Original Research Publications and Top TIMI Lessons of 2022

Anticoagulation and Antiplatelet Therapy for Prevention of Venous and Arterial Thrombotic Events in Critically Ill Patients With COVID-19: COVID-PACT. Circulation. 2022 Nov;146(18):1344-1356. Weighing clotting and bleeding risk, full-dose anticoagulation should be considered to prevent thrombotic events in selected critically ill patients with COVID-19.

Effect of Vupanorsen on Non-High-Density Lipoprotein Cholesterol Levels in Statin-Treated Patients With Elevated Cholesterol: TRANSLATE-TIMI 70. Circulation. 2022 May 3;145(18):1377-1386. In TRANSLATE-TIMI 70, vupanorsen (2nd gen ASO targeting ANGPLT3) lowered non-HDL-C and TG’s, but increased liver enzymes and hepatic fat at higher doses. Highlights need for careful assessment of new agents targeting TG-rich lipoproteins.

Randomized, Placebo-Controlled Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Lecithin Cholesterol Acyltransferase in Acute ST-Segment-Elevation Myocardial Infarction: Results of REAL-TIMI 63B. Circulation. 2022 Sep 20;146(12):907-916. In REAL-TIMI 63B, rh-LCAT given at the time of primary PCI for STEMI was safe and increased HDL-C levels, but did not reduce infarct size as measured by cMRI at 12 weeks.

Long-Term Evolocumab in Patients With Established Atherosclerotic Cardiovascular Disease. Circulation. 2022;146:1109–1119. Early and aggressive LDL-C lowering with evolocumab translates into greater long-term clinical benefit.

Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease. N Engl J Med 2022 Nov 17;387(20):1855-1864. Marked and sustained reduction of Lp(a) is possible through siRNA olpasiran dosed only once every 12 weeks.

Association of Serial High-Sensitivity Cardiac Troponin T With Subsequent Cardiovascular Events in Patients Stabilized After Acute Coronary Syndrome: A Secondary Analysis From IMPROVE-IT. JAMA Cardiol. 2022 Dec 1;7(12):1199-1206. Serial assessment of high-sensitivity cardiac troponin refines risk stratification in patients with established atherosclerosis and may be useful to inform decision-making for therapy.

Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation: Patient-Level Network Meta-Analyses of Randomized Clinical Trials With Interaction Testing by Age and Sex. Circulation. 2022 Jan 25;145(4):242-255. Comprehensive patient level meta-analysis of NOAC vs warfarin trials in AF demonstrates substantial benefits, reduction in mortality, and favorable safety profile of NOACs over warfarin overall and in multiple subgroups.

Predictive Utility of a Coronary Artery Disease Polygenic Risk Score in Primary Prevention. JAMA Cardiol. 2022 Dec 28. doi: 10.1001/jamacardio.2022.4466. Epub ahead of print. PMID: 36576811. Although not necessary in all individuals, a targeted approach to CAD PRS testing may help guide preventive strategies such as statin initiation in younger adults with borderline to intermediate cardiovascular risk.

Association of ApolipoproteinB-Containing Lipoproteins and Risk of Myocardial Infarction in Individuals with and without Atherosclerosis: Distinguishing Between Particle Concentration, Type, and Content. JAMA Cardiol. 2022 Mar 1;7(3):250-256. PMID: 34773460. Risk of myocardial infarction may best be captured by the number of apoB-containing lipoproteins, independent from lipid content (cholesterol or triglyceride) or type of lipoprotein (low-density lipoprotein or triglyceride-rich).

Growth differentiation factor 15 and cardiovascular risk: individual patient meta-analysis. Eur Heart J. 2022 Oct 28;ehac577. doi: 10.1093/eurheartj/ehac577. Online ahead of print. GDF-15 levels add prognostic information for a variety of CV adverse events beyond clinical risk factors and established CV biomarkers.


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