Purpose of the review: This review highlights selected cardiovascular disease (CVD) prevention studies presented at the 2019 American Heart Association (AHA) Scientific Sessions.
Recent findings: Several important cardiovascular prevention studies were presented at the 2019 AHA Scientific Sessions. Results from the Colchicine Cardiovascular Outcomes Trial (COLCOT) showed that low-dose colchicine reduces the risk of recurrent CVD events among patients with recent myocardial infarction. A prospective analysis from the UK Biobank cohort demonstrated that the increased CVD risk associated with clonal hematopoiesis of indeterminate potential is mitigated by a common disruptive mutation in the IL6R gene that suppresses the pro-inflammatory IL-1β/IL-6 pathway. The Treat Stroke to Target trial demonstrated that reducing low-density lipoprotein cholesterol to <70 mg/dL among patients with ischemic stroke or transient ischemic attack reduces the risk of recurrent CVD events as compared with a higher LDL-C target of 90-110 mg/dL. A secondary analysis focusing on American participants enrolled in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) showed that these patients receive a similar benefit in terms of cardiovascular risk reduction with icosapent ethyl as compared with the entire trial population. A post hoc analysis of the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial demonstrated that a genetic risk score comprising 27 single-nucleotide polymorphisms is associated with cardiovascular risk among patients with established atherosclerotic CVD and patients with high genetic risk receive a relatively higher benefit from evolocumab use. Similar results were observed with alirocumab use in a post hoc analysis of the ODYSSEY OUTCOMES trial where a genome-wide polygenic risk score comprising 6.5 million DNA variants was used. These studies presented at 2019 AHA Scientific Sessions will help guide our approach to preventing CVD.
Keywords: Cardiovascular disease; Icosapent ethyl; Inflammation; Prevention; Proprotein convertase subtilisin/kexin type 9 inhibitors; Stroke.