From ESC: Statin Nonadherence, LDL Cholesterol Lowering After Acute MI, Ablation Therapy for Atrial Fibrillation, Advances in Cardiac Amyloidosis, and more

Phil, JAMA published a trial related to LDL cholesterol lowering after acute MI.

And I wonder if we could begin with you, and can you tell us about it?

Thank you, Greg.

The trial was called the Amundsen Randomized Clinical Trial.

It was led by Professor Gilles Montelet-Scott from Paris.

This multi-site French trial was presented in a hotline session at ESC.

The trial evaluated the administration of Evalocumab as first-line therapy versus usual standard of care in high-risk acute MI patients undergoing percutaneous coronary intervention, which I'll subsequently call PCI.

Evalocumab is a PCSK9 inhibitor that is currently recommended for second or third-line lipid-lowering drug therapy after myocardial infarction.

if it is discovered that the LDL cholesterol lowering with statins and other agents was not able to achieve desired LDL levels.

The trial was designed to test whether starting avalachimab at the time of PCI could achieve target LDL levels sooner and thereby possibly also improve clinical outcomes.

The primary endpoint in this trial was LDL cholesterol, less than 55 milligrams per deciliter, as well as also greater than 50% reduction from baseline at 12 months.

They also studied clinical endpoints of all-cause deaths and unplanned cardiovascular hospitalization.

They randomized over 2,100 patients with mean age 67.

21% were female.

The primary endpoint of LDL lowering was achieved in 82% of those randomized to Evalocumab at the time of PCI, which was compared to only 40% in the usual care group, and this was a highly statistically significant result.

However, they did not find any clinical event benefit of early Evalocumab during the first year of follow-up.

Whether clinical benefit may emerge in longer follow-up is unknown.

JAMA also published an editorial for this report.

Great.

Thank you very much, Phil.

A very interesting piece of research, and we appreciate your presenting it.

We're going to go on now to an article titled Digital Outreach to Improve Statin Refills in Patients with Low Statin Adherence.

And as you know, adherence to statin therapy is not particularly good, and investigators are looking for ways to improve statin adherence, given the importance of this clinical therapy.

This study from the Kaiser Permanente of Northern California looked at a collection of digital outreach interventions aimed at trying to improve statin refill rates among a collection of patients who had demonstrated statin non-adherence.

There were 20,000 participants in the study.