CMHC Pulse Blog

The NLA Scientific Sessions (May 30-June 2, 2024) has concluded, providing key insights into lipid management and cardiovascular health. Here are some notable highlights: 

1.LOWER Registry 9-Year Data of Lomitapide in HoFH

  • Dr. James A. Underberg presented data on the safety and efficacy of lomitapide in HoFH (homozygous familial hypercholesterolemia). View Article In Press

2. Updated Use of Lp(a) in Clinical Practice

  • Dr. Christie M. Ballantyne addressed the NLA Sessions about the updated NLA statement on Lp(a). He emphasized that everyone should have their Lp(a) levels measured at least once, as these levels provide a continuous gradient of risk. For individuals with high Lp(a), lipid-lowering therapies are often appropriate. This is a focused update to the 2019 NLA Scientific Statement on the Use of Lipoprotein(a) in Clinical Practice. 

3. CVD Prevention and Cognitive Health

4. Clinical Pearls from Expert Lipid Panel

  • Panelists Christie M. Ballantyne, MD, FNLA, Robert A. Hegele, MD, FRCPC, Cert Endo, Daniel J. Rader, MD, FNLA, and Daniel E. Soffer, MD, FNLA, shared key insights. They highlighted that the non-HDL/HDL ratio is a better predictor of ASCVD and that triglycerides (TG) are a sensitive indicator of diet and exercise, emphasizing the importance of lifestyle factors in lipid management and cardiovascular risk reduction. 

5. Evolocumab in Autoimmune Diseases

  • Andre Zimerman, MD, PhD, presented his first Late-Breaker presentation at the NLA Scientific Sessions, discussing the use of evolocumab in patients with autoimmune or inflammatory diseases. He highlighted that evolocumab shows particular cardiovascular (CV) benefits in these patients. The CV benefits of PCSK9 inhibition with evolocumab may be stronger in patients with autoimmune or inflammatory diseases. Notably, the treatment effect differences occurred despite similar LDL reductions and no effect on CRP levels. 

6. Impact of LDL-C Control in Primary Prevention

  • Professor Kausik Ray, MD, FMedSci, emphasized that controlling LDL-C is of seminal importance despite the excitement about Lp(a) and TRLs. He stressed that the impact of LDL-C control in primary prevention is far greater than in secondary prevention, urging clinicians to start early. Prof. Dr. Ray discussed target LDL levels and their relevance, noting that greater LDL reduction with higher doses of statins can offset some of the risks associated with high Lp(a). 

7. Importance of Measuring Lp(a) Levels

  • Dr. Florian Kronenberg presented on Lp(a) during her session, “Lp(a) – Who to Measure and What to Do About It?” She emphasized the importance of measuring Lp(a) levels and addressing them by optimizing risk factor reduction. 

8. Untangling the Statins and Diabetes Link

  • Dr. Savitha Subtamaniam explored the incidence of diabetes associated with statin use, noting that the mechanism is unclear. She also highlighted uncertainty regarding whether statins worsen glycemic management in individuals with pre-existing diabetes. 

9. Targeting apoB to Lower ASCVD Risk

  • Dr. Daniel E. Soffer, MD, FNLA, shared insights on targeting apoB for the treatment of lipid- and lipoprotein-related ASCVD risk. He suggested that this approach may offer greater precision than focusing solely on LDL-C, which applies to individuals from the general population and those seeking specialty lipid management. 

10. Inflammation Takes Center Stage in Heart Disease

  • Dr. Michael S. Garshick unveiled the pivotal role of inflammation in heart disease treatment. Groundbreaking research has proven that targeting inflammation can significantly improve heart-related outcomes for select patients, marking a significant shift as inflammation takes center stage in cardiovascular prevention and treatment strategies. 

11. Addressing the Psoriasis and Cardiovascular Disease Link

  • Dr. Joel Gelfand shared data from The Gelfand Clinical Research Lab on the connection between psoriasis and cardiovascular outcomes, advocating for a multidisciplinary approach to treatment. 

12. Preventing Heart Disease During Menopause Transition

  • Dr. Chrisandra Shufelt, MD, MS, FACP, MSCP, highlighted the importance of heart disease prevention in women during the menopause transition. She noted that certain risk factors for heart disease change during this time. Therefore, it is crucial to assess lipids and other heart disease risk factors at the onset of menopause. 

13. The interplay of Obesity, Dyslipidemia, and CVD

  • Dr. Harold E. Bays, MD, DABOM, MFOMA, FTOS, FACC, FASPC, FNLA, provided an overview of a joint expert review by the National Lipid Association and the Obesity Medicine Association regarding the interplay of obesity, dyslipidemia, and cardiovascular disease (CVD). He highlighted that obesity elevates the risk of heart disease, partly due to its adverse effects on lipid levels. The primary focus for patients with obesity should be on weight reduction and lipid management by lowering atherogenic blood lipid levels to mitigate CVD risk. 

14. Colchicine in Cardiovascular Disease Management

  • Dr. Vijay Nambi, PhD, FNLA continued the discussion on cardiac rheumatology, focusing on the use of colchicine in cardiovascular disease management, especially when patients are also on statins.  

For further updates, the 19th Annual Cardiometabolic Health Congress (CMHC) will feature late-breaking trial data and industry updates from top experts, including Dr. Christie M. Ballantyne, this October 17-19, 2024 in Boston, MA. Learn more here!

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