Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempedACS Randomized Clinical Trial
Authors' conclusion
Adding bempedoic acid to statin-ezetimibe therapy in the setting of ACS is safe but failed to improve the percentage of patients achieving the LDL-C goal (<55 mg/dL) at 8 weeks.
Study context
- Population
- Patients randomised within 72 hours of acute coronary syndrome (ACS), Spain, November 2023 to October 2024
- Participants
- 206 patients
- Comparison
- Triple LLT vs dual LLT
- Primary endpoint
- Proportion of patients achieving low-density lipoprotein cholesterol (LDL-C) <55 mg/dL (<1.4 mmol/L)
- Follow-up
- 8 weeks after ACS
Methodological detailsmulticentre, independent, pragmatic, prospective, open, blinded end point, 12 Spanish hospitals
- Multicentre
- Independent
- Pragmatic
- Prospective
- Open
- Blinded end point
- 12 Spanish hospitals
Primary result
As reported in the abstract
LDL-C <55 mg/dL · 8 weeks
P = 0.376
Further findings
| Outcome | Triple LLT | Dual LLT | P value |
|---|---|---|---|
| Percentage change in LDL-C · 8 weeks | mean 57.5 (SD 17.8) % | mean 56.9 (SD 18.5) % | P = 0.823 |
| Reduction in non-HDL cholesterol | 49.0 (SD 25.4) | 49.1 (SD 31.2) | P = 0.970 |
| Reduction in TG | 14.9 (SD 36.9) | 16.8 (SD 36.0) | P = 0.718 |
Safety
Adverse events
- No differences in adverse events
Original publication
Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempedACS Randomized Clinical Trial. Circulation. Published 7 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it