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Improving LDL-C Therapy I Concussions’ CVD Risk
March 27, 2025
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Together with
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“Medicine gets ‘harder’ in many ways the longer you’re in it. Sure, some things become easier, but you understand how little we know and how badly some things can end.”
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Howard Luks, MD
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Cardiology Pharmaceuticals
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New results from a vast Mayo Clinic meta-analysis suggest that combining ezetimibe with statins to lower LDL-C could have significant mortality and MACE benefits over statin monotherapy.
- Statins are one of the most prescribed drugs in the U.S., with over 25% of all adults 40 and up taking them.
- However, not everyone with high cholesterol benefits from statins, leading many drug developers to focus on novel ways to lower LDL-C levels.
Digging through decades of data from PubMed, Embase, and ClinicalTrials.gov, researchers pooled all relevant articles published through June 2024 (108k patients) and found that a combination lipid-lowering therapy (LLT) of statins plus ezetimibe led to significantly better CV outcomes compared to statin monotherapy. Combination LLT patients showed…
- Greater baseline LDL-C reduction (mean difference, −12.96 mg/dL).
- Significantly reduced all-cause mortality (OR: 0.81).
- Lower MACE risk (OR: 0.82).
- And fewer strokes (OR: 0.83).
- Meanwhile, adverse events and discontinuation rates were similar for both combination LLT and monotherapy.
Where LLT fell short was its effect on cardiovascular mortality, which was lower (OR: 0.86), but not statistically significant compared to statin monotherapy.
Above all else, these results support the current guidelines that recommend adding ezetimibe to statin therapy when patient LDL-C targets aren’t met, yet a 2023 AHA study found only 4.4% of patients with high LDL-C were on ezetimibe.
The Takeaway
It might seem obvious that adding a cholesterol lowering drug to a statin regimen makes it better at LDL-C reduction, but this study is an important reminder to cardiologists to keep all pharmaceutical tools in mind, especially since ezetimibe has repeatedly shown to be effective yet is still seriously underused.
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Visit Us2.ai at ACC 2025
Us2.ai will be at ACC 2025 March 29-31. Join them for live scanning and experience the cutting-edge AI technology that’s redefining echocardiography. Find them in the booths of Viz.ai #11055 or Fujifilm #13001.
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The Benefits of Outsourced Post-Processing
Using an outsourced cardiac image post-processing solution doesn’t have to mean sacrificing control of the results. Discover how PIA’s customizable post-processing workflow can help you get the most out of your images.
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Heartflow Roadmap Analysis For Efficient Care
As Coronary CT scan volumes increase, your entire reading team needs to deliver efficient and consistent reads. Good thing Heartflow’s Roadmap Analysis can help you maintain accuracy and increase CCTA read speeds by up to 25%, with even level 3 readers seeing real efficiency benefits.
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- Concussions Increase CVD Risk: Although football concussions are usually associated with brain injury, new research suggests they could increase the risk of CVD. Researchers examined 39 college football athletes who sustained concussions during the playing season and found they faced increased SBP, increased DBP, and decreased E´ compared to matched controls. After following the athletes for a season, those who sustained concussions also had higher PWV, DBP, LV mass index, and lower E´.
- Supira Series E: Supira Medical completed a $120M Series E financing round (with support from Novo Nordisk and Qatar’s sovereign wealth fund) to accelerate development of its new percutaneous ventricular assist device (pVAD). The new funds will be used to expand Supira’s clinical programs for both high-risk percutaneous coronary intervention (HRPCI) and cardiogenic shock. This expansion also includes the SUPPORT II U.S. Pivotal Study for HRPCI, which Supira plans to use for FDA PMA approval.
- Secretome Earns FDA Fast Track: Secretome Therapeutics received FDA Fast Track designation for its STM-01 neonatal cardiac progenitor cell HFpEF therapy. The regulatory milestone comes as Secretome prepares to initiate STM-01’s first Phase 1 clinical trial in HFpEF patients, testing the drug’s potential inflammation reduction, fibrosis inhibition, and tissue repair effects. This fast track comes three months after Secretome landed $20M in funding to support STM-01 trials and manufacturing.
- Poxel’s HCM Progress: Topline results from Poxel’s preclinical mouse model suggest its experimental R-stereoisomer of pioglitazone (PXL065) could help prevent negative myocardial remodeling, including hypertrophic cardiomyopathy and cardiac fibrosis. Researchers found that many of these benefits are a result of PXL065’s mitochondrial pyruvate carrier and Acyl CoA Synthetase 4 inhibition, which reduces oxidative stress in animal cells. Although the results were in mice, further analysis could support human studies.
- Direct Drug Marketing for HF: Marketing may influence cardiologists to prescribe some HF medications more often, but a recent JACC study suggests the outcomes are often inconsistent. The study explored CMS data from 2019-2021 and found that free meals included in marketing campaigns increased both ARNI and SGLT2i prescriptions from general cardiologists, but not AHF cardiologists. Marketing ARNI and SGLT2i’s clinical benefits didn’t impact MRA prescription habits, but did slightly increase beta-blocker, ACEI, and ARB prescriptions.
- PMcardio FDA Breakthrough: In another win for AI-ECG, PMcardio announced its STEMI AI ECG model received Breakthrough Device Designation from the FDA. PMcardio’s AI model is capable of detecting both STEMI and STEMI equivalents directly on the ECG, which could help bridge the gap between timely heart attack diagnostics and care delivery. The designation suggests PMcardio’s model could have advantages over existing standards of care, and could support future regulatory approvals.
- M-TEER Mortality Post-Discharge: Although transcatheter-edge-to-edge repair for mitral regurgitation (M-TEER) has an all-cause mortality of just 3.0% at 30 days, roughly two out of every five deaths occur after hospital discharge. A JACC study examined data from the STS/TVT registry and found that patients who died within 30 days of M-TEER were usually sicker and often weren’t on GDMT. Patients who died after discharge also had significantly lower baseline KCCQ scores (-15 points).
- Fujifilm & Us2.ai Echo Partnership: Thanks to a new partnership, Fujifilm’s LISENDO 800 cardiovascular ultrasound system will now come with Us2.ai’s AI-driven, automated clinical workflow solution. Us2.ai’s software will fully automate the analysis and reporting of echocardiograms performed by the LISENDO 880 to provide cardiac measurements and diagnose heart disease. This means the user doesn’t need to manually measure the chambers of the heart, saving time during the diagnostic process.
- LDL-C vs. Remnant Cholesterol for PAD: We know elevated remnant cholesterol and LDL-C increase the risk of CAD, but what about their effect on PAD? By analyzing the UK Biobank, researchers uncovered that elevated remnant cholesterol had a causal effect on PAD risk (OR: 2.72) while elevated LDL-C only increased PAD risk while remnant cholesterol was also high (1.37). The takeaway: remnant cholesterol may be primarily responsible for increasing PAD risk, though head-to-head RCTs are needed to confirm this.
- Verve’s HeFH IND: The FDA approved Verve Therapeutics’s Investigational New Drug application for its VERVE-102 therapy that treats heterozygous familial hypercholesterolemia (HeFH) and/or premature CAD. VERVE-102 is an in vivo base editing drug that inactivates the PCSK9 gene in the liver to lower LDL-C. The IND approval follows clinical data from the dose-escalation portion of Verve’s Heart-2 Phase 1b clinical trial that suggests VERVE-102 is well-tolerated, with no treatment-related serious ADEs.
- Electrogram Jam or Scam?: Using ICD electrograms (ICD-EGs) during ablation for sustained monomorphic VT (SMVT) might help with arrhythmia burden, but doesn’t appear to reduce VT recurrence. A 260-patient trial in Spain showed similar SMVT recurrence at 6 months between ICD-EG and conventional ablation strategies (36% vs. 46%) but also lower VT episode counts and electrical storm rate after using ICD-EG (23% vs. 41%). However, there wasn’t a difference in ICD shocks between the groups.
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How to Improve Cardiology Workflows and Get More Patient Time
Complex processes and reporting requirements can mean cardiologists spend more time with clinical systems than they do with their patients. See how Merge Hemo and Merge Cardio work together to help you streamline and scale your clinical and data management workflows, so you can have more time in front of your patients.
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Measuring True Cardiac Risk
How can AI help physicians “see” beyond conventional lipid profiles? Tune in to this on-demand webinar showcasing how Cleerly’s AI-QCT solution complements conventional approaches to evaluating heart disease risk factors, and improves coronary artery disease diagnosis and heart attack risk assessments.
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- Vista.ai’s Cardiac MRI Results: Are your patients waiting too long for cardiac MRIs? See Brigham and Women’s Hospital’s real-world results showing how Vista.ai’s AI-driven image acquisition software improves image quality, shortens scan times, and increases patient throughput.
- Explore Vitrea Advanced Visualization: Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflows.
- Innovating AFib Care: The first manifestation of AFib is often stroke, but many hospitals aren’t set up to coordinate these patients’ post-stroke care. See how UCSD is leveraging Viz.ai’s Viz Connect solution to simplify neuro and EP collaboration in this HRX 2024 interview.
- Cardiology AI: From Research to Clinical Practice: Explore how AI algorithms are reshaping cardiology with insights from Tempus’ recent webinar, featuring Dr. David Ouyang of UCLA and Cedars-Sinai, alongside Tempus’ Dr. John Pfeifer and Dr. Brandon Fornwalt. This expert panel dives into how AI can bridge diagnostic gaps, enhance patient outcomes, and streamline workflows for conditions like AFib and pulmonary hypertension. Read the full recap to glimpse the future of AI-driven cardiology.
- Offer Hope Not Just Inotrope to Your Patients with Advanced Heart Failure: Left ventricular assist devices (LVADs) have received Level 1A Recommendation from the AHA/ACC/HFSA guidelines.
- Discover The Monebo Advantage: Need complex ECG monitoring algorithms for use in a variety of applications? Here are just a few reasons why companies across the healthcare spectrum rely on Monebo to power their ECG monitoring and analysis.
- Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!
- Optum’s Cloud ROI E-book: Learn how to measure costs, define your ROI, and what to look for in a potential vendor when moving your enterprise medical imaging to the cloud. Check out Optum’s e-book now!
- Automated and Intelligent EP Reporting: EP ablation procedures are difficult, but your EP reporting process shouldn’t be. See how GE HealthCare’s Centricity EP Structured Reporting allows for quick, accurate, and complete reporting in as few steps as possible.
- Addressing Coronary Artery Disease: Learn how the AGENT™ Drug-Coated Balloon provides a new treatment option for in-stent restenosis in the U.S. Rx Only. (Sponsored by Boston Scientific)
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