Three experts discuss the findings of the EVAPORATE study in detail and how to interpret these. The EVAPORATE trial examined the effect of icosapent ethyl on plaque formation and was a mechanistic study for the REDUCE-IT trial.
Prof. Klaus Parhofer discusses the role of hypertriglyceridemia in the setting of residual risk.
Lp(a) meeting Jeffrey Kroon presents his study on inflammatory mechanisms driving CV risk in patients with high Lp(a) levels and a potential new strategy to reduce atherogenesis in these patients.
Prof. Ray explains how he decides on the amount of LDL-c lowering that is needed in a given patient, and why he chooses this approach.
Learn how bempedoic acid an ACL inhibtor works in reducing LDL-c
The new ESC/EAS Dyslipidaemia Guidelines focus on high-risk patients, and prof. Laufs shares evidence for the treatment recommendations. Test your knowledge
Prof. Landmesser shows data that form the rationale behind new guideline recommendations, among which the lower LDL-c target for patients at very high risk.
Prof. Lüscher paints a picture of how atherosclerosis has been a fact of human life throughout time, and the evolution of insights on how to lower LDL-c and its associated CV risk.
Prof. Jukema explains the mechanism of epigenetics and how the BET inhibitor apabetalone can potentially impact CVD. In addition, he presents findings of first clinical studies with apabetalone.
Cardio Diabetes Masterclass Dubai Prof. John Deanfield discusses two new drug classes that benefit T2DM patients in terms of CV risk, with different modes of action indicating different potential for clinical implications.
Cardio Diabetes Masterclass Dubai Dr. Viljoen discusses findings of the Harmony Outcomes and DECLARE trials, emphasizing how different mechanisms of GLP-1RAs and SGLT2 inhibitors translate into CV benefits .
Cardio Diabetes Masterclass Dubai Prof. Montanya discusses the positive results observed with albiglutide and dapagliflozin in the Harmony Outcomes and DECLARE trial, respectively.
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.
Learn more about PACE-CME, our mission, our programmes and our cardiovascular educational services and resources
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.
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.
Clinical updates in management of cardiovascular risk CV risk factors that drive arterial disease in early life have a major impact on future CV risk. Communication about early lifestyle intervention to the public should be a major focus to reduce CV risk in later years.
Prof. John Kastelein describes 3 major disturbances in lipoprotein metabolism contributing to CV risk. Novel therapies are being developed to address residual risk after LDL-c eradication.
Dr. Christopher Cannon explains the CV benefits of CETP inhibition in relation to non-HDL-c reduction
Dr. Samia Mora summarizes the challenges in lipid management with respect to testing and treatment.
Several lipid-lowering treatments have been shown to exert CV benefits. Prof. Deepak Bhatt discusses how to integrate PCSK9 inhibitors into these therapies for primary and secondary CV prevention.
Dr. Robert Giugliano summarizes what we have learned over the past decades about the effectiveness and safety of reducing LDL-c to very low values.
AHA 2017 A new analysis of CANTOS dived into which patients may benefit most of canakinumab treatment. Baseline characteristics did not help, but response to treatment did.
AHA 2017 Dr. Giugliano summarises findings of 2 additional clinical trial updates and studies into infarct size, TIMI stable IHD risk and total events in the FOURIER trial.
AHA 2017 PAD patients enrolled in the FOURIER trial who were treated with PCKS9 inhibitor evolocumab showed a higher absolute and relative CV event reduction, and a large reduction in limb events.
Inflammation Expert Opinions Il prof. Raffaele De Caterina spiega perché CANTOS è uno studio clinico importante. E’ il primo studio clinico che dimostra che un farmaco anti-infiammatorio influenza favorevolmente importanti eventi cardiovascolari, e pertanto può diventare una terapia da inserire nell’armamentario terapeutico in aggiunto agli attuali trattamenti.
Inflammation Expert Opinions Prof. Raffaele de Caterina explains why CANTOS is an important trial. It is the first trial showing that an anti-inflammatory drug can affect important CV outcomes and thus may be a convenient therapy in addition to current treatment strategies.
Inflammation Expert Opinions According to prof. Ulf Landmesser, the CANTOS trial shows that inflammation is crucial for disease progression and that targeting inflammation as a risk factor may have important implications for high-risk populations.
Inflammation Expert Opinions Prof. Ulf Landmesser: Die CANTOS Studie zeigt erstmalig, dass eine Interleukin-1 Beta Inhibition, d.h. eine spezifische Entzündungshemmung, das kardiovaskuläre Risiko nach akutem Koronarsyndrom reduzieren kann.
Inflammation Expert Opinions Prof. Wolfgang Koenig: Die CANTOS Studie belegt dass inflammatorische Prozesse eine kausale Rolle in der Atherogenese spielen. Inhibition der Inflammation führt zu einer weiteren Reduktion des kardiovaskulären Risikos ohne Beeinflussung des Lipidstatus.
Inflammation Expert Opinions Prof. Wolfgang Koenig states that the CANTOS trial shows that inflammation plays a causal role in the atherogenic process. Blocking this inflammation may be an additional treatment option beyond lipid lowering for CV risk reduction.
Inflammation Expert Opinions Lina Badimon explica por qué el bloqueo de la inflamación puede representar un beneficio clínico significativo, debido al importante papel de la inflamación en la formación de la placa aterosclerótica. Los resultados de CANTOS pueden representar el inicio de una nueva era en la prevención cardiovascular.
Inflammation Expert Opinions Lina Badimon explains why blocking inflammation may have significant clinical benefit, as inflammation is important in plaque formation. The results of CANTOS can be the dawn of a new era of CV prevention.
ESC 2017 Virtual histology of components of plaque does not provide additional information in the serial imaging GLAGOV study that showed more coronary atherosclerosis regression when evolocumab was added to intensive statin-treatment.
FRANCAIS Philippe Gabriel Steg réfléchit sur les résultats de l’étude CANTOS, qui soutient l’hypothèse que l’athérosclérose est une maladie chronique inflammatoire.
Inflammation Expert Opinions Paul Ridker and Peter Libby look back at the evolution of their research efforts on the role of inflammation in CV risk, and how they saw their hypothesis confirmed in the CANTOS trial.
ESC 2017 Safe and optimal treatment regimen identified for inclisiran, an siRNA against PCSK9, which is still effective after one year in the ORION-1 trial.
ESC 2017 Paul Ridker shares what the results of the CANTOS trial mean to him as a clinician. Lowering inflammation by inhibiting IL-1β with canakinumab reduced CV events in aggressively treated CV patients.
PCSK9 Expert Opinions Prof. Wouter Jukema summarizes the results from FOURIER and SPIRE into the message that PCSK9 inhibition works – even lower is even better; it is safe, and you cannot force biology – it takes a long time to get atherosclerosis, so it will also take some time to get rid of it.
PCSK9 Expert Opinions Prof. Ulf Landmesser states that the results of both FOURIER and SPIRE fit into the concept that lowering LDL to very low levels results in a reduction in CV events
PCSK9 Expert Opinions According to prof. Eric Bruckert, FOURIER is a landmark study that will change clinical practice, especially for patients with the highest risk.
PCSK9 Expert Opinions Prof. Wolfgang Koenig describes the results of FOURIER and SPIRE. He expects that PCSK9 inhibitors will be drugs of great value in the future, especially for patients with FH and statin intolerance.
PCSK9 Expert Opinions Prof. Richard Hobbs states that recent data from FOURIER show that effective medical treatment to lower LDL-c reduces endpoints that are important and expensive both for individuals and for health systems.
PCSK9 Expert Opinions Prof. Gilles Lambert describes the development of PCSK9 inhibitors since the discovery in 2002 of PCSK9 as a circulating protein targeting the LDL receptor for degradation. Now in 2017, results of outcome trials with a PCSK9 inhibitor are available.
PCSK9 Expert Opinions By combining all recent insights on treatment with PCSK9 inhibitors, prof. Stephen Nicholls argues that the PCSK9 outcome trials reinforce the concept that patients with high CV risk may benefit from PCSK9 inhibiting treatment.
PCSK9 Expert Opinions Dr. Paul M. Ridker states that from FOURIER and SPIRE it becomes clear that further lowering of LDL-c during a longer period of time safely translates into lower rates of CVD.
PCSK9 Expert Opinions Prof. Kausik Ray describes the practical implications of the PCSK9 outcome trials. In terms of efficacy, there is no J-shaped curve, meaning there is no apparent diminution of benefit to very low LDL
PCSK9 Expert Opinions Prof. John Chapman gives his personal views on the results of FOURIER and SPIRE 1&2. Key question is whether in the light of the new data, the LDL-c goal will be maintained or lowered in high-CV risk individuals.
ACC 2017 Dr. Paul Ridker discusses data of the SPIRE studies into use of the PCSK9 antibody bococizumab, including the unexpected attenuation of the LDL-c response over time in some patients, as a consequence of development of antibodies against the drug.
ACC 2017 Marc S. Sabatine (Boston) presented the FOURIER-study, which evaluated a PCSK9 inhibitor during two years in over 27000 high-risk patients. LDL-c was reduced by 59%. Both the primary and the secundary clinical endpoint were significantly reduced.
CSI Rome Guido Kranenberg studied the potential impact of bisphosphonate on calcification of the arterial intima media. He shares the findings of a systematic review and meta-analysis with Nicole Jaspers and they discuss which other studies might shed light on this relationship.
This discussion combines the mechanistic insights into the inflammatory component in atherogenesis of Jon Laman with the clinical perspective of Wolfgang Koenig. They discuss how inflammation reseach may change CV treatment approaches in the future.
An investigational inhibitor of plasminogen activator inhibitor type 1 (PAI-1) prevented arteriosclerosis in mice and prolonged life in mice with a rapid aging phenotype. PAI-1 is a marker of cellular senescence, and the inhibitor is being developed to treat or slow down vascular aging.
Peter Libby considers how the pathophysiology of atherosclerosis and the mechanisms of ACS are changing, as a result of preventive therapies and a change in risk factors, toward superficial erosion.
Robert Giugliano summarises the recent evidence on lipid-lowering therapies beyond statins, with which further LDL-lowering can be achieved.
ACC 2016 Data from the GAUSS-3 study show that muscle-related statin intolerance is a real problem and PCSK9 inhibition with evolocumab dramatically reduces LDL-c in these patients.
ACC 2016 Stephen Nicholls discusses the results of the ACCELERATE-study, in which the favourable effects of the CETP-inhibitor evacetrapib on cholesterol did not translate into any reduction in the primary endpoint.
Prof. Peter Libby (Boston, MA, USA) discusses how views on mechanisms of ACS have changed over time and how traditional thoughts on plaque composition and vulnerability are now challenged. He proposes a new mechanism of coronary thrombosis that may cause ACS.
A mechanism of action video on the potential role of inflammation in atherothrombosis
Prof. Paul Ridker sets out how the hypothesised role for inflammation in atherosclerosis is now a pathway that can be targeted therapeutically. He consideres ongoing efforts to target the inflammatory response.
ISA 2015 Prof. Peter Libby recapitulates evolving insights into the mechanism of acute coronary syndromes, and how we may be shifting from a predominance of plaque ruptures towards superficial erosion as the cause of ACS.
ISA2015 | Clinical Breakthroughs Yanan Wang showed in a humanised animal model, the CETP-inhibitor anacetrapib reduced atherosclerosis development, by lowering non-HDL-c levels, via increased uptake in the liver. In addition, anacetrapib reduces plasma PCSK9 levels.
Prof Peter Libby, Boston, USA, discusses the implications of recent insights in inflammation in atherosclerosis with Göran Hansson, Stephen Nicholls and Paul Ridker.
Raphael Duivenvoorden, Amsterdam, describes an innovative nanotechnique to reduce the risk of a recurrent myocard infarct, in which inflammation is a key factor.