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Highlights from Selected Cardiovascular Disease Prevention Studies Presented at the 2019 European Society of Cardiology Congress

  • Xiaoming Jia
  • Mahmoud Al Rifai
  • Ty J. Gluckman
  • Yochai Birnbaum
  • Salim S. ViraniEmail author
Global Coronary Heart Disease (S.Virani and S. Naderi, Section Editors)

Abstract

Purpose of Review

This review intends to highlight selected cardiovascular disease (CVD) prevention studies presented at the 2019 European Society of Cardiology (ESC) Congress.

Recent Findings

Results from the Inclisiran for Subjects with ASCVD or ASCVD-risk Equivalent and Elevated Low-density Lipoprotein Cholesterol (ORION-11) trial validate inclisiran’s ability to significantly lower low-density lipoprotein cholesterol (LDL-C) levels in at-risk individuals on a background of maximally tolerated statin therapy. The EVOlocumab for Early Reduction of LDL-cholesterol Levels in Patients With Acute Coronary Syndromes (EVOPACS) trial provide additional support that a PCSK9 inhibitor can be initiated safely and effectively early after an acute coronary syndrome. A sub-study of the Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab (ODYSSEY OUTCOMES) trial provides further support for stratification of secondary prevention patients to help define the magnitude of risk reduction associated with PCSK9 inhibitor therapy. A post hoc analysis from the Aspirin in Reducing Events in the Elderly (ASPREE) trial suggest that any benefits associated with aspirin utilizing a risk-based approach are overwhelmed by increased bleeding risk. In a large retrospective cohort study of patients with diabetes mellitus and obesity, the addition of metabolic (weight loss) surgery to standard care led to greater improvement in CVD outcomes, weight loss, and glycemic control. Results from the Prospective Urban Rural Epidemiology (PURE) study demonstrate that while hypertension and dyslipidemia exert additive lifelong effects on CVD risk, other less established risk factors such as low education, household pollution, and poor diet also have a strong impact on CVD outcomes, especially in middle- and low-income countries. Finally, in the Heart Outcomes Prevention and Evaluation (HOPE) 4 trial, a comprehensive model of care adapted to address multiple barriers of specific communities led to substantial improved blood pressure (BP) control, medication use, and adherence.

Summary

A number of studies presented at the 2019 ESC Congress reinforced the value of preventative interventions in CVD risk reduction.

Keywords

Cardiovascular prevention Hyperlipidemia Hypertension Diabetes mellitus 

Notes

Compliance with Ethical Standards

Conflict of Interest

Xiaoming Jia declares that he has no conflict of interest.

Mahmoud Al Rifai declares that he has no conflict of interest.

Ty J. Gluckman declares that he has no conflict of interest.

Yochai Birnbaum declares that he has no conflict of interest.

Salim S. Virani has received research funding from the Department of Veterans Affairs, the American Heart Association, the American Diabetes Association, and the World Heart Federation; has received honoraria from the American College of Cardiology for his role as an Associate Editor; and has served on the steering committee for the Provider Assessment of Lipid Management (PALM) registry at Duke Clinical Research Institute, but received no financial remuneration.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Xiaoming Jia
    • 1
  • Mahmoud Al Rifai
    • 1
    • 2
  • Ty J. Gluckman
    • 3
  • Yochai Birnbaum
    • 1
  • Salim S. Virani
    • 4
    • 5
    Email author
  1. 1.Section of CardiologyBaylor College of MedicineHoustonUSA
  2. 2.Johns Hopkins Ciccarone Center for the Prevention of Heart DiseaseBaltimoreUSA
  3. 3.Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart InstituteProvidence St. Joseph HealthPortlandUSA
  4. 4.Health Policy, Quality & Informatics ProgramMichael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for InnovationsHoustonUSA
  5. 5.Section of CardiologyMichael E. DeBakey Veterans Affairs Medical CenterHoustonUSA

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