AHA 2018 The updated cholesterol guidelines help physicians to personalize treatment based on risk assessment, and now include CAC measurement to guide treatment decisions in certain patients.

In a substudy of GLAGOV, IVUS-based virtual histology showed regression of coronary atherosclerosis in evolocumab-treated patients, but no changes in plaque composition as compared with placebo.

This is a summary of the presentation by Jennifer Robinson, in which she explains that the greatest benefit of PCSK9 antibodies can be obtained at higher LDL-c levels, as seen in high-risk populations.

A subanalysis of the CANTOS study showed that modulation of the IL-6 signaling pathway with IL-1β inhibitor canakinumab, associates with reduced CV event rates, independent of lipid lowering.

In a subanalysis of the ALSPAC study, higher alcohol consumption and smoking were associated with increased arterial stiffness in teenagers. The good news is that the harmful effects of smoking seem reversible.

A large cohort study demonstrated that higher drinking intensity and smoking exposure are individually and additively associated with increased arterial stiffness in adolescence.

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The testosterone/estradiol ratio reflects both systemic and plaque inflammation in men undergoing carotid endarterectomy. Low ratio was associated with higher MACE risk, especially in overweight men.

Elevated Lp(a) is now officially considered a genetically determined risk factor for CVD in the USA. Chapman summarizes how Lp(a) is atherogenic and how novel therapies may target this process.

Clinical updates in management of cardiovascular risk Using data from large randomized clinical trials and from various cohorts, risk and treatment effects in individual patients can be predicted. Now even lifetime risk and lifetime treatment benefit can be predicted in terms of vascular disease-free life years gained.

DPP-4 inhibition with sitagliptin for 24 months decreased the intima-media thickness of the internal carotid artery in type 2 diabetic patients without established CVD.

Clinical updates in management of cardiovascular risk For lowering LDL-c, statins play a major role in both primary and secondary CV prevention in all patients. There is room for improvement with respect to choosing the right dosing regimen.