Family Heart at the 2025 American Heart Association Scientific Sessions +++

https://familyheart.org/family-heart-at-2025-aha-sessions AHA 2025: Landmark, Practice-Changing News for PCSK9 Inhibitors and Exciting Therapies on the Horizon The 2025 American Heart Association (AHA) Scientific Sessions in New Orleans brought powerful new science and hope for people affected by high LDL-cholesterol, familial hypercholesterolemia (FH), and homozygous FH (HoFH). It was one of the most exciting medical conferences for LDL-related news in many years, and the Family Heart Foundation was there with an exhibit booth and two important original data presentations. The message from this year’s meeting is clear: We’re entering a new era in lipid management — one driven by innovation, prevention, and precision. And for LDL cholesterol (LDL-C) specifically, the message is clear: lower for longer is truly best. In Global Trial, PCSK9 Inhibitor Provides Major Protection Against First CV Event Ted Bosworth https://www.medscape.com/viewarticle/global-trial-pcsk9-inhibitor-provides-major-protection-2025a1000uzp November 09, 2025 The VESALIUS-CV Trial – Evolocumab for Primary Prevention The VESALIUS-CV trial evaluated evolocumab (a PCSK9 inhibitor already available) in over 12,000 people without prior heart attack or stroke, but at high risk for cardiovascular disease. Over an average follow-up of 4.6 years, the evolocumab-treated group had a 25% reduction in major cardiovascular events (heart attack, stroke, or CHD death), with a median achieved LDL-C of 45 mg/dL in the evolocumab group vs. 109 mg/dL with placebo. Additionally, heart attacks were reduced by 36% and total deaths were reduced by 20% in the evolocumab-treated patients. Impressively, the benefit of evolocumab treatment was seen across all major subgroups, regardless of age, sex, baseline LDL-C, or background lipid-lowering therapy. Why this matters: The VESALIUS-CV trial is a truly landmark trial that will change the way healthcare practitioners treat LDL-C in their high-risk patients who have not yet suffered a cardiovascular event. Previous trials have demonstrated the benefits of PCSK9 inhibitors in people who have already had a heart attack or stroke (secondary prevention), but this study will likely move these innovative therapies upstream in the treatment paradigm. Additionally, an achieved LDL-C of 45 mg/dL in the PCSK9 inhibitor group may encourage guideline-writing committees to lower LDL-C treatment goals for high-risk patients. Lowering LDL Cholesterol Linked to 25% Lower Stroke Risk Deborah Brauser https://www.medscape.com/viewarticle/lowering-ldl-cholesterol-linked-25-lower-stroke-risk-2025a1000v7y?ecd=wnl_dne1_251112_MSCPEDIT_etid7869916&uac=127432AZ&impID=7869916 Aggressive LDL-C Lowering in People with a Previous Stroke Delivers Significant Benefits Another study presented at AHA 2025 suggested that for individuals who have suffered a prior stroke, achieving an LDL-C <40 mg/dL is optimal. The authors analyzed >5,000 people with prior ischemic stroke enrolled in the previously reported FOURIER trial, a randomized placebo-controlled trial that studied the PCSK9 inhibitor evolocumab in patients with stable cardiovascular disease, to examine the relationship between achieved LDL-C and the long-term incidence of major adverse cardiovascular events and stroke-related endpoints. In this analysis presented at AHA 2025, individuals with a prior stroke who achieved an LDL-C <40 mg/dL had a 31% lower rate of major adverse cardiovascular events versus those whose LDL-C remained >70 mg/dL. There was also a 27% reduction in the risk of having another stroke in the group who achieved an LDL-C <40 mg/dL. Why this matters: Prior studies have raised potential concerns about the safety of low LDL-C in people with a prior history of stroke; however, this analysis of >5,000 such individuals from the FOURIER trial provides strong evidence that — in this population — lowest is best for LDL-C. The CORALreef Lipids Trial – Oral PCSK9 Inhibitor Enlicitide Lowers LDL-C By Up to 60% Versus Placebo The Phase 3 CORALreef Lipids trial showed LDL-C reductions of 56–60% at 24 weeks with the oral PCSK9 inhibitor enlicitide compared with placebo, with significant improvements in non-HDL-C and ApoB as well. Interestingly, Lp(a) was reduced by 28% versus the placebo group, and 70% of patients achieved the dual goal of an LDL-C <70 mg/dL and a 50% reduction in LDL-C from baseline. Side-effect rates were similar to placebo, with 3.1% of enlicitide-treated patients discontinuing treatment due to an adverse event versus 4.1% of placebo-treated patients. November 11, 2025