5 things to look for at ACC23. CardioTwitter MedTwitter WCCardio
that it met its composite primary endpoint of first occurrence of CVD, MI, stroke, or coronary revascularization.Firstly, was the effect size clinically significant and statistically robust? In a trial of 14,000 patients, you could have a small absolute difference reach statistical significance without it being clinically meaningful.
And secondly: How will the authors explain statin intolerance? This is a huge issue because the placebo-resistant degree of statin intolerance is quite small. Thefound that patients have nearly as many adverse effects from a statin placebo as from the statin drug. One worry I have, and forgive me for any hint of cynicism, is that one of the marketing techniques we might see after this trial is to"raise awareness" of statin intolerance.
Proprotein convertase subtilisin/kexin type 9 inhibitors have remarkable cholesterol-lowering properties and two agents — evolocumab and alirocumab — have been shown to reduce cardiac outcomes when added to statin drugs. But these agents are costly and require injection.At ACC, we will learn results of aof Merck's oral PCSK9 inhibitor.
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