Depending on individual patient characteristics, novel therapeutic approaches can reduce CV risk, particularly in patients at high CV risk. Prof. Landmesser expects that future guidelines will reflect these developments.

CME accredited course focussed on the role of PCSK9 inhibitors in the management of patients at increased CV risk. Member registration (free) is needed to enroll in this course

A paradigm shift in the treatment of hypercholesterolemia has occurred since the role of PCSK9 in the regulation of LDL-c was discovered. A review discussed novel strategies to reduce PCSK9 levels beyond therapy with monoclonal antibodies.

In an open-label extension study, consistent and sustained LDL-c reduction was seen upon changing the dose of alirocumab based on LDL-c level, allowing for an individualized approach.

In patients with progressive CAD, stabilizing or even regression of disease is possible, targeting a combination of risk factors. Prof. Ray and Prof. Jukema discuss the importance of LDL-c lowering to halt progression.

In a total events analysis of ODYSSEY OUTCOMES, treatment with alirocumab reduced the total burden of fatal and nonfatal CV events in a post-ACS population, as compared with placebo.

Several incorrect beliefs exist about cholesterol lowering. Prof. Ray and prof. Montalescot discuss the importance of physician and patient education to improve their knowledge.

Reduction of LDL-c levels was highly consistent with evolocumab therapy among CVD patients as demonstrated by a subanalysis of the FOURIER trial.

New insights into lipid management have emerged since 2016. Prof. Ray discusses with prof. Mach in which respects the guidelines should be changed.

Prof. Masana explains whether achieving very low LDL-c levels with current treatments is safe and might cause any biological problems.

Prof. Kastelein discusses the biology of LDL with prof. Packard and which strategies are available for LDL-c lowering in CVD prevention in high-risk patients.

In a subanalysis of the FOURIER trial, treatment with evolocumab in patients with higher baseline Lp(a) resulted in non-significant greater percent reduction and greater absolute reduction of coronary events, compared to those with low baseline Lp(a).