Charalambos Antoniades explains why coronary inflammation needs to be diagnosed and treated and shows how perivascular fat analysis from routine CTCA can provide a quantitative assessment of coronary inflammation.

Prof. Peter Libby brings us up to date on some novel aspects of inflammation in atherosclerosis.

ESC 2021 The Nature-PCSK9 trial, a naturally randomized target trial, showed a stepwise increase in the proportional reduction in lifetime risk of CV events with each earlier decade that LDL-c lowering was started by inhibiting PCSK9 with one-yearly dose of siRNA.

Higher ratio of LDL-c/ApoB was associated with MACE and with all-cause mortality and total CV events in patients with established atherosclerosis in a prospective cohort study.

This study using data of PESA demonstrated that HbA1c levels are associated with risk for subclinical atherosclerosis in low-risk individuals without diabetes, even at levels below the prediabetes threshold.

This prospective registry study in the US showed that only 17.1% of patients with ASCVD on LLT had their therapy intensified over the next 2 years. Only 31.7% of patients achieved LDL-c levels <70mg/dL at 2 years.

ACC 2021 This subanalysis of the EVAPORATE trial showed a significant reduction in whole-heart atherosclerotic plaque burden over 18 months in statin-treated patients with elevated triglyceride levels who received icosapent ethyl compared to those on placebo.

This analysis in a community-based cohort showed that elevated carotid intima-media thickness and interadventitial diameter and lower carotid distensibility were associated with increased risk of incident dementia.

This pooled patient-level analysis of three phase 3 trials (ORION-9, -10 and -11) shows that inclisiran reduces LDL-c on average by 50.7% compared to placebo in patients on maximally tolerated statin-therapy.

The prospective BIOSIGNAL cohort study showed that elevated Lp(a) was independently associated with LAA stroke etiology and risk of recurrent AIS or TIA in patients <60 years.

In a contemporary primary prevention cohort, MI and ASCVD event rates increased with higher LDL-c and older age. NNT to prevent one MI or ASCVD event was lower in people aged 70-100 years compared to younger individuals.

AHA 2020 Prevalence of CAD in a Swedish population was 4 out of 10, using CCTA data from the SCAPIS cohort. A prediction model was developed to identify those with widespread atherosclerosis.