Countdown to FOURIER: Are very low levels of LDL cholesterol safe?
A view from PCSK9 Forum Editor Dr Peter Lansberg (Academic Medical Center, Amsterdam, the Netherlands) Comment relates to: Giugliano RP, Wiviott SD, Blazing MA et al. Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol A Prespecified Analysis of the IMPROVE-IT…read more »
IMPROVE-IT: Further reassurance on very low LDL cholesterol
In a pre-specified analysis of IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), patients with LDL cholesterol < 30mg/dL or <0.78 mmol/l after 1 month on treatment had a similar safety profile and fewer cardiovascular events over 6 years than those at higher levels….read more »
Does the mechanism of lowering LDL cholesterol matter? Insights from recent Mendelian Randomization studies
Meta-analyses of numerous randomized trials have demonstrated that lowering low density lipoprotein (LDL) cholesterol by inhibiting HMG-CoA reductase (HMGCR) with a statin reduces the risk of major cardiovascular events by approximately 20% for each mmol/L lower LDL cholesterol.1 However, several randomized trials have failed to…read more »
IMPROVE-IT: Trial data follow through on genetics
An ATVB editorial implies that results from IMPROVE-IT could have been predicted by considering genetics data. In a previous report from the Myocardial Infarction Genetics Consortium Investigators,1 carriage of inactivating mutations that attenuate Niemann-Pick C1-like 1 (NPC1L1) function reduced both LDL cholesterol and also protected…read more »
Enhancing and Improving cardiovascular outcomes
Implications from IMPROVE-IT: Perspective from Anthony S. Wierzbicki* The link between low density lipoprotein-cholesterol (LDL-C) and cardiovascular disease (CVD) is well established 1 2 . Statins are the first-line drug therapy for the treatment of lipid-associated CVD risk. However the role of second line therapies…read more »
Latest IMPROVE-IT commentaryread more »
How low should LDL-C be lowered? Thoughts of IMPROVE-IT rekindle debateread more »
IMPROVE-IT: will it prove anything?
Professor Anthony S. Wierzbicki, London UK Comments on the IMPROVE-IT debate Cardiovascular disease (CVD) guidelines are emphasising the use of clinical outcome data on major vascular events (American Heart Association/American College of Cardiology)1 or hard CVD events alone (UK NICE)2 . They have begun to…read more »