2) We are pleased and honored to welcome back our esteemed guest faculty is C. Michael Gibson MD @CMichaelGibson, Non-Profit Founder/Leader &❤️Doc from @harvardmed. #cmg previously educated us in this therapeutic area at https://t.co/XdayA7OAR3. pic.twitter.com/SufjAqeV8B
— cardio-met (@cardiomet_CE) September 1, 2024
3b) Which of the following statements about #RDW as a #CV risk marker is FALSE?
— cardio-met (@cardiomet_CE) September 1, 2024
a. It is nonspecific
b. It parallels #hsCRP
c. Elevated RDW is associated with development of intravascular atherosclerotic lesions
d. It is not routinely measured
4a) Reminder: Cardiovascular disease (#CVD) is #1 cause of death in 🇺🇸🇬🇧🇪🇺 . #Dyslipidemia is a primary causal factor in development of #atherosclerotic CVD (#ASCVD), & international guidelines rec tx of dyslipidemia for both primary & secondary prevention of ASCVD. pic.twitter.com/bS38bStn7w
— cardio-met (@cardiomet_CE) September 1, 2024
5a) Alternative & new drug classes have demonstrated further #CV event reduction when subbed for or added to #statins. See @nationallipid guidance on these drugs, found at https://t.co/GTHrtveS8v pic.twitter.com/87gtIrdOpP
— cardio-met (@cardiomet_CE) September 1, 2024
6) One of these new non-statin therapies is #bempedoic_acid, approved by @US_FDA in 2022. The #CLEAR Outcomes trial showing #cardiovascular benefit was published in @nejm: https://t.co/OG2ntak2Ce pic.twitter.com/cbI6ic6kbr
— cardio-met (@cardiomet_CE) September 1, 2024
8a) We know that much of the efficacy of #LLT derives from ⤵️ in #inflammation. Indeed, a substudy of #CLEAR_Outcomes at https://t.co/2lSiAdpzn9 showed that inflammation assessed by #hsCRP predicted risk for future #CV events & death …
— cardio-met (@cardiomet_CE) September 1, 2024
9) At #ESC2024, Patrick Moriarty presented new data from the trial on another marker of #inflammation: red cell distribution width #RDW, a measure of the variation in the size of #RBCs in a blood sample–originally used primarily to help differentiate the causes of anemia. pic.twitter.com/llp5jm3nxC
— cardio-met (@cardiomet_CE) September 1, 2024
11a) #RDW is thought to reflect underlying #inflammation & oxidative stress, both of which play a crucial role in the pathogenesis of #CV diseases. Inflammation can ➡️⬆️ RBC turnover, & oxidative stress can cause damage to RBCs, both of which contribute to ⬆️RDW.
— cardio-met (@cardiomet_CE) September 1, 2024
12) Baseline #RDW was identical at baseline for the #bempedoic_acid and placebo arms, and decreased more in the study group than the placebo group at multiple assays over 36 months. pic.twitter.com/hFPlavpiGq
— cardio-met (@cardiomet_CE) September 1, 2024
14) So what impact did treatment with #bempedoic_acid have?
— cardio-met (@cardiomet_CE) September 1, 2024
👉Compared to placebo, bempedoic acid reduced #RDW at Month 6 (sustained through month 36) & demonstrated efficacy in #CV risk reduction in patients with moderately increased RDW. pic.twitter.com/dm9I6d9hGZ
16) One of the advantages of RDW is that it is part of the standard #CBC, which is routinely performed in clinical practice. This makes it a readily available and cost-effective marker that does not require additional testing or expenses.
— cardio-met (@cardiomet_CE) September 1, 2024
18) So we have known #CV risk from #hyperlipidemia. Perhaps with #RDW we have another way to assess that risk. We have statin treatments and non-statin treatments to attenuate that risk. Why aren’t we seeing improved #CV health globally?
— cardio-met (@cardiomet_CE) September 1, 2024
20a) This author group performed a retrospective analysis of high-risk pts with prior #ACS or #stroke presenting with another ACS/stroke during 2022 in their UK District General Hospital. They compared their regional secondary prevention lipid-lowering pathway to:
— cardio-met (@cardiomet_CE) September 1, 2024
20c) Understandably, they considered this patient group, with recurrent events, to represent "very high" risk group" and had been through various clinicians multiple times, increasing the opportunity to treat to guidance.
— cardio-met (@cardiomet_CE) September 1, 2024
21b) During admission for a recurrent event:
— cardio-met (@cardiomet_CE) September 1, 2024
👉no #lipid profile 21% in #stroke group & 77% in #ACS group
👉65% of ACS group and 21% of stroke group had significant inpatient escalation in #LLT, but this was mainly confined to high dose #statins
21d) Not surprisingly then, only 45% of patients achieved the guideline target of LDL < 1.8 mmol/L and only 18% achieved the ESC target of LDL <1.4 during 1 year follow up.
— cardio-met (@cardiomet_CE) September 1, 2024
22b) And note this is in a district hospital with a guidelines-concordant treatment pathway!
— cardio-met (@cardiomet_CE) September 1, 2024
⭐️#cmgsays this is likely all too common. We have better risk strat and tx tools than ever for managing hyperlipidemia . . .
23) Thank you for joining us for this update from #ESC2024! You may now proceed to https://t.co/jrPAEVx750 and collect your 🆓CE/#CME certificate! Thanks as always to @CMichaelGibson for leading us through these hot-off-the-presses data!
— cardio-met (@cardiomet_CE) September 1, 2024