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Review
. 2023 Jun;25(6):309-321.
doi: 10.1007/s11883-023-01103-4. Epub 2023 Apr 22.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference

Kartik Gupta  1 , Isabel Balachandran  2 , Jacob Foy  1 , Melody Hermel  3 , Azka Latif  4 , Chayakrit Krittanawong  5 , Leandro Slipczuk  6 , Farhala Baloch  7 , Zainab Samad  7 , Salim S Virani  8   9   10
Affiliations
Review

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference

Kartik Gupta et al. Curr Atheroscler Rep. 2023 Jun.

Abstract

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.

Keywords: ACCESS; Bempedoic acid; CLEAR; LOADSTAR; PCDS; YELLOW.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Gupta K, Hirsch JR, Kalsi J, Patel V, Gad MM, Virani SS. Highlights of Cardiovascular Disease Prevention Studies Presented at the 2022 American Heart Association Scientific Sessions. Curr Atheroscler Rep. 2023;25(1):31–41. https://doi.org/10.1007/s11883-022-01079-7 . - DOI - PubMed
    1. Hermel M, Tsai S, Dlouhy L, et al. Highlights of Cardiovascular Disease Prevention Studies Presented at the 2022 American College of Cardiology Scientific Sessions. Curr Atheroscler Rep. 2022;24(8):671–80. https://doi.org/10.1007/s11883-022-01042-6 . - DOI - PubMed - PMC
    1. Bytyçi I, Penson PE, Mikhailidis DP, et al. Prevalence of statin intolerance: a meta-analysis. Eur Heart J. 2022;43(34):3213–23. https://doi.org/10.1093/eurheartj/ehac015 . - DOI - PubMed - PMC
    1. Virani SS, Ballantyne CM, Petersen LA. Guideline-Concordant Statin Therapy Use in Secondary Prevention: Should the Medical Community Wait for Divine Intervention? J Am Coll Cardiol. 2022;79(18):1814–7. https://doi.org/10.1016/j.jacc.2022.02.042 . - DOI - PubMed
    1. • Nelson AJ, Haynes K, Shambhu S, et al. High-Intensity Statin Use Among Patients With Atherosclerosis in the US. J Am Coll Cardiol. 2022;79(18):1802–13. https://doi.org/10.1016/j.jacc.2022.02.048 . Highlights significant gap in prescription of statins for secondary prevention in the US in a contemporary cohort of patients enrolled in a commercial health plan. - DOI - PubMed - PMC

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