Inflammation and Cholesterol as Predictors of Cardiovascular Events Among 13 970 Contemporary High-Risk Patients With Statin Intolerance
Authors' conclusion
Among contemporary statin-intolerant patients, inflammation assessed by hsCRP predicted risk for future cardiovascular events and death more strongly than hyperlipidemia assessed by LDLC.
Study context
- Population
- Statin-intolerant patients randomised to bempedoic acid 180 mg daily or placebo
- Participants
- 13,970 patients
- Comparison
- Highest vs lowest quartile of baseline high-sensitivity C-reactive protein (hsCRP) and of baseline LDL-C as predictors of CV events
- Primary endpoint
- Primary composite end point of:
- Major CV events (MI, stroke, coronary revascularization or CV death) by baseline hsCRP
- Low-density lipoprotein cholesterol (LDLC) quartile
Methodological detailsmultinational
- Multinational
Primary result
As reported in the abstract
Primary composite end point (major CV events)
Hazard ratio (95% CI)
Highest hsCRP quartilevs Lowest hsCRP quartile
1.43(1.24–1.65)
Highest LDL-C quartilevs Lowest LDL-C quartile
1.19(1.04–1.37)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| CV mortalityHighest hsCRP quartilevs Lowest hsCRP quartile | 2.00 (1.53–2.61) | |
| CV mortalityHighest LDL-C quartilevs Lowest LDL-C quartile | 0.90 (0.70–1.17) | |
| All-cause mortalityHighest hsCRP quartilevs Lowest hsCRP quartile | 2.21 (1.79–2.73) | |
| All-cause mortalityHighest LDL-C quartilevs Lowest LDL-C quartile | 0.95 (0.78–1.16) | |
| 0.20.5125Hazard ratio (log scale) |
hsCRP and LDL-C change with bempedoic acid vs placebo · 6 months
- Median hsCRP reduced
- 21.6%
- Mean LDL-C reduced
- 21.1%
Bempedoic acid efficacy across hsCRP and LDL-C levels
- Similar efficacy in reducing CV events across all levels of hsCRP and LDL-C
- Risks high with elevated hsCRP irrespective of LDL-C level
Original publication
Inflammation and Cholesterol as Predictors of Cardiovascular Events Among 13 970 Contemporary High-Risk Patients With Statin Intolerance. Circulation. Published 6 November 2023. doi:10.
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