70th ESC Congress 2022

29,000 delegates registered for the 70th Annual Congress of the European Society of Cardiology (26-29 August 2022) held in Barcelona, Spain, and online. Among the highlights for specialists in atherosclerosis was a state-of-the-art review of novel treatment options for hypertriglyceridaemia, latest data on the importance of cholesterol remnants, post hoc analyses from the REDUCE-IT trial, Phase 2 data on fibroblast growth factor (FGF21) analogue treatment for severe hypertriglyceridaemia and gene editing research into the inactivation of the ANGPTL3 gene.

Reducing elevated levels of triglyceride-rich lipoprotein (TRL) particles remains a promising approach to lowering residual cardiovascular (CV) risk, though recent clinical trial results have raised more questions than answers about optimal strategies, Professor Erik Stroes told delegates at the New Lipid-Lowering Treatment Options symposium.

New research linking cholesterol remnant elevation with significant changes in cardiac structure and function support the need for treatment options specifically targeting remnant cholesterol, conclude clinicians from Denmark.

Post hoc data from the REDUCE-IT trial in patients with established CV disease or diabetes with risk factors show that icosapent ethyl (IPE) significantly reduced ST-segment elevation myocardial infarction (STEMI), non-ST segment elevation myocardial infarction (NSTEMI), and other MI subtypes. Latest analyses also show that cardiovascular (CV) events were significantly reduced in patients with a history of smoking.

Phase 2 data on the fibroblast growth factor (FGF21) analogue, pegozafermin, in patients with severe hypertriglyceridaemia have demonstrated reductions of approximately 50-60% in triglycerides, 20-30% in non-HDL- cholesterol, 10-20% in apoB and 40% in liver fat fraction. These results from the ENTRIGUE study, together with additional cardiometabolic improvements, make pegozafermin an attractive therapy.

Nearly half of 7479 consecutive patients admitted for acute coronary syndrome (ACS) at two different centres in Spain were found to have high remnant cholesterol levels.1 Dr Alberto Cordera (University Hospital of San Juan, Alicante, Spain) reported a median (interquartile range) remnant level of 28 mg/dl (21-39), with 3,429 (45.85%) patients having levels ≥30 mg/dl.