Maciej Banach presents the results of a subanalysis of the ODYSSEY APPRISE study. In this analysis differences in physicans’ behavior and factors influencing the intensity of PCSK9i therapy with alirocumab were determined in Central and Eastern Europe vs. other European countries plus Canada.

EAS Congress 2023 Florian Kronenberg discusses the EAS consensus statement on Lp(a) in ASCVD and aortic stenosis, which contains recommendations for testing of Lp(a), risk estimation, and management of patients with elevated Lp(a) levels.

A secondary analysis of the FOURIER-OLE trial investigated what the optimal achieved LDL-c levels are with PCSK9i in patients with ASCVD, with regards to long-term cardiovascular and safety outcomes.

In 2019, the ESC/EAS recommended more stringent LDL-c goals, and a greater use of combination therapies. In the SANTORINI study was investigated whether the treatment landscape has improved since then.

In an age-stratified post-hoc analysis of the RACING trial, combination therapy with a moderate-intensity statin plus ezetimibe showed similar CV benefits as high-intensity statin monotherapy in elderly ASCVD patients, regardless of age group.

In the single-arm ARCHITECT study, the authors demonstrated that the addition of alirocumab to statin therapy in asymptomatic patients with FH reduces coronary plaque burden and promotes plaque stabilization.

In a Dutch, real-world study of patients at very high CVD risk on maximum-tolerated lipid-lowering therapy, PCSK9 antibodies resulted in less relative LDL-c reduction at 6 months in women compared with men. Of note, women did have higher baseline LDL-c levels.

A pooled analysis of patients with established ASCVD showed a 10-year risk of recurrent ASCVD events of 20% and a lifetime risk of 54%. Theoretically, optimization of both lifestyle and medications could reduce both risks and add 7.3 event-free years.

ACC.23 “Lowering LDL-c by any means reduces CV events […], but any drug on its own is not going to be enough for high risk patients. We've got to use combination therapies and it’s great to have all these different options, which we can now combine in our patients”, says Prof. Ray.

ACC.23 Prof. Libby shares his view on the clinical impact of the results of the CLEAR Outcomes trial which investigated the effect of bempedoic acid on CV outcomes.

ACC.23 In a multisite-RCT study was examined whether an intervention including individualized reminders sent to primary care clinicians improved use of high-intensity statin in patients with ASCVD.

ACC.23 Injectable treatments may have poor adoption due to access barriers and the need for repeat injections. An oral PCSK9 inhibitor, MK-0616, was developed and tested in a phase 2b trial.