For this year's review, Bob Harrington and Mike Gibson revisit the major cardiology conferences -- from ACC in New Orleans to AHA in Philly.
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-- TRANSCRIPT --
Robert A. Harrington, MD: Hi. This is Bob Harrington from Weill Cornell Medicine on theheart.org | Medscape Cardiology. Today we are taping my favorite podcast of the year, the wrap-up that I've done for a number of years now with my good friend and colleague, Mike Gibson. We get to talk about some of the hot news in cardiology that played out over the course of the year. We tend to go through the trials and then maybe hit some big topics on either the news of cardiology or the policy issues affecting cardiology. And along the way, Mike and I might add a few other topics.
Typically what we've done is to group topics like heart failure, intervention, and lipids. This year we're going to walk through the calendar year, and we'll start with ACC '23, work our way to ESC '23, and end up at AHA '23. So with that as the plan, I'm really pleased to be joined by Mike Gibson. Mike is an interventional cardiologist at the Beth Israel Deaconess Lahey Hospital in Boston. He's a professor of medicine at Harvard Medical School, and he is the CEO of the BAIM Institute for Clinical Research, an academic research organization. Mike, thanks for joining us on Medscape Cardiology.
C. Michael Gibson, MD: Always my favorite podcast of the year.
Harrington: Oftentimes you tell me, "If you really want people to listen to it, keep it less than 5 minutes." But in this particular case, you and I like to really riff on these topics.
Gibson: Sounds great.
Bempedoic Acid and Statin Intolerance
Harrington: So ACC '23 returned to one of my favorite cities for a medical meeting: New Orleans, Louisiana. Always a great time. You certainly get your steps in at that convention center. You also have great food, great areas for networking. All in all, are you a fan of New Orleans for the meetings?
Gibson: I love New Orleans. it's a city where you get to literally bump into everyone you know; it's not too big. Probably one of my favorite cities.
Harrington: When I go to New Orleans, I get a taxi or Uber on the way from the airport to my hotel, and then back to the airport. Most of the rest of the time, I'm walking.
ACC '23 was a terrific meeting. And I've picked out a couple of things I want to talk about, both in the lipid space, because I thought they were important for different reasons. The first one was CLEAR Outcomes. This trial was done in statin-intolerant patients, an important group of patients that we all see. We can talk about how they chose to find the statin-intolerant population. They were randomized to bempedoic acid, which is a new LDL-C-lowering agent, and some terrific results from this trial showed that the addition of bempedoic acid to other therapies led to a meaningful reduction in clinical events.
Mike, give us your overall impressions of the trial, but I don't want you to talk about the statin-intolerant population.
Gibson: Whether you want to admit it or not, at least patients perceive that they are intolerant to statins. There are some data to suggest it may not be real; but in the patient's mind, it's very real. So we need alternatives to statins.
They had to either not be able to take two statins in the past or not be able to take one statin and unwilling to try a second one; that's how they got into the study. This drug is metabolized in the liver, a bit above where a regular statin is metabolized. It's not metabolized in the periphery or in the muscle, so you don't have that potential for muscle pain. And as you said, they had good outcomes: 13% relative risk reduction in death, myocardial infarction (MI), stroke, revascularization, and about a 1.6% absolute risk reduction - that's pretty good. And then on the triple endpoint, a 15% reduction in death, MI, and stroke. For my thinking, this is good news because it's always good news to have alternatives, and this is a well-tolerated alternative for patients with statin intolerance.
Transcript in its entirety can be found by clicking here:
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