Lipids
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
Lipid‐lowering trials are not representative of patients managed in clinical practice: a systematic review and meta‐analysis of exclusion criteria
2 Feb, 2023 | 14:52h | UTC
M-A | Association between autism spectrum disorders and cardiometabolic diseases
1 Feb, 2023 | 13:11h | UTCAssociation Between Autism Spectrum Disorders and Cardiometabolic Diseases: A Systematic Review and Meta-analysis – JAMA Pediatrics (free for a limited period)
Editorial: Autism, Physical Health Conditions, and a Need for Reform – JAMA Pediatrics (free for a limited period)
Commentary on Twitter
Study results suggest that having autism may be associated with a higher risk of developing diabetes, dyslipidemia, and heart disease. https://t.co/T19VAQxdjf
— JAMA Pediatrics (@JAMAPediatrics) January 30, 2023
Perspective | The case of statins, diabetes, and bias in observational studies
24 Jan, 2023 | 14:35h | UTCThe Case of Statins, Diabetes, and Bias in Observational Studies – Sensible Medicine
Restoring mortality data in the FOURIER trial of evolocumab in patients with CVD: a reanalysis based on regulatory data
10 Jan, 2023 | 14:49h | UTCCommentaries:
Yet Another Story on Re-Analyzing a Major Trial – Sensible Medicine
Study Alleges Mortality Miscount in FOURIER Trial; TIMI Group Disagrees – TCTMD
The year in cardiovascular medicine 2022: the top 10 papers in dyslipidemias
9 Jan, 2023 | 14:26h | UTC
Commentary on Twitter
The Year in Cardiovascular Medicine 2022 series: the Top 10 papers in Dyslipidaemia https://t.co/jpkqgt4Hf1 @escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes #CVD #dyslipidemia pic.twitter.com/UBfKy45mAu
— European Society of Cardiology Journals (@ESC_Journals) January 2, 2023
Cohort Study | Association of the triglyceride glucose index as a measure of insulin resistance with mortality and CVD
9 Jan, 2023 | 13:42h | UTCInvited Commentary: The triglyceride glucose index and cardiovascular disease outcomes – The Lancet Health Longevity
Cohort Study | Lipoprotein(a) in youth and prediction of major cardiovascular outcomes in adulthood.
9 Dec, 2022 | 13:11h | UTCLipoprotein(a) in Youth and Prediction of Major Cardiovascular Outcomes in Adulthood – Circulation
Commentary: Lp(a) in Youth and Risk of ASCVD Outcomes in Adulthood – American College of Cardiology
Commentary on Twitter
#OriginalResearch Childhood Lp(a) levels are associated with significantly increased risk of develping ASCVD as adults @UTUpophealth @olraita #AHAJournals https://t.co/oqHv19QU6l pic.twitter.com/ByZmtRrXqy
— Circulation (@CircAHA) November 30, 2022
Podcast | Advanced lipidology.
30 Nov, 2022 | 13:32h | UTC#361 Advanced Lipidology – The Curbsiders
RCT | Vitamin D fails to prevent statin-associated muscle symptoms among new statin users.
25 Nov, 2022 | 12:40h | UTCStatin-Associated Muscle Symptoms Among New Statin Users Randomly Assigned to Vitamin D or Placebo – JAMA Cardiology (free for a limited period)
Commentary: Vitamin D fails to reduce statin-associated muscle pain – Northwestern University
Commentary on Twitter
Vitamin D supplementation did not prevent statin-associated muscle symptoms or reduce statin discontinuation among new statin users in the randomized VITAL trial. https://t.co/wNZoeJ8PZf
— JAMA Cardiology (@JAMACardio) November 23, 2022
Cohort Study | Race-dependent association of HDL-C levels with incident coronary artery disease.
23 Nov, 2022 | 14:02h | UTCNews Release: Study challenges “good” cholesterol’s role in universally predicting heart disease risk – National Institutes of Health
Inclisiran and cardiovascular events: a patient-level analysis of phase III trials.
17 Nov, 2022 | 12:17h | UTCCommentary: Inclisiran and Cardiovascular Events – American College of Cardiology
Commentary on Twitter
https://twitter.com/ESC_Journals/status/1592113799481692162
RCT | Comparative effects of low-dose rosuvastatin vs. dietary supplements on lipids and inflammatory biomarkers.
16 Nov, 2022 | 13:41h | UTCNews Release: 6 common “heart-health” supplements ineffective at lowering cholesterol compared to statins – American Heart Association
Commentaries:
Study – For Lowering Cholesterol, Statins Work, Supplements Don’t – Science-Based Medicine
Statins vs. supplements: New study finds one is ‘vastly superior’ to cut cholesterol – NPR
Canadian guideline for the prevention and management of cardiovascular disease in primary care.
8 Nov, 2022 | 12:37h | UTCNews Release: New one-stop guideline for cardiovascular health in Canada – Canadian Medical Association Journal