Moderator of 9 Sessions
Presenter of 12 Presentations
What have we learnt about Peadiatric Screening from the FHSC (ID 1423)
Panel discussion and Q&A (ID 1639)
FIBRATES: The PROMINENT trial (ID 1448)
Introduction to Anitschkow Prize winner, Prof Nicholls (ID 1662)
The role of inclisiran in lipid management: long-term efficacy and safety (ID 1553)
The 8 Pillars of Cholesterol Lowering throughout the Life-course (ID 1418)
Lipid management in Europe: the SANTORINI study (ID 1635)
The SANTORINI/ HEYMANS (ID 1446)
Young Investigator Award (ID 1661)
Welcome from EAS President (ID 1416)
O059 - LIPID MANAGEMENT IN PATIENTS WITH HIGH AND VERY HIGH CARDIOVASCULAR RISK: DATA FROM ROUTINE CLINICAL PRACTICE IN EUROPE (SANTORINI STUDY) (ID 1536)
Abstract
Background and Aims
SANTORINI is the first study since the 2019 ESC/EAS lipid guidelines which investigates how lipid management evolved in clinical practice after lower LDL-C goal recommendations.
Methods
A multicentre, observational, European study (NCT04271280) conducted between March 2020 and February 2021 with a follow-up until 31 May 2022, assessing approaches of lipid management in patients with high and very high-cardiovascular (CV) risk over 1-year.
Results
Of 9136 patients enrolled, 7210 had LDL-C values available at baseline and at 1-year follow-up. Physicians classified patients into high (28.2%) and very high CV-risk (71.8%) groups. Overall, mean LDL-C in both risk groups was lower at follow-up vs baseline, irrespective of CV risk status (overall: 1.98 vs 2.42 mmol/L; high risk: 2.29 vs 2.74 mmol/L; very high risk: 1.86 vs 2.29 mmol/L). More patients reached LDL-C goals at follow-up vs baseline (high risk: 34.2% vs 24.4%, very high risk: 30.1% vs 20.0%; Table 1A). Overall, high-intensity statin use increased at follow-up in both monotherapy and in combination with ezetimibe. Combination therapy use increased at follow-up in both categories (high risk: 30.8% vs 21.6%; very high risk: 45.3% vs 29.8%; Table 1B). Compared to baseline, an increase in the use of combination therapies was observed in patients achieving LDL-C goal at 1-year follow-up in both categories (Figure 1).
Conclusions
The SANTORINI study suggests that with an increased use of combination therapies, a higher proportion of high and very high-CV risk patients reach their LDL-C goals. Using combination therapies as standard of care should improve the proportion of patients at goal.
O060 - ESTIMATING THE POTENTIAL IMPACT OF LDL-C LOWERING THROUGH SIRNA THERAPIES ON POPULATION HEALTH: A SIMULATION STUDY (ID 1585)
Abstract
Background and Aims
Inclisiran, an siRNA therapy, provides sustained reductions in LDL-C. Potential CV benefits of inclisiran, as an adjunct to statins, were evaluated through simulation.
Methods
Ten-year CV risk (RISK10) was estimated using the SMART equation in patients with ASCVD from the ORION-10 and ORION-11 trials, comparing inclisiran vs placebo. Change in RISK10 (mean [SD]) between groups was estimated with Cholesterol Treatment Trialists risk ratio for major vascular events using change from baseline in time-averaged LDL-C between Days 90–540. Impact on population health in 500,000 hypothetical ORION‑like inclisiran-treated patients was estimated by Monte Carlo simulation.
Results
Baseline characteristics in inclisiran (n=1288) and placebo (n=1264) arms were similar (LDL-C 2.7 mmol/L [0.9] vs 2.6 mmol/L [0.9] and RISK10 24.9% [14.2] vs 24.6% [14.5], respectively). Change in time-adjusted LDL-C was −1.3 mmol/L (0.7) with inclisiran vs −0.004 mmol/L (0.6) with placebo (p<0.001). The predicted RISK10 was 18.1% (10.8) with inclisiran vs 24.7% (15.1) with placebo, corresponding to absolute and relative risk reductions with inclisiran of 7.0% (95% CI 6.7–7.3) and 27.5% (95% CI 26.6–28.3), respectively. Additionally, Monte-Carlo simulation based on baseline RISK10, and LDL-C predicted this approach might avert CV events in 31,522 individuals (6.3% of the hypothetical population) over 10 years, assuming no other lipid-lowering therapies were added.
Conclusions
Simulation using known measures of risk and benefit suggest that sustained reductions in LDL-C achieved with inclisiran could provide substantial population health benefits. The effect of inclisiran on CV outcomes is being evaluated in the ORION-4 and VictORION-2 Prevent trials.