Lipids
Observational Study | More data suggesting Rosuvastatin 10mg/Ezetimibe 10mg combo may be an alternative to Rosuvastatin 20mg
31 Jul, 2023 | 14:38h | UTCCombination Lipid-Lowering Therapy in Patients Undergoing Percutaneous Coronary Intervention – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries:
Statins post PCI: Moderate intensity plus ezetimibe may be preferable – Cardiology News
Combination Lipid-Lowering Therapy After PCI – American College of Cardiology
Commentary on Twitter
The current observational analysis assessed the clinical impact of 2 strategies (moderate-intensity statin therapy/ezetimide compared to high-intensity statin monotherapy) among patients undergoing PCI in the Korean nationwide cohort database. https://t.co/liOwFt1NHR #JACC pic.twitter.com/zM4vJhR3id
— American College of Cardiology (@ACCinTouch) July 29, 2023
RCT | Pitavastatin effective in the primary prevention of cardiovascular disease in HIV-infected individuals
26 Jul, 2023 | 13:35h | UTCPitavastatin to Prevent Cardiovascular Disease in HIV Infection – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
Pitavastatin lowers risk of cardiovascular events in people living with HIV – Aidsmap
Statins reduce cardiovascular risk in people living with HIV, new global study finds – STAT
Pitavastatin Cuts MACE in HIV-Infected Patients: REPRIEVE – TCTMD
Commentary on Twitter
Original Article: Pitavastatin to Prevent Cardiovascular Disease in HIV Infection https://t.co/HuR0Lt24N5
Editorial: HIV and Cardiovascular Disease — An Ounce of Prevention https://t.co/fsxCqrLKi0#IAS2023 pic.twitter.com/TCSQkJQNYa
— NEJM (@NEJM) July 24, 2023
M-A | Vegetarian diets may modestly improve cardiometabolic profile in high-risk individuals
26 Jul, 2023 | 13:15h | UTCCommentary: M-A: Vegetarian diets may modestly improve cardiometabolic profile in high-risk individuals – HCP Live
USPSTF Statement | Evidence lacking for lipid disorders screening in asymptomatic children and adolescents
20 Jul, 2023 | 11:13h | UTCEvidence Report: Screening for Lipid Disorders in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Patient Page: Screening for Lipid Disorders in Children and Adolescents – JAMA
Commentary: USPSTF: Screening Kids for Lipid Disorders Still Needs More Data – TCTMD
Secondary analysis of a RCT | Bempedoic acid reduces CV events in statin-intolerant patients with high CV risk
26 Jun, 2023 | 00:49h | UTCSummary: This secondary analysis of a Randomized Clinical Trial (RCT) evaluated the efficacy of bempedoic acid in primary prevention of cardiovascular events among statin-intolerant patients at high cardiovascular risk. From a total of 13,970 participants, 4206 met the criteria for primary prevention and were analyzed in this study. Those allocated to receive bempedoic acid showed a significant reduction in major cardiovascular events, reflected in a hazard ratio of 0.70.
The average age of this patient cohort was 68 years, and most participants (66%) were diagnosed with diabetes. Treatment with bempedoic acid also led to a significant 21.3% reduction in low-density lipoprotein cholesterol (LDL-C) levels and a 21.5% decrease in high-sensitivity C-reactive protein levels, suggesting improved cardiovascular health.
This study underscores the potential benefits of lipid-modulating therapy for primary prevention in high-risk patients, who are often undertreated. However, it is important to note the inherent limitations of this secondary analysis. The analysis was performed on a subgroup within a larger clinical trial, which could potentially lead to false-positive findings due to multiple testing. Furthermore, the results may not generalize to younger populations, those with lower pretreatment LDL-C levels, those without diabetes, or those with a lower baseline cardiovascular risk.
Article: Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients – JAMA (free for a limited period)
Editorial: Bempedoic Acid for High-Risk Primary Prevention of Cardiovascular Disease: Not a Statin Substitute but a Good Plan B – JAMA (free for a limited period)
See also: Visual Abstract
Commentary: Study Suggests Bempedoic Acid Could Find Role in Primary Prevention – HCP Live
Original Study: RCT | Bempedoic acid shows modest reduction in cardiovascular events for statin-intolerant patients
M-A | Plant-based diets reduce key atherogenic lipoproteins
30 May, 2023 | 11:48h | UTCEditorial: Plant-based dietary patterns and atherogenic lipoproteins – European Heart Journal
RCT | Statins do not prevent early cardiac dysfunction in anthracycline-treated cancer patients
15 May, 2023 | 13:07h | UTCStatins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines – European Heart Journal – Cardiovascular Pharmacotherapy (link to abstract – $ for full-text)
Commentary on Twitter
Primary prevention with atorvastatin during anthracycline therapy did not prevent cardiac dysfunction and myocardial tissue changes: SPARE-HF randomized trial https://t.co/9s2p9JSSq4 #echofirst #HF #LVEF #CMR #ESCYoung #EHJPharmacotherapy @FeliceGragnano @AgewallStefan pic.twitter.com/7tKG4tdpcD
— European Society of Cardiology Journals (@ESC_Journals) May 13, 2023
Consensus Statement | Homozygous Familial Hypercholesterolemia: new treatments and clinical guidance
5 May, 2023 | 14:58h | UTC
M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk
3 Apr, 2023 | 13:59h | UTCSummary: This systematic review and network meta-analysis aimed to determine the relative efficacy of different diets for preventing mortality and major cardiovascular events in patients at increased risk of cardiovascular disease. The study identified 40 randomized trials with 35,548 participants across seven dietary programs.
Moderate certainty evidence showed that Mediterranean and low-fat diets, with or without physical activity or other interventions, reduced all-cause mortality and non-fatal myocardial infarction in patients with increased cardiovascular risk. Mediterranean diet programs were also likely to reduce stroke risk.
Other dietary programs generally were not superior to minimal intervention. When compared with one another, no convincing evidence was found that the Mediterranean diet was superior to the low-fat diets in preventing mortality or non-fatal myocardial infarction.
News Release: Benefits of Mediterranean and low fat diet programmes in patients at risk of cardiovascular disease – BMJ Newsroom
Commentary: Mediterranean, Low-Fat Diets Both Good for Health: Network Meta-analysis – TCTMD
M-A | Effects of statin therapy on glycemic control and insulin resistance
31 Mar, 2023 | 13:45h | UTCRelated:
Cohort study: Statin therapy initiation linked to increased risk of diabetes progression.
Meta-Analysis: Medications that Reduce or Increase the Risk of New Onset Diabetes
Observational Study Points to an Increased Risk of Diabetes Among Patients Using Statins
Cohort Study: Statin Use Associated with a 38% Higher Risk of Incident Type 2 Diabetes
Coffee consumption vs. caffeine avoidance: cardiac ectopy, daily steps, and sleep impacts
27 Mar, 2023 | 13:32h | UTCSummary: A prospective, randomized, case-crossover trial studied the acute health effects of caffeinated coffee consumption in 100 ambulatory adults.
Participants were monitored using continuous electrocardiogram devices, wrist-mounted accelerometers, and ongoing glucose monitoring systems for 14 days. They received daily text messages instructing them to either consume caffeinated coffee or abstain from caffeine.
The primary outcome was the mean number of daily premature atrial contractions. Results indicated that caffeinated coffee consumption didn’t lead to significantly more daily premature atrial contractions compared to caffeine avoidance. However, it was associated with a higher number of daily premature ventricular contractions, increased daily steps, and reduced nightly sleep.
Article: Acute Effects of Coffee Consumption on Health among Ambulatory Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
What to know about new research on coffee and heart risks – Associated Press
CRAVE Trials Offers Most Comprehensive Overview Yet of Impact of Coffee, Caffeine Intake – HCP Live
Acute Effects of Coffee Consumption on Health – American College of Cardiology
Dissecting coffee’s impact: high consumption lowers blood pressure, raises LDL-cholesterol
27 Mar, 2023 | 13:25h | UTC
M-A | Effects of dairy intake on markers of cardio-metabolic health in adults
23 Mar, 2023 | 12:35h | UTC
Commentary on Twitter
Working with results of 19 randomized controlled trials (1427 total participants), #AdvNutr review authors conclude "high dairy intake (irrespective of fat content) showed no detrimental effects on anthropometric outcomes, blood lipids and blood pressure." https://t.co/59EiLeTW6g pic.twitter.com/ApVtfmfpsL
— American Society for Nutrition Journals (@jnutritionorg) March 13, 2023
Phase 2b RCT | New oral PCSK9 inhibitor reduces LDL cholesterol by 40% to 60%
22 Mar, 2023 | 13:20h | UTCCommentary: Oral PCSK9 Inhibitor Reduces LDL Cholesterol in Phase IIb Study – TCTMD
Study shows inflammation is a stronger predictor of CV events than cholesterol in patients receiving statin therapy
20 Mar, 2023 | 13:31h | UTCInflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials – The Lancet (link to abstract – $ for full-text)
Commentaries:
CRP More Predictive of Future Events Than LDL in Statin-Treated Patients – TCTMD
The global burden of metabolic disease: data from 2000 to 2019
13 Mar, 2023 | 14:39h | UTCThe global burden of metabolic disease: Data from 2000 to 2019 – Cell Metabolism (free for a limited period)
RCT | Treat-to-target strategy is noninferior to high-intensity statin therapy in patients with coronary artery disease
10 Mar, 2023 | 14:44h | UTCSummary: This randomized, multicenter, noninferiority trial in South Korea enrolled 4,400 patients with known coronary artery disease. Patients were randomly assigned to one of two groups: a treat-to-target group and a high-intensity statin group.
The treat-to-target group received moderate or high-intensity statins and titrated their medication to achieve an LDL-C goal of 50-70 mg/dL, while the high-intensity statin group received rosuvastatin 20 mg or atorvastatin 40 mg. The primary endpoint was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.
The study found that the primary endpoint occurred in 8.1% of the treat-to-target group and 8.7% of the high-intensity statin group, indicating that the treat-to-target strategy was noninferior to the high-intensity statin strategy.
Overall, the results of this study indicate that a treat-to-target strategy could be an appropriate substitute for high-intensity statin therapy in patients with coronary artery disease. This approach enables a personalized treatment plan that accounts for variations in individual drug response to statin therapy.
Article: Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial – JAMA (free for a limited period)
Commentaries:
Not all patients with coronary artery disease require high intensity statins – MedicalResearch.com
Commentary on Twitter
Among patients with coronary artery disease, a treat-to-target LDL-C strategy was noninferior to a high-intensity statin strategy for major clinical outcomes. https://t.co/Orv8IeF4Gv #ACC23 #WCCardio pic.twitter.com/NVEEJfQYfJ
— JAMA (@JAMA_current) March 6, 2023
WHO Meta-Analysis | Saturated fat and trans-fat intakes and their replacement with other macronutrients
9 Mar, 2023 | 14:24h | UTC
Commentary on Twitter
Saturated fat and trans-fat intakes
and their replacement with other
macronutrients
published on behalf @WHO https://t.co/fNXmKwWOMQ pic.twitter.com/0Qi8PNqyqq— Lukas Schwingshackl (@LSchwingshackl) March 6, 2023
RCT | Bempedoic acid shows modest reduction in cardiovascular events for statin-intolerant patients
8 Mar, 2023 | 14:39h | UTCSummary:
Bempedoic acid is an ATP citrate lyase inhibitor that reduces LDL cholesterol levels and is associated with a low incidence of muscle-related adverse events. The study enrolled 13,970 patients at increased cardiovascular risk, with 6,992 randomized to bempedoic acid and 6,978 randomized to placebo, with a median duration of follow-up of 40.6 months.
The study found that bempedoic acid was associated with a statistically significant 13% reduction in the primary endpoint of major adverse cardiovascular events, which included death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization. However, the absolute risk reduction of events was modest, at 1.6% over nearly four years.
The study also reported higher incidences of gout and cholelithiasis with bempedoic acid compared to placebo, as well as small increases in serum creatinine, uric acid, and hepatic-enzyme levels.
Article: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
CLEAR Positives and Cautions With Bempedoic Acid for Statin Intolerance – Medscape (recommended reading – free registration required)
Cardiovascular Outcomes After “Statin-Intolerant” Patients Take Bempedoic Acid – NEJM Journal Watch (free for a limited period)
Commentary on Twitter
Bempedoic acid showed a modest absolute reduction in CV outcomes, relative to placebo, in patients “unable or unwilling” to take a statin. https://t.co/hQUfvFwz68 #ACC23 @hmkyale @NEJM #CardioTwitter pic.twitter.com/YMoNsce8MI
— NEJM Journal Watch (@JWatch) March 7, 2023
M-A | Long-term consumption of 10 food groups and cardiovascular mortality
7 Mar, 2023 | 12:58h | UTCSummary:
This systematic review and meta-analysis of 22 prospective cohort studies evaluated the association between the consumption of 10 food groups and cardiovascular mortality.
The researchers found that a long-term high intake of whole grains, fruits and vegetables, and nuts was associated with reduced cardiovascular mortality, while a high intake of red/processed meat was associated with increased risk. On the other hand, the consumption of dairy products and legumes did not show a significant association with cardiovascular risk.
The researchers acknowledge the limitations of observational studies and the need for further research on the long-term effects of specific food groups on cardiovascular mortality.
Cohort Study | Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein
27 Feb, 2023 | 12:44h | UTCLipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein – European Heart Journal (link to abstract – $ for full-text)
Commentary: Lp(a) Is Linked to Atherothrombosis Independent of CRP – American College of Cardiology
M-A | Soluble fiber supplementation and serum lipid profile
20 Feb, 2023 | 12:18h | UTCSummary: The article presents the results of a systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) that evaluated the effect of soluble fiber supplementation on blood lipid parameters in adults. The review included 181 RCTs with 220 treatment arms and 14,505 participants. The meta-analysis found that soluble fiber supplementation significantly reduced LDL cholesterol, total cholesterol, triglycerides, and apolipoprotein B concentrations. The article suggests that increasing fiber intake using soluble fiber supplementation could be an effective intervention in the prevention and management of dyslipidemia, and consequently may contribute to the risk reduction of cardiovascular diseases. However, the article also notes that because of the high between-study heterogeneity and publication bias, the findings should be interpreted cautiously.
M-A | Aspirin with or without statin in individuals without atherosclerotic CVD across risk categories
17 Feb, 2023 | 13:22h | UTCSummary: This meta-analysis examined the effects of aspirin in adults without atherosclerotic cardiovascular disease (ASCVD), stratified by statin use across different ASCVD risks. The analysis found that aspirin reduced myocardial infarction but increased major bleeding, and was not associated with total or cardiovascular survival benefits. In adults without ASCVD, concomitant statin appeared to significantly reduce absolute risk reduction for MI associated with aspirin without influencing bleeding risk. The study highlights that the risk-benefit equilibrium may be tilted towards more harm for primary prevention, and that the expected absolute risk of major bleeding exceeds absolute MI benefits by aspirin for every level of ASCVD risk. The findings have implications for the use of aspirin in those already on statin therapy for primary ASCVD prevention.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Updated Guideline | Cardiovascular disease risk assessment and reduction, including lipid modification
13 Feb, 2023 | 12:47h | UTCRelated Guidelines:
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease – Circulation
#ESCCongress – 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias
#ESCCongress – 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
Abbreviated lipid guidelines for clinical practice
13 Feb, 2023 | 12:46h | UTCOriginal Guidelines
#ESCCongress – 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias
#ESCCongress – 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
Related:
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease – Circulation