After a successful trial showed GIK could halve cardiac arrest and mortality, researchers were surprised it wasn't adopted. Pharmaceutical companies refused to manufacture the simple glucose, insulin, and potassium mixture because it didn't fit their business model of patenting a new drug and marketing it heavily. This forced the researchers to form their own company.

Research shows the L-BHB form of ketones acts as a signaling molecule to expand major arteries like the aorta. This allows the heart to pump up to 40% more blood per beat with less effort, reducing cardiovascular strain and lowering blood pressure. This presents a promising therapeutic avenue for heart failure.

The traditional drug-centric trial model is failing. The next evolution is trials designed to validate the *decision-making process* itself, using platforms to assign the best therapy to heterogeneous patient groups, rather than testing one drug on a narrow population.

A $2,000 preventative injection like a PCSK9 inhibitor sounds expensive. However, its cost is likely justified when calculated against the massive societal and individual expense of future medical bills, plus the economic value of additional healthy, productive years.

The traditional medical ethos prevents interventions on non-sick patients. This conservative approach may be irrational when low-risk therapies could add decades of healthy life, challenging the fundamental definition of when a doctor should act.

Chronic illnesses like cancer, heart disease, and Alzheimer's typically develop over two decades before symptoms appear. This long "runway" is a massive, underutilized opportunity to identify high-risk individuals and intervene, yet medicine typically focuses on treatment only after a disease is established.

Agencies like BARDA are funding drugs that treat severe symptoms common to various pathogens, such as acute respiratory distress syndrome (ARDS). This strategy aims to have pre-approved, pathogen-agnostic treatments available immediately during a new pandemic to reduce mortality while vaccines are developed.

The KIDO 905 trial revealed high rates of adverse events even in the control arm receiving only surgery. This suggests the invasive procedure itself is a major source of patient harm, paving the way for future surgery-free regimens if systemic treatments like EVP prove sufficiently effective.

There are 12 million major diagnostic mistakes per year in the U.S., resulting in 800,000 deaths or disabilities. Cardiologist Eric Topol frames this as a massive, under-acknowledged systemic crisis that the medical community fails to adequately address, rather than a series of isolated incidents.