Videos

Lerodalcibep: What does LIBerate-HeFH tell us?

The Phase 3 LIBerate-HeFH trial showed that lerodalcibep significantly reduced LDL-cholesterol (LDL-C) in patients with heterozygous familial hypercholesterolaemia (HeFH) on background stable lipid lowering therapy (LLT). Professor Derick Raal discusses the data and explains what the results mean to practising clinicians. Lerodalcibep (LIB-003) consists of…

Verve-101: Where are we up to with PCSK9 gene editing?

VERVE-101 is a novel CRISPR base editing agent designed to knock out expression of the PCSK9 gene by changing a single DNA base, thereby turning off PCSK9 protein production in hepatocytes and lowering LDL-C. VERVE-101 consists of an mRNA for an adenine base editor and…

Apo(a) size and PAD revascularisation outcomes: What’s the link?

High Lp(a) increases the risk of peripheral arterial disease (PAD) and adverse limb events,1 and apo(a) is an essential component of Lp(a). Apo(a) is expressed as large and small isoforms, and small size is associated with higher Lp(a) levels and greater risk of cardiovascular disease.2,3…

Lepodisiran: What progress towards Lp(a) reduction?

Lepodisiran (LY3819469) is a short interfering RNA (siRNA) targeted at the mRNA for apolipoprotein A (apoA) – an essential component of lipoprotein a (Lp(a)). Elevated levels of Lp(a) are associated with atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis, and Lp(a) measurement is recommended at least…

What’s new on the horizon for lipoprotein(a) therapies?

For too long an enigma, lipoprotein(a) [Lp(a)] has now taken centre stage on the strength of epidemiologic and genetic studies showing that an elevated Lp(a) level is a causal risk factor for cardiovascular disease. However, there is a major obstacle to the management of high…

Should ACS patients start a PCSK9 inhibitor in hospital?

Guidelines recommend that very high-risk patients require combination lipid lowering therapy, ideally the combination of statin-ezetimibe and a PCSK9 inhibitor, to attain LDL cholesterol goal. The question is whether those with an acute coronary syndrome (ACS) should initiate a PCSK9 inhibitor with intensive statin therapy…

APOLLO trial with SLN360

Professor Stephen Nicholls (Monash University, Australia) discusses the APOLLO trial with SLN360.  

What can we learn from the Homozygous Familial Hypercholesterolaemia International Clinical Collaboration registry?

Homozygous familial hypercholesterolaemia (HoFH) is the most severe presentation of this inherited lipid disorder, characterised by accelerated premature atherosclerotic cardiovascular disease due to the burden of extremely elevated LDL cholesterol levels from birth. Insights into management, however, are limited due to the rarity of the…

What does the future hold for CRISPR base editing of PCSK9?

Kiran Musunuru, Professor and Genetics Researcher at University of Pennsylvania, USA discusses the prospects for a one-shot “vaccination” against heart attacks, the leading cause of death worldwide. CRISPR (clustered regularly interspaced short palindromic repeats) gene editing has evolved rapidly to allow for testing in a…

ESC 2021 Inclisiran in polyvascular disease

Polyvascular disease is a severe manifestation of atherosclerotic cardiovascular disease and an independent predictor of increased risk of cardiovascular events. Prof Derick Raal (University of the Witwatersrand, Johannesburg, South Africa) discusses findings from post hoc analyses from the ORION-9, -10 and -11 trials with the…

Huygens: Does PCSK9 inhibition impact the vulnerable plaque?

The HUYGENS study (High-Resolution Assessment of Coronary Plaques in a Global Evolocumab Randomized Study NCT03570697) investigated the impact of PCSK9 inhibition on the vulnerable plaque. Results were reported at ESC Congress 2021 (Virtual). Professor Stephen Nicholls, Monash University, Melbourne, Australia discusses the background to the…

LDL cholesterol lowering and effects on plaque: what can we learn from INTENSITY-HIGH?

INTENSITY-HIGH: Investigating the Lowest Threshold of Vascular Benefits from LDL Cholesterol Lowering with a PCSK9 mAb Inhibitor (Alirocumab) in Patients with Stable Cardiovascular Disease The landmark PCSK9 inhibitor trials – FOURIER and ODYSSEY OUTCOMES – established the cardiovascular benefits of lowering LDL cholesterol to very…

Why should clinical practice move to an intensive LDL-C lowering approach?

Professor Chris Packard discusses the need for this change in the light of the 2019 ESC/EAS dyslipidaemia guidelines.

How do clinicians translate intensive LDL-C lowering to their practice?

Professor Chris Packard discusses the highest-risk-highest benefit strategy.

Are very low lipoprotein(a) levels safe? Insights from the Copenhagen General Population Study

High lipoprotein(a) levels are clearly established as a risk factor for cardiovascular disease and aortic valve stenosis (1,2). Recent lipid guidelines have affirmed the importance of measuring lipoprotein(a) [Lp(a)] in individuals with intermediate risk or with a family or personal history of premature or recurrent…

Which lipid markers best identify residual risk in statin-treated patients?

LDL cholesterol is undoubtedly the priority lipid target to prevent atherosclerotic cardiovascular disease. Yet even with attainment of very low levels, high risk patients continue to experience cardiovascular events. The question is: which is the best lipid to target this residual risk? The options include…

Very low lipoprotein(a) and very low LDL cholesterol – are they safe?

High lipoprotein(a) [Lp(a] is a cardiovascular risk factor. With the development of novel therapies for lowering elevated Lp(a), a key concern is whether very low levels pose any risk. A similar debate has engendered with LDL cholesterol. Professor Chris Packard, University of Glasgow, UK puts…

Combination therapy in familial hypercholesterolaemia: what can we gain from novel agents?

Triglyceride lowering and residual risk: what can we learn from the trials?

VIDEO: GPs in FH care