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ACC 2023: Bempedoic Acid Reduces Risk for Major Cardiovascular Events in Statin-Intolerant Patients
Significant reduction seen in incidence of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization

MONDAY, March 13, 2023 (HealthDay News) – Bempedoic acid reduces the risk for major adverse cardiovascular events among patients who are statin-intolerant, according to a new study published in the New England Journal of Medicine to coincide with the annual meeting of the American College of Cardiology together with the World Congress of Cardiology, held from March 4 to 6 in New Orleans.
“Statin intolerance is an enormous problem, and these patients are hard to manage,” Steven Nissen, M.D., of the Cleveland Clinic, told Elsevier’s PracticeUpdate. “We knew bempedoic acid was unlikely to cause the muscle side effects that statins do. The hypothesis was that it would be well-tolerated and that it would reduce both low-density lipoprotein (LDL) cholesterol and cardiovascular events, and that’s exactly what we saw.”
Nissen and colleagues conducted a double-blind, randomized, placebo-controlled study of 13,970 patients with or at risk for cardiovascular disease who were unable or unwilling to take statins due to unacceptable adverse effects. Patients were randomly assigned to bempedoic acid or placebo. The primary end point was a composite of major adverse cardiovascular events, including death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization.
At six months, the reduction in LDL cholesterol was 29.2 mg/dL greater among patients in the bempedoic acid group versus those in the placebo group. The incidence of a primary end point was significantly lower in the bempedoic acid group versus the placebo group: 11.7 versus 13.3 percent (P = 0.004). The incidence of a composite of death from cardiovascular causes, nonfatal stroke, or nonfatal myocardial infarction was also significantly lower in the bempedoic acid group: 8.2 versus 9.5 percent (P = 0.006). There was also a significant reduction in coronary revascularization in the bempedoic acid group: 6.2 versus 7.6 percent (P = 0.001).
“These results are practice-changing,” Nissen told Elsevier’s PracticeUpdate. “This will become a standard treatment approach for statin-intolerant patients. We always want to try statins first. Statins are a cornerstone for preventive care, and this is not a replacement for statins. This is a drug that can be used instead of statins only in patients that can’t tolerate statins.”
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