Beyond the Event: Optimizing PCSK9-Targeting Therapies in Secondary ASCVD Prevention - Episode 1
Cumulative LDL-C Exposure and the Persistent Challenge of Recurrent ASCVD
This program brings together leading experts to discuss evolving strategies for reducing recurrent cardiovascular risk in patients with ASCVD, emphasizing the importance of cumulative LDL-C exposure and the need for earlier, more intensive lipid lowering. The panel explores current guidelines, emerging data from recent trials, and practical approaches to integrating PCSK9-targeting therapies to improve long-term adherence, access, and outcomes in secondary prevention
The panelists open the discussion by addressing the persistent cardiovascular risk seen in patients with established ASCVD, even with widespread statin use. The experts note that recurrent events remain common due to a combination of factors, including residual inflammatory, thrombotic, and cardiometabolic risk, along with insufficient LDL-C lowering.
Data show that many secondary prevention patients still have LDL-C levels above 70 mg/dL, and therapy intensification is infrequent over time. The panelists emphasize that cumulative LDL-C exposure is a critical determinant of ongoing atherosclerotic progression—patients who experience a cardiac event often carry a lifelong burden of atherogenic exposure and are at highest risk shortly after their initial event. Many discontinue lipid-lowering therapy once they feel better, losing long-term benefit.
The discussion concludes that sustained, aggressive LDL-C reduction beyond the acute phase is essential to alter the trajectory of recurrent cardiovascular risk in ASCVD management.
