Shoa Clarke
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shoaclarke.bsky.social
Shoa Clarke
@shoaclarke.bsky.social
750 followers 310 following 270 posts

Assistant Professor, Stanford University // Preventive cardiologist for adults & children // https://clarkelab.stanford.edu 🧬🫀💻
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shoaclarke.bsky.social
Science. We had a good run...
Figure showing dramatic gains in survival among children with acute lymphoblastic leukemia. Source: https://www.nejm.org/doi/full/10.1056/NEJMra1400972 Figure showing steady declines in overall cancer death rates in the United States, which are most notable when also accounting for increasing lifespan. Source: https://ourworldindata.org/data-insights/americans-are-now-one-third-less-likely-to-die-from-cancer-at-the-same-ages-as-americans-in-1990 Figure showing rapid decline in deaths due to heart disease and stroke in the United States. Source: https://data.cdc.gov/d/6rkc-nb2q
July 3, 2025 at 6:47 PM
shoaclarke.bsky.social
Thanks, Jay.
Screen shot of text from article: “We have never, ever, had any political interference like this,” says a long-time NIH programme official, who requested anonymity because they were not authorized to speak to the press. “It means we’re not doing science — we’re doing politics, and we’re engaging in censorship.”
May 21, 2025 at 7:54 PM
shoaclarke.bsky.social
Come on now, let's see the QQ Plot 😉
Manhattan plot for GWAS of "neuroticism" suggesting extreme inflation
May 20, 2025 at 8:18 PM
shoaclarke.bsky.social
This is actually pretty clever 😂😭
April 30, 2025 at 9:02 PM
shoaclarke.bsky.social
The frustrating thing is that there is actually an interesting question to be explored here. But instead of doing rigorous work, a private citizen is funding clickbait articles to feed the grifter machine...
Screenshot of clickbait videos generated about the paper
April 9, 2025 at 9:03 PM
shoaclarke.bsky.social
This is akin to saying that, restricting to people who smoke >3 packs-per-day, smoking is not associated with 1-year risk of lung cancer. To see the association, you need to properly sample the exposure.

[Also, as an aside, you do see the expected trend w/ baseline ApoB & change in plaque volume.]
April 9, 2025 at 8:08 PM
shoaclarke.bsky.social
1. The authors' big finding was that change in ApoB did not predict change in plaque. The problem: ApoB DIDN'T change (as the authors explicitly note). Importantly, essentially EVERYONE'S plaque volume DID increase. Hence, this association tells us very little.
April 9, 2025 at 8:02 PM
shoaclarke.bsky.social
Thrilled that our work on coronary dominance made the cover of @cellpress.bsky.social! This beautiful image is thanks to the incredible work of @pamrc.bsky.social! 😍

#CardioSky

www.cell.com/cell/fulltex...
The cover of Cell showing an image of a human heart and coronary arteries during development
April 3, 2025 at 4:53 PM
shoaclarke.bsky.social
Bingo
www.cnn.com/2025/03/28/h...
Article text: She thinks her funding was caught in a dragnet of NIH grant cancellations driven by haphazard, error-prone word searches rather than careful review of the research in question. HHS has not clarified how it is selecting grants for termination.
March 28, 2025 at 7:30 PM
shoaclarke.bsky.social
What the actual f---!?

Florida debates lifting some child labor laws to fill jobs vacated by undocumented immigrants

www.cnn.com/2025/03/25/b...
Screen shot of article text: The state’s legislature on Tuesday advanced a bill that would loosen child labor laws, allowing children as young as 14 years old to work overnight shifts. If the new law is passed, teenagers would be able to work overnight jobs on school days. They are currently prevented from working earlier than 6:30 am or later than 11 pm per state law.
March 26, 2025 at 1:46 PM
shoaclarke.bsky.social
Interesting. It looks like @ajpcardio.bsky.social articles now come with AI-generated Q/A bullet points. Here's an example from our recent study on poor implementation of cholesterol guidelines in young adults.

Overall, I'd give it a B. Is this useful?

www.sciencedirect.com/science/arti...
AI-generated questions and answers summarizing key points from a research article
March 25, 2025 at 3:46 PM
shoaclarke.bsky.social
We are in the midst of a pandemic of emboldened mids who think themselves clever...
www.wired.com/story/plaint...
Screenshot of text: Consider the email from one recent would-be codebreaker. “What took 35 years and even the NSA with all their resources could not do I was able to do in only 3 hours before I even had my morning coffee,” it began, before the writer showed Sanborn what they believed to be the cosmically elusive solution. “History’s rewritten,” wrote the submitter. “no errors 100% cracked.” You might ask, what enables someone to believe they’d outperformed the world’s most elite mathematicians and cryptologists, including some spooks who maybe have a quantum computer in the basement? The answer is pure 2025: a chatbot!
March 7, 2025 at 9:01 PM
shoaclarke.bsky.social
In mice, we show that patterns of right vs left septal artery dominance are altered by decreasing Cxcl12 expression through heterozygous knockout.
Experiments showing that right septal dominance becomes less common in mice with heterozygous knockout of Cxcl12, which leads to decreased Cxcl12 expression.
March 5, 2025 at 7:45 PM
shoaclarke.bsky.social
We show that dominance is established during fetal development when CXCL12 is being expressed.
Imaging of fetal hearts with immunolabling and fluorescence in situ hybridization showing coronary artery developmental anatomy and CXCL12 expression
March 5, 2025 at 7:43 PM
shoaclarke.bsky.social
We used angiograms from the Million Veteran Program to conduct GWAS of coronary dominance, identifying multiple loci. Strikingly, CXCL12 has been implicated in atherosclerotic coronary artery disease (CAD). Hence, our findings suggest overlap in the biology of coronary development and CAD 🤔
Manhattan plots for GWAS of coronary dominance. CXCL12 is the strongest association. Colocalization analysis of coronary dominance and coronary artery disease, indicating shared associations.
March 5, 2025 at 7:37 PM
shoaclarke.bsky.social
Most hearts have right dominant coronary anatomy but some have left. Why? Is it random? When/how is dominance established?

Now out in @cellpress.bsky.social, the 1st GWAS of coronary dominance + experiments implicating CXCL12 as a driver of human coronary patterning!

www.cell.com/cell/fulltex...
Visual abstract illustrating coronary artery dominance, phenotyping using angiograms, GWAS, and downstream studies of human and mouse hearts.
March 5, 2025 at 7:01 PM
shoaclarke.bsky.social
Should race be used to guide when we screen for coronary artery calcium?

No. Here's why. #CardioSky #MedSky

www.ahajournals.org/doi/10.1161/...
screenshot of article screenshot of article screenshot of article
March 3, 2025 at 8:59 PM
shoaclarke.bsky.social
Our recent work on Lpa, LDL, and coronary plaque severity made it into the "Most read" list! (Barely 😅)

Check it out! #lipids #CVPrev
academic.oup.com/eurjpc/artic...
Screen shot of the top 5 most read articles in the European Journal of Preventive Cardiology
February 14, 2025 at 12:04 AM
shoaclarke.bsky.social
The BMJ will always be the funniest journal 😂
#CardioSky #MedSky
The competing interests for a letter to BMJ: I am 60 years of age, lean and more-or-less active, with no history or family history of cardiovascular disease. Since soon after beginning a LCHF diet 8 years ago, I have no longer needed to visit my GP for illness or medicines as I once did frequently, and my fitness has markedly improved. However, my GP then became concerned about the rise in my LDL cholesterol level and advises me to take a statin, despite every other available marker of cardiometabolic health now being ideal
February 4, 2025 at 4:51 PM
shoaclarke.bsky.social
At the core of so many of our country's problems is that no one trusts anyone anymore

news.gallup.com/poll/655106/...
January 14, 2025 at 2:41 PM
shoaclarke.bsky.social
Not looking forward to the coming onslaught of request to review shoddy Mendelian Randomization papers in 2025...
Graph of articles in PubMed with "Mendelian Randomization" in the title, showing exponential growth
January 6, 2025 at 4:14 PM
shoaclarke.bsky.social
Dang. How much do Danish dogs cost?
www.bbc.com/news/article...
December 24, 2024 at 6:29 PM
shoaclarke.bsky.social
This RCT of an intra-atrial shunt device in HF is remarkable for 2 reasons.

1: What a placebo effect! Those who got sham procedure reported significant improvements in symptoms out to 24 months!

2: the device had complete opposite effects on HFpEF vs HFrEF!

www.ahajournals.org/doi/full/10....
December 18, 2024 at 4:29 PM
shoaclarke.bsky.social
So why are 1.7 million younger adults with class 1 indications for statin left untreated?

Here is what they report
Data showing <25% of guideline eligible younger adults report being advised to take cholesterol medication by their doctor
December 17, 2024 at 6:09 PM
shoaclarke.bsky.social
I have been frustrated with guidelines that focus so much on adults age 40-75, that many clinicians forget that there are indeed CLASS 1 RECOMMENDATIONS to treat younger adults with statins:

1. Secondary prevention
2. LDL-C ≥190 mg/dL
December 17, 2024 at 6:06 PM