1b) Patients with #diabetes are at substantially increased risk of #CV disease, often in association with hyperlipidemia #HL. Therefore it's no surprise that a 🌶️topic at #ADA2023 would be management of #HL and #CV disease prevention!#FOAMed @MedTweetorials
— cardio-met (@cardiomet_CE) June 27, 2023
3) There are two areas of #CVD #prevention: #primary and #secondary: pic.twitter.com/VPJuwTWTVd
— cardio-met (@cardiomet_CE) June 27, 2023
5a) One of these new non-statin therapies is #bempedoic_acid, which was approved by @US_FDA in 2022. The #CLEAR_Outcomes trial showing #CV benefit was presented at #ACC2023 & published Apr 2023.
— cardio-met (@cardiomet_CE) June 27, 2023
6) This week at @AmDiabetesAssn meeting #ADA23, we learned all about the #primary_prevention cohort from #CLEAR_Outcomes from Steve Nissen MD @ClevelandClinic. Data were published simultaneously in @JAMA_current.
— cardio-met (@cardiomet_CE) June 27, 2023
🔓 https://t.co/RLM3usviXa pic.twitter.com/VLCVE8c4PJ
8) A 🔑finding was that there was significant benefit from #bempedoic acid in #primary_prevention in both #CV death and all-cause mortality ☠️. pic.twitter.com/JwU7RgpBx7
— cardio-met (@cardiomet_CE) June 27, 2023
9b) … #bempedoic acid was associated with
— cardio-met (@cardiomet_CE) June 27, 2023
a significant ⬇️in the primary composite end point of time to ☠️from #CV causes, nonfatal #MI, nonfatal #stroke, or coronary #revascularization.
9d) See my prior #tweetorial on these data, available for even MORE 🆓CE/#CME credit, at https://t.co/03d7bb0AXb.#FOAMed #CardioTwitter @MedTweetorials
— cardio-met (@cardiomet_CE) June 27, 2023
11) The first one was #WOSCOPS with #pravastatin – and it showed a significant benefit over a 5 year treatment period.
— cardio-met (@cardiomet_CE) June 27, 2023
🔓 https://t.co/UhcUoFjyU9 pic.twitter.com/yI4ogfGRNc
13) Next was the #CARDS trial in patients with #diabetes – also showing a benefit of #atorvastatin 10 mg.https://t.co/HiUVFiYzZq pic.twitter.com/9M8E7BrCfb
— cardio-met (@cardiomet_CE) June 27, 2023
15) And finally #HOPE_3, using #rosuvastatin 10mg, showed a 25% HR reduction (95% CI, 0.64-0.88)
— cardio-met (@cardiomet_CE) June 27, 2023
🔓 https://t.co/E1CIu9MV0m pic.twitter.com/kqzhqzyoqZ
17) There was also a primary prevention trial with #ezetimibe that showed benefit on #CV events.
— cardio-met (@cardiomet_CE) June 27, 2023
🔓 https://t.co/xvpBNBZgr0 pic.twitter.com/SS3VHWI1Hs
18b) We addressed that question in the #IMPROVE_IT trial (a #secondary_prevention trial) – and found the benefit with adding ezetimibe was exactly what one would have expected based on the amount of LDL reduction.
— cardio-met (@cardiomet_CE) June 27, 2023
🔓 https://t.co/Uo1lxSmfJB pic.twitter.com/BpWVsgKYCW
19b) They applied the #CTT methodology & endpoint defs to #CLEAR_Outcomes to derive normalized HRs associated with #bempedoic_acid tx for the composite MVE endpoint (fatal #CHD, non-fatal MI, stroke, or revasc) & individual CV outcomes per 1 mmol/L #LDL-C reduction at 1 year.
— cardio-met (@cardiomet_CE) June 27, 2023
19d) They concluded: The #CV benefits achieved with #bempedoic acid are comparable to those obtained with #statins, being proportional to the magnitude of absolute reductions in #LDL-C. pic.twitter.com/pGd6d0eIga
— cardio-met (@cardiomet_CE) June 27, 2023
21a) So we can conclude that lowering #LDL by any of the current means – #statins, #ezetimibe, #PCSK9 inhibitors, and now #bempedoic_acid – all lead to clinical benefit in reducing the risk of #cardiovascular events.
— cardio-met (@cardiomet_CE) June 27, 2023
22a) So what have you learned?
— cardio-met (@cardiomet_CE) June 27, 2023
The benefit of lipid lowering drugs #LLT is proportional to the amount of #LDL lowering
23a) In patients receiving #primary_prevention, #bempedoic acid reduces the risk of all these #CV outcomes except:
— cardio-met (@cardiomet_CE) June 27, 2023
24) And, wrapping up #ADA23, you just earned .5h 🆓CE/#CME! Claim your certificate at https://t.co/lcgSWzRVxu, and FOLLOW @cardiomet_ce for the latest #cardiometabolic #MedEd delivered wholly on Twitter! @cpcannon thanks you for joining us!#FOAMed #MedEd #CardioTwitter
— cardio-met (@cardiomet_CE) June 27, 2023