Cardio Metabolic Health Congress – Official Blog

ACC Releases Guidance on Role of Nonstatin Therapies for LDL-C Lowering

The American College of Cardiology (ACC) has released guidance on the role of nonstatin therapies in the lowering of LDL cholesterol, as additional data on their use have become available since the ACC and American Heart Association (AHA) last updated the cholesterol guidelines in 2013. According to Donald M. Lloyd-Jones, MD, Northwestern University Clinical and Translational Sciences Institute, and Chair of the document’s writing committee, the goal of this latest guidance is to assist clinicians in interpreting the newest data for use in clinical practice and help guide their patients in making treatment decisions.

Seven different algorithms were produced for patients with cardiovascular disease or comorbidities and recommends the consideration of nonstatin drugs for patients at high risk whose LDL has not been reduced by 50% with lifestyle and statin therapy. The algorithms endorse the four evidence-based statin benefit groups already identified in the 2013 ACC/AHA cholesterol guidelines and assume the patient is taking a statin or has attempted statin therapy. Two different algorithms were created for patients with familial hypercholesterolemia (FH) and recommend a lower threshold for the use of PCSK9 inhibitors. Read more

Are We Any Closer to Understanding What’s Driving the Cardiovascular Benefits Seen in EMPA-REG?

Theories abound on what’s driving the cardiovascular benefits seen in EMPA-REG, as an FDA advisory panel votes to support a claim of CV risk reduction on the SGLT-2 inhibitor empagliflozin’s label.

An advisory panel to the US FDA has voted, albeit narrowly, to allow the claim that treatment with the SGLT-2 inhibitor epagliflozin reduces the risk of cardiovascular death in patients with type 2 diabetes. Results of EMPA-REG, which were published last year, showed that the drug reduced cardiovascular death by 38% and reduced the combined risk of cardiac death, non-fatal myocardial infarction, and non-fatal stroke by 14%. The potential mechanisms by which empagliflozin works to reduce this cardiovascular risk are still not known, however, and were the focus of discussion at the recent ADA 2016 Scientific Sessions.

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