Highlights of Cardiovascular Disease Prevention Studies Presented at the 2026 American College of Cardiology...

To summarize key findings from cardiovascular disease prevention trials at the 2026 American College of Cardiology (ACC) Conference.

The Ez-PAVE trial demonstrated that targeting low-density lipoprotein cholesterol (LDL-C) levels < 55 mg/dL significantly reduces major adverse cardiovascular events compared with a target of < 70 mg/dL in patients with established atherosclerotic cardiovascular disease (ASCVD). A subgroup analysis of the VESALIUS-CV trial showed that Evolocumab reduced first cardiovascular events in high-risk individuals with diabetes who did not have known significant atherosclerosis. The CORALreef AddOn trial demonstrated the superior LDL-C-lowering efficacy of the oral PCSK9 inhibitor Enlicitide compared with ezetimibe, bempedoic acid, and the combination of the two. The Ez-PAVE trial demonstrated that targeting low-density lipoprotein cholesterol (LDL-C) levels < 55 mg/dL significantly reduces major adverse cardiovascular events compared with a target of < 70 mg/dL in patients with established atherosclerotic cardiovascular disease (ASCVD). A subgroup analysis of the VESALIUS-CV trial showed that Evolocumab reduced first cardiovascular events in high-risk individuals with diabetes who did not have known significant atherosclerosis. The CORALreef AddOn trial demonstrated the superior LDL-C-lowering efficacy of the oral PCSK9 inhibitor Enlicitide compared with ezetimibe, bempedoic acid, and the combination of the two. Imaging and diagnostic advances were highlighted by the GPS-CAD study, which demonstrated variability in the reliability of a coronary artery calcium score (CACS) of zero across diverse populations. In contrast, the Essence-TIMI 73b substudy found no significant impact of triglyceride lowering with olezarsen on coronary plaque progression over 12 months. Lifestyle and health equity-focused interventions, including the GoFreshRx and THRIVE trials, demonstrated meaningful reductions in blood pressure through dietary and food-as-medicine strategies in underserved populations. Additionally, the SURPASS-CVOT post hoc analysis showed that tirzepatide reduced composite cardiorenal outcomes compared with dulaglutide in patients with type 2 diabetes. Finally, the SMART-DECISION trial suggested that discontinuation of beta-blockers in stable patients one year after myocardial infarction with an LVEF of at least 40% may be safe and noninferior to continuation. The studies presented at ACC 2026 emphasize the importance of intensive lipid-lowering strategies, expand the use of new cardiometabolic therapies, and showcase emerging diagnostic and preventive strategies for ASCVD.