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Al Rifai M, Jia X, Al-Mallah MH, Miedema MD, Martin SS, Virani SS. Major Randomized Clinical Trials in Cardiovascular Disease Prevention Presented at the 2019 American College of Cardiology Annual Scientific Session. Current Atherosclerosis Reports. 2019 May 24; 21(8):31.
PURPOSE OF REVIEW:
At the 2019 American College of Cardiology annual scientific sessions, major randomized clinical trials in cardiovascular disease (CVD) prevention were presented.
The CLEAR Wisdom trial examined the safety and efficacy of adding bempedoic acid to maximally tolerated statin for reducing low-density lipoprotein cholesterol. Post hoc analyses from the REDUCE-IT trial evaluated the efficacy of icosapent ethyl for lowering risk of total (first time and recurrent) CVD events. A sub-analysis of ODYSSEY OUTCOMES examined the effect of alirocumab on lipoprotein(a) lowering for reducing CVD risk. The CREOLE trial compared three different combination antihypertensive therapies for blood pressure lowering among black individuals in sub-Saharan Africa. The INFINITY trial examined the effect of intensive blood pressure control on progression of brain white matter changes and various components of mobility and cognitive function. Lastly, post hoc analyses from DECLARE-TIMI 58 evaluated the efficacy of dapagliflozin among patients with type 2 diabetes mellitus and heart failure or peripheral artery disease. These trials hold future promise for novel agents aimed at reducing CVD burden among high-risk patients who continue to experience CVD events despite treatment with currently available guideline-directed therapy.