto Clean’s founders stepped onto the Shark Tank stage, they were prepared to showcase their unique product and convince the sharks of its value. With a captivating presentation and a compelling story behind the brand, Keto Clean managed to capture the attention of all five sharks. The founders eloquently explained the benefits of their keto-friendly product and highlighted its potential in the market. Their passion and dedication to their business resonated with the sharks, setting the stage for a successful pitch.

As the sharks grilled the founders with tough questions and raised concerns about the product’s scalability, Keto Clean remained composed and confident in their responses. They addressed each question with poise and transparency, demonstrating their deep understanding of the industry and their commitment to the success of their brand. The sharks were impressed by Keto Clean’s knowledge and expertise, which ultimately played a crucial role in sealing the deal.

Despite facing intense scrutiny and pressure from the sharks, Keto Clean’s founders stood their ground and defended their business model with conviction. They remained true to their values and vision for the brand, refusing to compromise on their principles in exchange for a deal. This unwavering dedication to their mission left a lasting impression on the sharks and set Keto Clean apart from the competition.

The Negotiation

As the negotiations heated up and the sharks began making offers, Keto Clean’s founders carefully weighed their options and considered each proposal with meticulous attention to detail. They remained focused on securing a deal that would not only benefit their business but also align with their long-term goals and values. The founders engaged in strategic back-and-forth discussions with the sharks, leveraging their knowledge of the industry and their understanding of market trends to drive a favorable outcome.

After carefully evaluating the offers on the table, Keto Clean’s founders ultimately accepted a deal from one of the sharks that aligned with their vision for the brand. The terms of the agreement were mutually beneficial for both parties, setting the stage for a successful partnership that would propel Keto Clean to new heights. The negotiation process was a testament to the founders’ resilience and determination, showcasing their ability to navigate challenges and seize opportunities in the competitive world of entrepreneurship.

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The Success

Following their appearance on Shark Tank, Keto Clean experienced a surge in demand for their product and a significant increase in brand awareness. The exposure from the show catapulted Keto Clean into the spotlight, garnering attention from consumers and retailers alike. The founders wasted no time capitalizing on their newfound success, leveraging their appearance on Shark Tank to expand their distribution network and reach new markets.

With the support of their shark investor, Keto Clean was able to scale their business and introduce new product lines to meet the growing demand for keto-friendly options. The founders remained steadfast in their commitment to quality and innovation, continuously refining their products to meet the evolving needs of their customers. As Keto Clean continued to thrive in the competitive health and wellness industry, their journey on Shark Tank served as a catalyst for their growth and success.

Overall, Keto Clean’s transformational journey on Shark Tank is a testament to the power of perseverance, passion, and strategic thinking in the world of entrepreneurship. By showcasing their ingenuity and resilience on a national stage, Keto Clean’s founders not only secured a deal with a shark investor but also paved the way for a bright future ahead. Their journey serves as an inspiration to aspiring entrepreneurs and a reminder that with dedication and determination, anything is possible.

Summary and FAQ

As Keto Clean continues to thrive in the competitive market, it’s essential to understand the key takeaways from their journey on Shark Tank. Here are some frequently asked questions and a summary of Keto Clean’s transformational experience on the show:

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