Deepak Bhatt, MD, MPH

Updated ACC/AHA Dyslipidemia Guidelines Incorporate LDL-C Goals, Lp(a) Focus, With Deepak Bhatt, MD, MPH

On March 13, 2026, the American College of Cardiology (ACC) and American Heart Association (AHA) released an updated clinical guideline for the management of 

, replacing the 2018 Guideline on the Management of Blood Cholesterol.

Among some of the most significant changes, the new guidelines encourage clinicians to enhance their focus on lipoprotein(a), or Lp(a). This updated version suggests clinicians measure Lp(a) ≥1 time in all adults when addressing 

atherosclerotic cardiovascular disease (ASCVD) 

risk. This suggestion is now a Class of Recommendation (COR) 1 suggestion.

“I’ve been a believer in measuring Lp(a) for a long time, way before it was in vogue. I used to test it in patients who came in with premature MI,” Deepak Bhatt, MD, MPH, director of Mount Sinai Fuster Heart Hospital and the Dr. Valentin Fuster Professor of Cardiovascular Medicine at the Icahn School of Medicine at Mount Sinai, told 

 in an exclusive interview. “I think one can debate the exact level of evidence – we’re all eagerly awaiting, probably later this year, the first randomized clinical trials looking at Lp(a) drugs. If those trials are positive, that validates that specific therapeutics lowering Lp(a) as clinically useful.”

Additionally, the 2026 guidelines have shifted from percent reduction of LDL-C back to specific, targeted goals. The previous 2018 version introduced the use of percent LDL-C reductions as a method of monitoring lipid levels and guiding lipid-lowering therapy (LLT). This method was widely considered vague, as these percentages were inherently subjective between patients. Goals, however, establish concrete targets. Although percentage risk reduction in LDL-C was retained as a priority for individuals, LDL-C and non-HDL-C treatment goals are reclaiming their spot as the backbone of LLT guidance.

Specific goals are determined by PREVENT risk tier, with those at borderline risk – between 3 and <5% - having a goal LDL-C of <100 mg/dL and a goal non-HDL-C of <130 mg/dL. Those at intermediate risk – 5 to <10% - have a goal LDL-C of <100 mg/dL, while those at high risk - ≥10% - have a goal LDL-C of <70 mg/dL and a non-HDL-C goal of <100 mg/dL.

Secondary prevention also incorporates LDL-C goals based on these new guidelines; those with high risk, defined as ≥2 major ASCVD events or 1 event and ≥2 high-risk features have a goal LDL-C of <55 mg/dL and non-HDL-C <85 mg/dL. These patients should also receive ezetimibe in addition to maximum tolerated statin. However, those not at very high risk have an LDL-C goal of <70 mg/dL and non-HDL-C of <100 mg/dL.

“I do like the fact that targets are clearly back in the guidelines,” Bhatt said. “That was a real backward step some years ago when the guidelines eliminated targets for LDL. It’s a good illustration of the fact that the guidelines are not always sacrosanct. If you look at different times and places, guidelines have made mistakes. They don’t replace good clinical judgment or individualized patient care.”

Editors’ Note: Bhatt reports disclosures with GSK, Merck, Cereno Scientific, Angiowave, Boehringer Ingelheim, Novo Nordisk, and others.

Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA guideline on the management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online March 13, 2026. 

Livingston R. AHA/ACC Dyslipidemia Guidelines Reinstate LDL-C Goals, With Viet Le, DMSc, PA-C. 

. March 17, 2026. Accessed March 25, 2026. 

https://www.hcplive.com/view/aha-acc-dyslipidemia-guidelines-reinstate-ldl-c-goals-with-viet-le-dmsc-pa-c

Videos

Bhatt shares his thoughts on the recently released dyslipidemia guidelines, highlighting the return of goal-based LDL-C therapy and Lp(a) receiving a COR 1 suggestion.

RSV Vaccine Demonstrates Cardioprotective Effects, Reduces MACE and Hospitalizations, With Deepak Bhatt, MD, MPH

A study conducted by GSK, investigating its Respiratory Syncytial Virus (RSV) Vaccine, Adjuvanted (Arexvy), has highlighted the vaccine’s efficacy in reducing 

major adverse cardiovascular events (MACEs)

 and RSV-related hospitalizations in adults ≥60 years.

Arexvy is comprised of recombinant RSV glycoprotein F stabilized in the prefusion conformation, combined with GSK’s proprietary adjuvant AS01E. The vaccine has already received approval for the prevention of lower respiratory tract disease due to RSV in the same patient population, as well as for those aged 50-59 years who are at greater risk of the disease.

“First of all, preventing a bad infection can secondarily prevent bad side effects of the infection, and we this all the time even outside of RSV when patients come in and they’re vulnerable, or they’re over the age of 60, and they may have underlying cardiac disease,” Deepak Bhatt, MD, MPH, director of the Mount Sinai Fuster Heart Hospital and the Dr. Valentin Fuster Professor of Cardiovascular Medicine at the Icahn School of Medicine at Mount Sinai, told 

 in an exclusive interview. “The other possibility is a little more speculative; perhaps the infection itself is triggering inflammation that is triggering the heart attack.”

Presented at RSVVW’26, the 9th Conference of the Respiratory Syncytial Virus Foundation in Rome, this retrospective cohort study aimed to estimate the vaccine effectiveness of Arexvy against MACE and severe exacerbations of 

chronic obstructive pulmonary disease (COPD)

. The team collected claims data from the Optum Research Database, including patients aged ≥60 years identified between August 2023 and May 2024. For vaccinated patients, the index date was the date of vaccination.

Investigators then matched each vaccinated patient to 4 unvaccinated patients on age, sex, insurance type, and state of residence. Baseline characteristics were measured during the 12 months pre-index, while the follow-up period began 14 days post-index. Each outcome, including MACE and flare-ups of COPD or asthma, was measured overall and regarding RSV-related outcomes.

Ultimately, the trial enrolled a total of 520,440 vaccinated patients, who were then exact matched in a 1:4 to 2,081,760 unvaccinated patients. Mean age across all patients was 74.3 years (standard deviation [SD], 6.7). 869,980 patients had existing cardiovascular disease, 362,615 had existing COPD, and 244,226 had existing asthma.

Among adults with existing cardiovascular disease, the vaccine’s effectiveness against MACE was 20.4% (95% CI, 18-22.9%). Effectiveness against RSV-related MACE was 63.1% (41.8-76.6%), while effectiveness against severe COPD and asthma exacerbations overall was 8.6% (4.2-12.7%) and 19.4% (5.7-31.1%), respectively. For RSV-related severe COPD and asthma exacerbations, effectiveness estimates were 74.4% (59.3-83.9%) and 61.6% (9.1-83.7%), respectively.

Ultimately, investigators determined that these data highlight a substantial benefit of adjuvanted RSVPreF3 vaccination in preventing RSV-related MACE, as well as severe asthma and COPD exacerbations among patients ≥60 years.

“I think this is going to be an area of future investigation for other vaccines as well,” Bhatt said. “For instance, vaccinating for shingles, beyond just reducing the risk of developing recurrent shingles, can potentially have cardiovascular benefits. This is something that would need to be studied in randomized clinical trials, of course, but certainly there are emerging observational data supporting that.”

Editor’s Note: Bhatt reports disclosures with GSK, Merck, Cereno Scientific, Angiowave, Boehringer Ingelheim, Novo Nordisk, and others.

GSK. GSK’s Arexvy associated with reductions in certain RSV-related risks including heart attack, stroke, and severe flare-ups of COPD and asthma, real-world study shows. February 17, 2025. Accessed February 26, 2026 

https://www.gsk.com/en-gb/media/press-releases/gsk-s-arexvy-associated-with-reductions-in-certain-rsv-related-risks-including-heart-attack-stroke-and-severe-flare-ups-of-copd-and-asthma-real-world-study-shows/

Livingston R. Arexvy Vaccine Reduces Hospitalization, Major Adverse Cardiovascular Events in RSV. 

. February 18, 2026. Accessed February 26, 2026. 

https://www.hcplive.com/view/arexvy-vaccine-reduces-hospitalization-major-adverse-cardiovascular-events-in-rsv

Singer D, Steffens A, La E, et al. Effectiveness of adjuvanted RSVPreF3 vaccine in preventing major adverse cardiovascular events, severe asthma exacerbations, and severe COPD exacerbations among US adults aged 60 years and older. Poster presented at the ReSViNET 2026; February 17, 2026. Accessed February 26, 2026. 

https://www.rtihs.org/publications/effectiveness-adjuvanted-rsvpref3-vaccine-preventing-major-adverse-cardiovascular

Bhatt discusses a recent study from GSK highlighting AREXVY’s efficacy in lowering major adverse cardiovascular events.

TRANQUILITY: Pacibekitug Safely Lowers hs-CRP in ASCVD, With Deepak Bhatt, MD

The interleukin-6 (IL-6) inhibitor pacibekitug (TOUR006) has indicated its safety and efficacy in reducing high-sensitivity C-reactive protein (hs-CRP) levels in patients with 

atherosclerotic cardiovascular disease (ASCVD)

, based on results from the phase 2 TRANQUILITY trial.

American Heart Association’s Scientific Sessions 2025

 in New Orleans, Louisiana, by Deepak Bhatt, MD, director of the Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai.

Pacibekitug is an investigational long-acting fully human monoclonal antibody against the IL-6 cytokine, in development by Tourmaline Bio. While the TRANQUILITY trial investigated its efficacy in treating ASCVD, pacibekitug is also under development for thyroid eye disease, with plans to expand into abdominal aortic aneurysm in the future.

“We showed incremental benefit in hs-CRP reduction, and hopefully that will translate into cardiovascular event reduction,” Bhatt said in an exclusive interview with 

. “But this wasn’t a trial designed to measure cardiovascular events. TRANQUILITY was designed to look at safety and to look at hs-CRP, and it seemed to be safe and highly efficacious in reducing risk.”

Patients were included in the TRANQUILITY trial if they were ≥18 years old, had a serum hs-CRP level ≥2.0 mg/L and <15 mg/L, and a diagnosis of CKD. Patients were excluded if they exhibited evidence of active infection, had serious infections within 6 months or >1 episode within 18 months, a known history of immunodeficiency, a history of gastrointestinal ulceration or perforation within 12 months, a history of active diverticulitis, inflammatory bowel disease, or GI abscess within 12 months, among other criteria.

The treatment period lasted 6 months, followed by a follow-up period of an additional 6 months. The primary endpoint was median time-averaged percent change in hs-CRP through day 90, adjusting for baseline. The key secondary endpoint was the percentage of participants achieving time-averaged hs-CRP below 2 mg/L through day 90. Additionally, investigators noted the percentage of participants achieving hs-CRP reductions of ≥50%.

Bhatt and colleagues ultimately included 143 patients, stratifying them by CKD stage and randomly assigning them to receive either pacibekitug 25 mg quarterly, 50 mg quarterly, or 15 mg monthly, or placebo, all delivered subcutaneously. Median age was 71 years, and 62% of patients were women. Baseline estimated glomerular filtration rate and hs-CRP were 43 ml/min/1.73m2 and 4.45 mg/L, respectively.

By day 90, the median time-averaged percent reduction in hs-CRP was 86% for the 50 mg dose, 75% for the 25 mg dose, and 85% for the 15 mg dose, versus 15% for the placebo arm (all 

 <.0001). Several patients achieved hs-CRP reductions ≥50%, and the percentage of patients with hs-CRP <1 mg/L at day 90 was 60%, 45%, and 65% for the 50 mg, 25 mg, and 15 mg arms compared to 13% for placebo (all 

Bhatt and colleagues concluded that hs-CRP was reduced significantly across all prespecified groups with pacibekitug. They also observed significant reductions in serum amyloid A, fibrinogen, and lipoprotein(a). The incidence of adverse events was 54% and 56% in the pooled pacibekitug and placebo arms, respectively. The team noted similar findings for serious adverse events (10% vs 11%), infections (24% vs 22%), and serious infections (4% vs 3%). According to the study abstract, pacibekitug is now the first IL-6 inhibitor to demonstrate sustained and significant reductions in hs-CRP with quarterly dosing.

“Our hope is that, on the basis of the TRANQUILITY trial, there will be a phase 3 trial powered to look at cardiovascular end points,” Bhatt said. “That’s really what the purpose of the TRANQUILITY trial was: to see if it looked like the drug was safe, if it looked like there was an advantage potential over other IL-6 inhibitors, and to proceed with phase 3 testing.”

Pergola P, Szarek M, Zayed H, et al. A Phase 2 Multicenter, Randomized Double-Blind, Placebo-Controlled Study of Monthly or Quarterly Subcutaneous Administration of the Interleukin-6 Inhibitor Pacibekitug in Patients With Elevated High-Sensitivity C-Reactive Protein and Chronic Kidney Disease: 90-Day Analyses from TRANQUILITY. Abstract presented at the American Heart Association’s Scientific Sessions 2025. New Orleans, Louisiana. November 8-10, 2025.

Tourmaline Bio, Inc. A Study to Evaluate TOUR006 in Patients With Chronic Kidney Disease and Elevated Hs-CRP (TRANQUILITY). ClinicalTrials.gov Identifier: NCT06362759. Updated November 14, 2025. Accessed November 20, 2025. 

https://clinicaltrials.gov/study/NCT06362759

Mishek S. Tourmaline Bio Announces Positive Topline Results from the Ongoing Phase 2 TRANQUILITY Trial Evaluating Pacibekitug in Patients with Elevated High-Sensitivity C-reactive Protein and Chronic Kidney Disease. Tourmaline Bio. May 20, 2025. Accessed November 20, 2025. 

https://ir.tourmalinebio.com/news-releases/news-release-details/tourmaline-bio-announces-positive-topline-results-ongoing-phase

Bhatt discusses the positive results from the phase 2 trial of quarterly and monthly doses of investigational IL-6 inhibitor pacibekitug.

ACC 2025 Clinical Trials to Watch with Deepak Bhatt, MD, MPH, MBA

Few fields have experienced as much rapid advancement and transformation in recent years as cardiology. With groundbreaking insights into 

 mechanisms driving innovations in treatment, from novel lipid-lowering therapies to next-generation heart failure (HF) management and structural interventions, cardiologists must navigate a landscape of continuous breakthroughs that many specialties would equate to decades’ worth of progress.

These notable advancements in recent years continue to set the stage for the 

American College of Cardiology 74th Annual Scientific Session & Expo

. This year’s meeting, taking place in Chicago from March 29-31, boasts more than 4,750 accepted abstracts, with 1,300 expert faculty and 300 sessions, encompassing 53 late-breaking clinical trials.

A leading subject matter expert in cardiology, Deepak Bhatt, MD, MPH, MBA, director of the Mount Sinai Fuster Heart Hospital and the Dr. Valentin Fuster Professor of Cardiovascular Medicine at Icahn School of Medicine at Mount Sinai, is among the meeting’s planned attendees and presenters at this year’s ACC congress. For more insight into his perspective on this year’s meeting, the editorial team of HCPLive Cardiology spoke with Bhatt to learn what trials he was most looking forward to in Chicago.

Check out a rundown of Bhatt’s top 3 picks and when they are scheduled to be presented in our list below:

The Effect Of Once-weekly Subcutaneous Semaglutide On Functional Capacity In People With Type 2 Diabetes (T2D) And Peripheral Artery Disease (PAD): Primary Results From The Phase 3b, Randomized, Placebo-controlled, Double-Blind Stride Trial

: Saturday, March 29, 2025, from 09:50-10:02 AM CT

: STRIDE (NCT04560998) is a randomized, placebo-controlled, double-blind phase 3b trial evaluating 1 mg once-weekly subcutaneous semaglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) versus placebo, in people with symptomatic PAD (Fontaine IIa claudication) and T2D. Eligible participants were ≥18 years old, had hemodynamically stable PAD, had no planned intervention, and were not receiving a GLP-1 RA.

The primary endpoint is the change in maximum walking distance on a constant-load treadmill (CLT), with secondary endpoints including quality of life and cardiometabolic assessments. STRIDE will provide evidence on functional outcomes with semaglutide in people with PAD and T2D.

Oral Semaglutide Reduces Cardiovascular Events In People With Type 2 Diabetes With Atherosclerotic Cardiovascular And/or Chronic Kidney Disease: Primary Results From The SOUL Randomized Trial

: Saturday, March 29, 2025, from 1:30-1:40 PM CT

: SOUL is a multi-center, international, randomized, double-blind, parallel-group, placebo-controlled, phase 3 cardiovascular outcomes trial assessing the effect of once-daily oral semaglutide (Rybelsus) versus placebo on cardiovascular outcomes in 9650 people with T2D and established cardiovascular disease (CVD) and/or chronic kidney disease (CKD).

Headline results reported by Novo Nordisk found SOUL achieved its primary objective by demonstrating a statistically significant and superior reduction in major adverse cardiovascular events (MACE) of 14% with oral semaglutide treatment compared with placebo.

Dapagliflozin In Patients Undergoing Transcatheter Aortic Valve Implantation

Presentation Time: Saturday, March 29, 2025, from 2:15-2:25 PM CT

Presenter: Sergio Raposeiras Roubin, MD, PhD

: Patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis relief are at an elevated risk of developing heart failure (HF) within the first months of intervention. In the Dapagliflozin after Transcatheter Aortic Valve Implantation (DapaTAVI) trial, investigators sought to assess the clinical benefit and safety of dapagliflozin 10 mg/day on mortality and worsening HF in 1020 patients with severe AS undergoing TAVI

For the independent pragmatic, controlled, prospective, randomized, open-label blinded endpoint, multicenter trial in Spain, patients needed a prior history of HF admission plus diabetes mellitus, left ventricular ejection fraction (LVEF) ≤40%, or estimated glomerular filtration rate (eGFR) between 25 and 75 ml/min/1.73 m2.

Relevant disclosures for Bhatt include Amarin, AstraZeneca, Sanofi, Pfizer, Roche, Amgen, and Eli Lilly and Company, among others.

Bonaca MP, Catarig AM, Hansen Y, et al. Design and baseline characteristics of the STRIDE trial: evaluating semaglutide in people with symptomatic peripheral artery disease and type 2 diabetes. Eur Heart J Cardiovasc Pharmacother. 2025;10(8):728-737. doi:10.1093/ehjcvp/pvae071

Oral semaglutide demonstrates a 14% reduction in risk of major adverse cardiovascular events in adults with type 2 diabetes in the SOUL trial. Novo Nordisk. October 21, 2025. Accessed March 21, 2025. 

https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=171480

Amat-Santos IJ, Sánchez-Luna JP, Abu-Assi E, et al. Rationale and design of the Dapagliflozin after Transcatheter Aortic Valve Implantation (DapaTAVI) randomized trial. Eur J Heart Fail. 2022;24(3):581-588. doi:10.1002/ejhf.2370

Bhatt previews 3 late-breaking clinical trials being presented at this year's American College of Cardiology Annual Scientific Sessions.

Deepak Bhatt, MD, MPH

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