The goal of LDL-c management is to reduce long-term CVD risk. Statins form the foundation of lipid-lowering therapy, but more ammunition is needed to attain LDL-c goals in all patients. This series of 3 presentations discusses current and evolving therapeutic LDL-c lowering options.
What is the rationale for CETP inhibition? Does it have the potential to lower the risk of CHD in addition to high-intensity statin therapy? What have we learned from previous CETP inhibitor outcome trials? and what trials can we expect in the near future? In this series of three presentations, you will be provided with novel insights on CETP inhibition.
Aaram Omar Kader talks about the PENELOPE study, that investigated the effect of a guideline-based approach on achieving LDL-c goals in very high-risk ACS patients in the Netherlands.
AHA 2022 An RCT showed that low-dose statin is superior in lowering LDL-c compared with placebo and 6 different dietary supplements. Moreover, dietary supplements did not significantly reduce LDL-c compared with placebo.
AHA 2022 In individuals with an increased 10-year ASCVD risk, rosuvastatin 5 mg daily reduced LDL-c, TC, and TG more than fish oil, cinnamon, garlic, turmeric, plant sterols, red yeast rice, or placebo. Moreover, no supplements reduced LDL-c significantly compared with placebo.
AHA 2022 The PROMINENT trial showed that pemafibrate reduces TG, VLDL-c, remnant cholesterol and ApoCIII in patients with T2DM, mild-to-moderate hypertriglyceridemia and low HDL-c. However, it did not reduce CV outcomes.
In an RCT with 71 participants, low-frequency intermittent fasting for 26 weeks did not alter LDL-c levels compared with an ad libitum diet. However, it did lower insulin resistance and the metabolic syndrome score.
In a post-hoc analysis of 4 RCTs, a ≥30% LDL-c reduction with bempedoic acid was seen in 25% of statin-treated patients and in more than half of statin-naïve patients. Factors associated with this reduction were also assessed.
RCTs among adults with HeFH show that treatment with evolocumab does not lead to cognitive dysfunction. But does the same hold true for pediatric patients with HeFH? This post-hoc analysis of data from the HAUSER-RCT study offers more insight.
Prof. Räber and Prof. Nicholls discuss the results and implications of the PACMAN-AMI study, that investigated the effect of PCSK9i alirocumab on top of high-intensity statins on coronary plaque characteristics in patients with acute MI.
The importance of measuring Lp(a) has been established. The next big question is: will we be able to attenuate Lp(a)-associated risk?
Raul Santos and Maciej Banach talk about the safety of PCSK9 mAbs and of very low cholesterol levels, and discuss the importance of patient education to improve adherence.