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Cardiovascular Disease Prevention in Focus: Highlights from the 2019 American Heart Association Scientific Sessions

Abstract

Purpose of the Review

This review highlights selected cardiovascular disease (CVD) prevention studies presented at the 2019 American Heart Association (AHA) Scientific Sessions.

Recent Findings

Several important cardiovascular prevention studies were presented at the 2019 AHA Scientific Sessions. Results from the Colchicine Cardiovascular Outcomes Trial (COLCOT) showed that low-dose colchicine reduces the risk of recurrent CVD events among patients with recent myocardial infarction. A prospective analysis from the UK Biobank cohort demonstrated that the increased CVD risk associated with clonal hematopoiesis of indeterminate potential is mitigated by a common disruptive mutation in the IL6R gene that suppresses the pro-inflammatory IL-1β/IL-6 pathway. The Treat Stroke to Target trial demonstrated that reducing low-density lipoprotein cholesterol to <70 mg/dL among patients with ischemic stroke or transient ischemic attack reduces the risk of recurrent CVD events as compared with a higher LDL-C target of 90–110 mg/dL. A secondary analysis focusing on American participants enrolled in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) showed that these patients receive a similar benefit in terms of cardiovascular risk reduction with icosapent ethyl as compared with the entire trial population. A post hoc analysis of the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial demonstrated that a genetic risk score comprising 27 single-nucleotide polymorphisms is associated with cardiovascular risk among patients with established atherosclerotic CVD and patients with high genetic risk receive a relatively higher benefit from evolocumab use. Similar results were observed with alirocumab use in a post hoc analysis of the ODYSSEY OUTCOMES trial where a genome-wide polygenic risk score comprising 6.5 million DNA variants was used.

Summary

These studies presented at 2019 AHA Scientific Sessions will help guide our approach to preventing CVD.

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    Correspondence to Salim S. Virani.

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    Conflict of Interest

    A.M., D.M., M.G., L.S.S., and R.S.B. each declare that they have no conflict of interest. S.S.V. reports research support from the Department of Veterans Affairs, the World Heart Federation, and the Tahir and Jooma Family; honorarium from the American College of Cardiology (Associate Editor for Innovations, acc.org); and membership with the Steering Committee of the Patient and Provider Assessment of Lipid Management (PALM) registry at the Duke Clinical Research Institute (no financial remuneration).

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    Mehta, A., Mahtta, D., Gulati, M. et al. Cardiovascular Disease Prevention in Focus: Highlights from the 2019 American Heart Association Scientific Sessions. Curr Atheroscler Rep 22, 3 (2020) doi:10.1007/s11883-020-0822-6

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    Keywords

    • Prevention
    • Cardiovascular disease
    • Inflammation
    • Stroke
    • Proprotein convertase subtilisin/kexin type 9 inhibitors
    • Icosapent ethyl