Xiaoming Jia1, Mahmoud Al Rifai1,2, Ty J Gluckman3, Yochai Birnbaum1, Salim S Virani4,5. 1. Section of Cardiology, Baylor College of Medicine, Houston, TX, USA. 2. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA. 3. Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence St. Joseph Health, Portland, OR, USA. 4. Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, 2002 Holcombe Boulevard, Houston, TX, 77030, USA. virani@bcm.edu. 5. Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. virani@bcm.edu.
Abstract
PURPOSE OF REVIEW: This review intends to highlight selected cardiovascular disease (CVD) prevention studies presented at the 2019 European Society of Cardiology (ESC) Congress. RECENT FINDINGS: Results from the Inclisiran for Subjects with ASCVD or ASCVD-risk Equivalent and Elevated Low-density Lipoprotein Cholesterol (ORION-11) trial validate inclisiran's ability to significantly lower low-density lipoprotein cholesterol (LDL-C) levels in at-risk individuals on a background of maximally tolerated statin therapy. The EVOlocumab for Early Reduction of LDL-cholesterol Levels in Patients With Acute Coronary Syndromes (EVOPACS) trial provide additional support that a PCSK9 inhibitor can be initiated safely and effectively early after an acute coronary syndrome. A sub-study of the Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab (ODYSSEY OUTCOMES) trial provides further support for stratification of secondary prevention patients to help define the magnitude of risk reduction associated with PCSK9 inhibitor therapy. A post hoc analysis from the Aspirin in Reducing Events in the Elderly (ASPREE) trial suggest that any benefits associated with aspirin utilizing a risk-based approach are overwhelmed by increased bleeding risk. In a large retrospective cohort study of patients with diabetes mellitus and obesity, the addition of metabolic (weight loss) surgery to standard care led to greater improvement in CVD outcomes, weight loss, and glycemic control. Results from the Prospective Urban Rural Epidemiology (PURE) study demonstrate that while hypertension and dyslipidemia exert additive lifelong effects on CVD risk, other less established risk factors such as low education, household pollution, and poor diet also have a strong impact on CVD outcomes, especially in middle- and low-income countries. Finally, in the Heart Outcomes Prevention and Evaluation (HOPE) 4 trial, a comprehensive model of care adapted to address multiple barriers of specific communities led to substantial improved blood pressure (BP) control, medication use, and adherence. A number of studies presented at the 2019 ESC Congress reinforced the value of preventative interventions in CVD risk reduction.
PURPOSE OF REVIEW: This review intends to highlight selected cardiovascular disease (CVD) prevention studies presented at the 2019 European Society of Cardiology (ESC) Congress. RECENT FINDINGS: Results from the Inclisiran for Subjects with ASCVD or ASCVD-risk Equivalent and Elevated Low-density Lipoprotein Cholesterol (ORION-11) trial validate inclisiran's ability to significantly lower low-density lipoprotein cholesterol (LDL-C) levels in at-risk individuals on a background of maximally tolerated statin therapy. The EVOlocumab for Early Reduction of LDL-cholesterol Levels in Patients With Acute Coronary Syndromes (EVOPACS) trial provide additional support that a PCSK9 inhibitor can be initiated safely and effectively early after an acute coronary syndrome. A sub-study of the Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab (ODYSSEY OUTCOMES) trial provides further support for stratification of secondary prevention patients to help define the magnitude of risk reduction associated with PCSK9 inhibitor therapy. A post hoc analysis from the Aspirin in Reducing Events in the Elderly (ASPREE) trial suggest that any benefits associated with aspirin utilizing a risk-based approach are overwhelmed by increased bleeding risk. In a large retrospective cohort study of patients with diabetes mellitus and obesity, the addition of metabolic (weight loss) surgery to standard care led to greater improvement in CVD outcomes, weight loss, and glycemic control. Results from the Prospective Urban Rural Epidemiology (PURE) study demonstrate that while hypertension and dyslipidemia exert additive lifelong effects on CVD risk, other less established risk factors such as low education, household pollution, and poor diet also have a strong impact on CVD outcomes, especially in middle- and low-income countries. Finally, in the Heart Outcomes Prevention and Evaluation (HOPE) 4 trial, a comprehensive model of care adapted to address multiple barriers of specific communities led to substantial improved blood pressure (BP) control, medication use, and adherence. A number of studies presented at the 2019 ESC Congress reinforced the value of preventative interventions in CVD risk reduction.
Authors: David C Goff; Donald M Lloyd-Jones; Glen Bennett; Sean Coady; Ralph B D'Agostino; Raymond Gibbons; Philip Greenland; Daniel T Lackland; Daniel Levy; Christopher J O'Donnell; Jennifer G Robinson; J Sanford Schwartz; Susan T Shero; Sidney C Smith; Paul Sorlie; Neil J Stone; Peter W F Wilson; Harmon S Jordan; Lev Nevo; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Salim S Virani; Julia M Akeroyd; Sidney C Smith; Mouaz Al-Mallah; Thomas M Maddox; Pamela B Morris; Laura A Petersen; Christie M Ballantyne; Scott M Grundy; Neil J Stone Journal: J Am Coll Cardiol Date: 2019-08-06 Impact factor: 24.094
Authors: Scott M Grundy; Neil J Stone; Alison L Bailey; Craig Beam; Kim K Birtcher; Roger S Blumenthal; Lynne T Braun; Sarah de Ferranti; Joseph Faiella-Tommasino; Daniel E Forman; Ronald Goldberg; Paul A Heidenreich; Mark A Hlatky; Daniel W Jones; Donald Lloyd-Jones; Nuria Lopez-Pajares; Chiadi E Ndumele; Carl E Orringer; Carmen A Peralta; Joseph J Saseen; Sidney C Smith; Laurence Sperling; Salim S Virani; Joseph Yeboah Journal: Circulation Date: 2018-11-10 Impact factor: 29.690
Authors: Louise Bowman; Marion Mafham; Karl Wallendszus; Will Stevens; Georgina Buck; Jill Barton; Kevin Murphy; Theingi Aung; Richard Haynes; Jolyon Cox; Aleksandra Murawska; Allen Young; Michael Lay; Fang Chen; Emily Sammons; Emma Waters; Amanda Adler; Jonathan Bodansky; Andrew Farmer; Roger McPherson; Andrew Neil; David Simpson; Richard Peto; Colin Baigent; Rory Collins; Sarah Parish; Jane Armitage Journal: N Engl J Med Date: 2018-08-26 Impact factor: 91.245
Authors: Ralph B D'Agostino; Ramachandran S Vasan; Michael J Pencina; Philip A Wolf; Mark Cobain; Joseph M Massaro; William B Kannel Journal: Circulation Date: 2008-01-22 Impact factor: 29.690
Authors: Salim Yusuf; Philip Joseph; Sumathy Rangarajan; Shofiqul Islam; Andrew Mente; Perry Hystad; Michael Brauer; Vellappillil Raman Kutty; Rajeev Gupta; Andreas Wielgosz; Khalid F AlHabib; Antonio Dans; Patricio Lopez-Jaramillo; Alvaro Avezum; Fernando Lanas; Aytekin Oguz; Iolanthe M Kruger; Rafael Diaz; Khalid Yusoff; Prem Mony; Jephat Chifamba; Karen Yeates; Roya Kelishadi; Afzalhussein Yusufali; Rasha Khatib; Omar Rahman; Katarzyna Zatonska; Romaina Iqbal; Li Wei; Hu Bo; Annika Rosengren; Manmeet Kaur; Viswanathan Mohan; Scott A Lear; Koon K Teo; Darryl Leong; Martin O'Donnell; Martin McKee; Gilles Dagenais Journal: Lancet Date: 2019-09-03 Impact factor: 79.321
Authors: John J McNeil; Mark R Nelson; Robyn L Woods; Jessica E Lockery; Rory Wolfe; Christopher M Reid; Brenda Kirpach; Raj C Shah; Diane G Ives; Elsdon Storey; Joanne Ryan; Andrew M Tonkin; Anne B Newman; Jeff D Williamson; Karen L Margolis; Michael E Ernst; Walter P Abhayaratna; Nigel Stocks; Sharyn M Fitzgerald; Suzanne G Orchard; Ruth E Trevaks; Lawrence J Beilin; Geoffrey A Donnan; Peter Gibbs; Colin I Johnston; Barbara Radziszewska; Richard Grimm; Anne M Murray Journal: N Engl J Med Date: 2018-09-16 Impact factor: 91.245
Authors: Ali Aminian; Alexander Zajichek; David E Arterburn; Kathy E Wolski; Stacy A Brethauer; Philip R Schauer; Michael W Kattan; Steven E Nissen Journal: JAMA Date: 2019-10-01 Impact factor: 56.272
Authors: Matthew T Roe; Qian H Li; Deepak L Bhatt; Vera A Bittner; Rafael Diaz; Shaun G Goodman; Robert A Harrington; J Wouter Jukema; Patricio Lopez-Jaramillo; Renato D Lopes; Michael J Louie; Patrick M Moriarty; Michael Szarek; Robert Vogel; Harvey D White; Andreas M Zeiher; Marie T Baccara-Dinet; Ph Gabriel Steg; Gregory G Schwartz Journal: Circulation Date: 2019-09-02 Impact factor: 29.690