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Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology
Kartik Gupta1, Isabel Balachandran2, Jacob Foy1
1Department of Medicine, Henry Ford Hospital, Detroit, MI, USA.
Insights
New cardiovascular disease prevention research highlights alternatives to statin therapy. Studies examined novel drugs, dietary impacts, and risk stratification for better patient outcomes.
Area of Science:
- Cardiovascular disease prevention
- Clinical trial research
- Translational science
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality globally.
- Statin therapy is the cornerstone of CVD prevention but has limitations and side effects.
- Emerging research explores novel therapeutic targets and strategies for CVD risk reduction.
Purpose of the Study:
- To summarize late-breaking cardiovascular science presented at the 2023 American College of Cardiology (ACC) conference.
- To highlight advancements in CVD prevention strategies and clinical trial findings.
- To provide insights into current research on managing cardiovascular risk factors.
Main Methods:
- Review of late-breaking abstracts and presentations from the 2023 ACC conference.
- Inclusion of findings from randomized controlled trials (RCTs), cohort studies, and AI-driven analyses.
- Focus on studies evaluating pharmacological interventions, lifestyle factors, and risk prediction models.
Main Results:
- CLEAR outcomes trial: Bempedoic acid showed efficacy in high-risk patients with statin intolerance.
- YELLOW III: Evolocumab impacted coronary plaque characteristics.
- LOADSTAR trial: Compared targeted LDL-C reduction with high-intensity statins.
- PCDS trial: Electronic reminders improved high-intensity statin use.
- Other studies explored ketogenic diets, endurance athletes, AI for risk targets, copayment elimination, residual inflammatory risk, and oral PCSK9 inhibitors (MK-0616).
Conclusions:
- The 2023 ACC conference showcased significant advancements in cardiovascular disease prevention.
- Evidence supports alternative therapies and personalized approaches beyond traditional statin use.
- These findings offer valuable data for common clinical scenarios in cardiovascular practice.
Purpose Of Review:
To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 American College of Cardiology (ACC) conference.
Recent Findings:
The CLEAR outcomes randomized control trial (RCT) compared bempedoic acid to placebo in patients at high-risk of cardiovascular disease (CVD) or prevalent CVD and statin intolerance for CV outcomes. The YELLOW III was a single-arm study that evaluated the effect of Evolocumab on coronary plaque characteristics in patients with stable coronary artery disease (CAD). A cohort evaluated the association between a self-reported low-carbohydrate high-fat (ketogenic) diet and serum lipid levels as compared to a standard diet. The LOADSTAR trial compared CV outcomes with targeted low-density lipoprotein cholesterol (LDL-C) approach vs. high-intensity statin in patients with CAD. The PCDS statin cluster randomized trial compared the effectiveness of an electronic reminder to the clinician on a high-intensity statin use among patients with a history of ASCVD as compared to no reminder. A prospective cohort study compared the extent of coronary atherosclerosis among lifelong endurance athletes and healthy non-athletes. A causal artificial intelligence study combined polygenic risk scores with data from large CV prevention RCTs to guide systolic blood pressure and LDL-C reduction targets to reach average CV risk. The ACCESS trial evaluated the impact of eliminating copayment for low-income older adults in Canada with chronic CV diseases on composite CV outcomes. A pooled analysis of 3 large RCTs evaluated the association between residual inflammatory risk and CV outcomes, as compared to residual elevated cholesterol risk in patients receiving statin therapy. A Phase 2B RCT compared the efficacy of an oral PCSK9i, MK-0616, in reducing LDL-C as compared to a placebo. The late-breaking clinical science presented at the 2023 conference of the ACC paves the way for an evidence-based alternative to statin therapy and provides data on several common clinical scenarios encountered in daily practice.
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