Podcast Summary: Healthier World with Quest Diagnostics

Episode Title: Viral infections and cardiometabolic complications
Air Date: December 11, 2025
Host: Dr. Mason Latsko (Quest Diagnostics)
Guest: Dr. Mark Penn, Founder and Chief Medical Officer, Cleveland Heart Lab
Duration: 12 minutes

Overview: Main Theme and Purpose

This episode delves into the critical connection between viral infections and cardiometabolic complications. Dr. Mason Latsko and Dr. Mark Penn discuss how inflammation from viral infections can escalate the risk of serious cardiovascular events, such as heart attacks, particularly in vulnerable populations. The episode emphasizes the role of inflammation, metabolic health, and preventative care—including vaccines and advanced biomarkers—to minimize these risks.

Key Discussion Points and Insights

Historical Perspective on Viral Infections and Heart Attacks

• [01:10] Dr. Penn: Historically, the CDC classified a flu outbreak in a region by an increase in myocardial infarction (heart attack) deaths among the elderly, highlighting a long-recognized connection between infections and cardiac events.
  • Quote: “The CDC used to classify a flu outbreak as an excess in myocardial infarction, death in the elderly in a region...if there's a flu outbreak, the elderly will die more commonly of a heart attack. So the concepts here are incredibly old.” – Dr. Penn [01:20]

Recent Research and Evolving Understanding

• [02:02] Dr. Penn: Modern research has uncovered that acute and chronic inflammation—whether from infection or conditions like rheumatoid arthritis—makes individuals with vulnerable arterial plaques far more likely to have a heart attack.
  • “What we now are starting to see in the literature are...papers that demonstrate that the risk of having a heart attack is highest within the seven days of having influenza.” – Dr. Penn [02:50]
• The relationship holds for multiple respiratory viruses, including COVID-19, and is now validated in top medical journals (NEJM 2018, JAMA).

Role of Inflammation and its Markers

• [04:07] Dr. Latsko & Dr. Penn: Inflammation is described as the “final common pathway” for a cardiovascular event following plaque rupture.
  • Key biomarkers for assessment:
    • HSCRP (general inflammation)
    • MPO (myeloperoxidase, specific to vascular inflammation)
    • LpPLA2 (associated with necrotic core activation)
  • Quote: “If we get an LDL to 90, an A1C down to 5, 2, and their MPO, LP, PLA2, and CRP are normal, I don't know that that patient needs much more aggressive care.” – Dr. Penn [05:15]
  • Residual elevation in these markers, even with controlled cholesterol and glucose, signals ongoing risk.

Of Metabolic Dysfunction and Individualized Risk

• [06:23] Dr. Latsko & Dr. Penn: Metabolic health (A1C, insulin resistance) is central to both forming vulnerable plaque and the body’s inflammatory response to viral infections.
  • Recent studies indicate not all diabetic or pre-diabetic patients have the same risk profile—factors like insulin resistance and albuminuria distinguish higher-risk subgroups.
  • Individualized care is emphasized: “We really now have...the ability to individualize care in a way we haven't had in years or ever.” – Dr. Penn [07:35]

Laboratory Assessment and Clinical Action

• [08:29] Dr. Latsko: Which labs should clinicians order to gauge risk?
  • Dr. Penn’s Recommendations:
    • Essential labs: A1C, insulin resistance score, LDL, ApoB, MPO, LpPLA2, HSCRP
    • Dental health (gum disease) can also contribute to residual inflammation.
  • Classic readout: If A1C and LDL are controlled but inflammation is high, look for other sources like oral disease or undiagnosed chronic inflammation.
  • Quote: “Classic board question. You have a patient who has had a prior MI...The answer is flu shot. A little bit more than quitting smoking.” – Dr. Penn [09:13]

The Power of Vaccination & Prevention

• Flu and COVID vaccines are strongly advocated to lessen the inflammatory response to viral exposure and therefore lower cardiac risk.
  • “It's a very effective way to minimize risk in the setting of the respiratory virus.” – Dr. Penn [09:45]
• Expanding biomarker use into primary care could help better stratify patients and direct prevention.

Memorable Quotes and Moments

• “Cholesterol doesn't drive heart attacks. Right. It drives vascular inflammation, which leads to heart attacks, as does other chronic conditions such as hypertension, diabetes, stress, anxiety, as well as respiratory infections.”
  – Dr. Latsko [04:07]

• “If the patient has residual inflammatory marker elevation, we have not mitigated all the risk.”
  – Dr. Penn [05:45]

• “Now's the time to really up our game in prevention so that the milieu necessary for a heart attack in the setting of a virus isn't present.”
  – Dr. Penn [11:13]

• Final Takeaway:
  [11:40] Dr. Penn: “Get your flu shots.”

Timestamps for Important Segments

• 00:03 – Intro and episode theme
• 01:10 – Historical context: viral outbreaks and heart attacks
• 02:02 – Evolving research: inflammation and plaque rupture
• 04:07 – Discussing inflammatory markers and risk stratification
• 06:23 – Role of metabolic health and individualized risk
• 08:29 – Recommended labs and clinical interpretation
• 09:13 – Vaccination’s role in prevention
• 11:13 – Bringing biomarkers to primary care
• 11:40 – Closing advice: Get vaccinated

Summary: Actionable Insights

• Inflammation from viral infections increases cardiovascular risk, especially in the presence of cardiometabolic dysfunction.
• Modern preventive care relies on vaccines and advanced inflammatory markers alongside traditional cholesterol and glucose monitoring.
• Individualized patient assessment—using a full range of biomarkers—can guide both clinicians and patients to minimize risk, especially during flu and respiratory virus season.

Tone: Clear, authoritative, and pragmatic, emphasizing scientific evidence and actionable prevention.