Statins
EPIC-STEMI: Early Routine PCSK-9 Use Added to High Intensity Statin Reduces LDL after Primary PCI for STEMI
Key Points:
- Early high-intensity statin therapy is standard of practice in acute STEMI patients, but this is often insufficient to achieve LDL targets. PCSK-9 therapy has never been tested as routine therapy in STEMI.
- In the EPIC STEMI trial, routine PCSK-9 initiation in addition to high-intensity statin prior to primary PCI resulted in a 22% LDL reduction at 6 weeks relative to sham, with a higher proportion of patients achieving therapeutic LDL targets.
TIPS-3 Trial: The Combination of Polypill and Aspirin Administered to Patients at Intermediate Risk Led to a Lower Incidence of Cardiovascular Events Compared With Double Placebo
A recent trial by Dr. Salim Yusuf, published in The New England Journal of Medicine, indicated that combination therapy with aspirin plus a polypill (consisting of a statin plus three blood-pressure-lowering drugs) can reduce the incidence of cardiovascular events compared with placebo among participants without established cardiovascular disease, but at moderate cardiovascular risk.
PREMIER Trial Shows Incremental Plaque Regression by a Single Lipid Apheresis and Maintained Statin Therapy in ACS Patients Treated With PCI
A recent study by Dr. Banerjee, published in Circulation: Cardiovascular Interventions, demonstrated the efficacy and safety of low-density lipoprotein (LDL) lowering therapy via a single LDL apheresis treatment plus ongoing statin therapy in nonfamilial hyperlipidemia acute coronary syndrome patients treated with the percutaneous coronary intervention (PCI).
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Treatment with Statins, RAAS Inhibitors and Platelet Inhibitors After CABG is Essential, While the Use of Beta-blockers is Questionable: Swedish Study Secondary prevention medications after coronary artery bypass grafting and long-term survival: a population-based longitudinal study from the SWEDEHEART registry
In a recent study published in the European Heart Journal, Erik Björklund et al. found that the secondary prevention medications, such as statins and renin-angiotensin-aldosterone system (RAAS) inhibitors, and platelet inhibitors used after coronary artery bypass grafting (CABG) are essential while the use of B-blockers had no association with survival and is questionable.
HOPE 4: A Comprehensive Community-based Program Surpassing the Barriers in Improving BP Control and Associated Cardiovascular Disease Risk in 2 Middle Income Countries A successful 12-months follow-up open-labeled, cluster-randomized controlled trial
Significant improvement in blood pressure control and related cardiovascular disease (CVD) risk is seen as a result of a potentially effective and pragmatic comprehensive model of care conducted as HOPE 4 trial (Heart Outcomes and Prevention Evaluation-4) presented by Dr. JD Schwalm at the European Society of Cardiology (ESC) Congress 2019 and simultaneously published in The LANCET.
Nationwide Study Shows Pharmacy Closure Associated with Significant Decrease in Adherence to Cardiovascular Medications
According to a new national study led by Dr. Dima M. Qato that was recently published in JAMA Network Open, among 3.1 million Americans 50 years and older filling cardiovascular medications at pharmacies that eventually closed, there was a significant and immediate decline in medication adherence. This change in adherence persisted over 12 months and was prominent among older adults living in neighborhoods with fewer pharmacies.
Study in China Indicates Current Practice of Lipid-Lowering Treatment Needs Improvement
In an article published in the American Heart Journal, Dr. Yueyan Xing emphasized the need to improve on current lipid-lowering treatment practices in patients with a history of myocardial infarction or revascularization. Patients with a previous history of acute coronary syndrome are at a high risk of a recurrent coronary event and death. Lowering low-density lipoprotein cholesterol (LDL-C) in these patients is essential in order to reduce the risk of a recurrent event. The authors used the Improving Care for Cardiovascular Disease in China (CCC) Project to assess current lipid-lowering treatment practices in China.
Total Event Analysis from REDUCE-IT Showcases a Substantial Reduction in the Burden of Ischemic Events, Experts Debate Possible Mechanisms of Action of Icosapent Ethyl Presented at ACC 2019, New Orleans, Los Angeles
The total event analysis from the REDUCE-IT trial, presented at ACC 2019 showed that among statin-treated patients with elevated triglycerides and cardiovascular disease or diabetes, icosapent ethyl substantially reduced the burden of first, subsequent, and total ischemic events. The results are exciting as this is one of the first non-LDL targeted trials to demonstrate a cardiovascular benefit, and is likely to be featured in future guidelines. Continue reading
Statin vs Healthy Adherer Effect On Mortality in ASCVD Association of Statin Adherence With Mortality in Patients With Atherosclerotic Cardiovascular Disease
In a vigorous retrospective cohort study published in JAMA, Fatima Rodriguez et al. found an inverse graded association between long-term statin adherence and all-cause mortality using a nationwide sample of the Veterans Affairs Health System, in patients with atherosclerotic cardiovascular disease(ASCVD). The study proposed that there was room for improvement in statin adherence and also stressed on its importance as a measure of secondary prevention of ASCVD. Continue reading
