- Review by Laura Ross, PA-C, AACC, CLS President-Elect
The CLEAR trial results were presented last month by Dr. Steven Nissen at the American College of Cardiology annual conference in New Orleans. The primary outcome of major adverse cardiovascular events (nonfatal MI, nonfatal stroke, coronary revascularization or CV death) for bempedoic acid was 11.7% compared to 13.3% with placebo. 13,970 patients (almost half were women) underwent randomization. The percent reduction in the LDL cholesterol level was 21 percentage points greater with bempedoic acid than with placebo. This reduction in cholesterol level corresponded to a 13% lower risk of major adverse cardiovascular events. Bempedoic acid monotherapy lowers the LDL cholesterol level up to 28%, and 16% in patients receiving the maximum tolerated dose of statins, and did not have an increase in myalgias or glucose that can be associated with statin use. It also lowered hsCRP from baseline at 12 months by 20.6%. Side effects include about a 1% increase in gout and cholelithiasis.
You can celebrate by checking the lipoprotein (a) lab for your patients once in their life. 20% of people have an elevated level, and this protein makes the cholesterol more “sticky”/atherogenic and should promote more aggressive cholesterol lowering. Also, if you have patients with a baseline LDL of >190 and a family history of premature cardiovascular disease, consider testing for Familial Hypercholesterolemia. 1:250 people have a heterozygous form, and if present, there is a 50% risk of males having a heart attack by the time they are in their 50s, and a 30% risk of females having one by their 60s.
Save the date! APAC, in partnership with APAPP and PCE, is launching the first annual Cardiovascular and Pulmonary Summit for Advanced Practice Providers (CAPSAPP), for NPs and PAs specializing in cardiology and pulmonary medicine. It will be September 8-10, 2023 in Orlando, Florida.
Participate in this interactive CE/CME program featuring cardiology experts as they review recent evidence and guideline updates for the management of heart failure with reduced ejection fraction (HFrEF). New recommendations for medication management will be provided, as well as guidance on how to address potential barriers that limit patient access and adherence to therapy. Expires May 15, 2023.
AAPA has announced the first of two Main Stage Events at #AAPA23! “The Future of Healthcare: How Trends in Research, Technology, and Innovation are Redefining the Patient Experience” features the following speakers: -Gitanjali Rao, Innovator, Changemaker, Author, STEM Promoter -John Gerzema, CEO, The Harris Poll -Jamie Metzl, Leading Technology and Healthcare Futurist, WHO Advisor
The Gaples Institute is a wonderful resource for information about using food as medicine and has a mission to increase nutrition and lifestyle education in medical training. Useful CME is available and applicable to start using with patients today.
