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From the Editors

Proof-of-concept: Gene-editing for PCSK9 inhibition

Proof-of-concept: Gene-editing for PCSK9 inhibition

Prof. John Chapman  Pitié-Salpêtrière University Hospital, Sorbonne University, and National Institute for Health and Medical Research (INSERM), Paris, France. Cholesterol-rich low-density lipoprotein (LDL) is indisputably a causal factor for premature atherosclerotic cardiovascular disease (ASCVD) (1,2). Evidence from real world observational studies, however, consistently shows that…

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Treating high risk cardiovascular disease: Is combination lipid lowering therapy now the rule not the exception?

Treating high risk cardiovascular disease: Is combination lipid lowering therapy now the rule not the exception?

In 2019 the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) updated their guidelines for the management of dyslipidaemia to prevent atherosclerotic cardiovascular disease (ASCVD). On the basis of evidence from IMPROVE-IT with ezetimibe and the two landmark PCSK9 inhibitor trials, FOURIER with…

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The LDL frontier: what else do we need to know?

The LDL frontier: what else do we need to know?

Prof. Anthony Wierzbicki, Guy’s & St Thomas’ Hospitals, London UK discusses knowledge and questions about very low LDL cholesterol levels. With the advent of the PCSK9 inhibitors very low LDL cholesterol levels – less than 30 mg/dL or 0.78 mmol/L- are now a clinical reality….

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SAMSON’s undoing is in the details

SAMSON’s undoing is in the details

Prof. Robert S. Rosenson, Mount Sinai Icahn School of Medicine, New York, USA discusses results from the SAMSON trial of symptoms reported with statin treatment. Statins are indisputably the backbone of lipid lowering therapy for preventing cardiovascular events. Ensuring adherence with treatment is essential for…

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No age limits for treating high cholesterol?

No age limits for treating high cholesterol?

Prof Derick Raal (University of the Witwatersrand, Johannesburg, South Africa) discusses the latest evidence on this contentious question. Atherosclerosis is a progressive disease in which LDL cholesterol is a major driver. Supported by incontrovertible evidence that LDL is causal for atherosclerotic cardiovascular disease (ASCVD)(1,2), current…

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Paediatric familial hypercholesterolaemia attracts new focus

Paediatric familial hypercholesterolaemia attracts new focus

Dr Albert Wiegman, Amsterdam University Medical Center, The Netherlands discusses the latest findings that have highlighted familial hypercholesterolaemia in children. For the second time within 12 months, a study about children with familial hypercholesterolaemia (FH, inherited high cholesterol) is published in The New England Journal…

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HAUSER-RCT with evolocumab: what role in children with FH?

HAUSER-RCT with evolocumab: what role in children with FH?

PCSK9 Forum Editor Professor Derick Raal (University of the Witwatersrand, Johannesburg, South Africa) comments on the findings of the HASUER-RCT study and potential implications for patient care. HAUSER-RCT is an important study for the care of children and adolescents with familial hypercholesterolaemia (FH). The study…

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Looking beyond LDL: PCSK9 inhibition and remnants

Looking beyond LDL: PCSK9 inhibition and remnants

Professor Chris Packard (Institute of Cardiovascular and Medical Sciences, Glasgow University, UK) discusses how PCSK9 inhibition might affect remnant particles.  The case for the causality of LDL cholesterol in atherosclerotic cardiovascular disease (ASCVD) is indisputable (1). Consequently, attention has now focused on the role of…

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LDL cholesterol targets in stroke patients: where to?

LDL cholesterol targets in stroke patients: where to?

Professor Pierre Amarenco, Bichat Hospital, University of Paris, France, makes the case for reconsideration of LDL cholesterol targets to prevent stroke, based on evidence from recent trials.  Stroke is a major contributor to the global cardiovascular disease burden (1). Major modifiable risk factors including elevated…

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PCSK9 inhibition, low LDL cholesterol and lack of cognitive impairment: QED?

PCSK9 inhibition, low LDL cholesterol and lack of cognitive impairment: QED?

Prof Derick Raal, University of the Witwatersrand, Johannesburg, South Africa, discusses the latest data from FOURIER regarding cognitive safety. What is the take home message for clinicians? Clinicians have long been concerned about ‘going too low’ when prescribing lipid-lowering therapy. A key issue is whether…

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PCSK9 inhibition: impact on stroke

PCSK9 inhibition: impact on stroke

Prof Raul Santos, from the Heart Institute (InCor) University of Sao Paulo Medical School Hospital and the Hospital Israelita Albert Einstein, São Paulo, Brazil discusses the latest findings from FOURIER. Stroke brings a high burden of individual and family suffering, in addition to elevated health…

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Monogenic versus polygenic familial hypercholesterolaemia: how does cardiovascular risk compare?

Monogenic versus polygenic familial hypercholesterolaemia: how does cardiovascular risk compare?

Professor Derick Raal, University of the Witwatersrand, Johannesburg, South Africa Familial hypercholesterolaemia (FH, inherited high cholesterol) is one of the most common inherited disorders, affecting approximately one in every 250 people or over 30 million people worldwide.  FH is usually caused by pathogenic variants in…

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Managing homozygous FH: what can we learn from TAUSSIG?

Managing homozygous FH: what can we learn from TAUSSIG?

Professor Eric Bruckert (Hôpital Pitié Salpêtrière, Paris, France) gives his perspective on the take home messages from TAUSSIG.  Patients with homozygous familial hypercholesterolaemia (FH) are extremely difficult to manage. High LDL cholesterol levels associated with this disorder put patients at very high risk of premature…

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Are we doing any better with familial hypercholesterolaemia care?

Are we doing any better with familial hypercholesterolaemia care?

Professor Eric Bruckert, Pitié-Salpêtrière Hospital, Paris, France In the last 5 years, there has been a drive to improve the care of familial hypercholesterolaemia (FH), one of the most common inherited disorders, affecting as many as 1 in 200-250 individuals worldwide.1,2 This follows on from…

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Targeting PCSK9 inhibitors to the right patient

Targeting PCSK9 inhibitors to the right patient

Professor Stephen J Nicholls MBBS PhD, Monash Cardiovascular Research Centre, Monash University, Melbourne, Australia  The clinical development of pharmacological inhibitors of proprotein convertase subtilisin kexin type 9 (PCSK9) has received considerable attention by virtue of the expectation that these treatments would have the potential to…

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LDL cholesterol goals in patients with diabetes – How low?

LDL cholesterol goals in patients with diabetes – How low?

Professor Derick Raal, University of the Witwatersrand, Johannesburg, South Africa. Patients with diabetes and a history of acute coronary syndrome (ACS) are at enhanced risk of recurrent events and death compared with those without diabetes.1 Does this mean that treatment with a PCSK9 inhibitor will…

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Surfing the PCSK9 wave of discovery

Surfing the PCSK9 wave of discovery

Prof Derick Raal (University of Witwatersrand, Johannesburg, South Africa) gives his perspective on the newest ‘PCSK9 kids on the block’ amidst the wave of PCSK9 discovery. In 2012, there was the first clinical evidence of dramatic reductions in LDL cholesterol by inhibiting PCSK9 with monoclonal…

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Did someone say “Beyond LDL-cholesterol”?

Did someone say “Beyond LDL-cholesterol”?

PCSK9 Forum Editor Professor John Chapman (Pitié-Salpétrière University Hospital, and Sorbonne University, Paris, France) discusses how ‘OMICS’ technologies could provide a precision medicine approach to managing non-LDL lipids. As a causal factor in atherosclerotic cardiovascular disease (ASCVD), measurement of LDL cholesterol has facilitated enormous progress…

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Coronary artery calcium in familial hypercholesterolaemia

Coronary artery calcium in familial hypercholesterolaemia

Coronary artery calcium (CAC) score may have a role in stratifying short-term risk in patients with familial hypercholesterolaemia (FH, inherited high cholesterol), according to a new study. The authors suggest that this noninvasive approach may have value in targeting treatment with a PCSK9 inhibitor to…

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Stratifying risk in familial hypercholesterolaemia: does coronary artery calcium have a role?

Stratifying risk in familial hypercholesterolaemia: does coronary artery calcium have a role?

PCSK9 Forum Editors Professor Gerald Watts (University of Western Australia, Perth, Australia) and Professor Derick Raal (University of the Witwatersrand, Johannesburg, South Africa) give their view. As a result of life-long exposure to high LDL cholesterol levels, individuals with familial hypercholesterolaemia (FH, inherited high cholesterol)…

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