American Heart Association

New research suggests blood thinners do not prevent cognitive decline or strokes in younger adults with atrial fibrillation. The study, presented at the American Heart Association meeting, involved over 1,200 participants aged 53 on average, with A-fib but no other stroke risk factors. Half received rivaroxaban, the others a placebo; outcomes were similar. The study supports current guidelines indicating anticoagulation is not useful for reducing cognitive decline risk in this group.

Japanese researchers found edoxaban as effective as warfarin in preventing stroke and blood clots post-heart valve surgery, with fewer doctor visits and no need for blood tests. Edoxaban showed lower rates of stroke or embolism (0.5% vs. 1.5%) but higher major bleeding (4.1% vs. 1%) and gastrointestinal bleeding (2.1% vs. 0%).

Muvalaplin, an oral lipoprotein(a) inhibitor, reduced lipoprotein(a) levels by up to 85.8% in a phase 2 study of high-risk patients, with no safety concerns. The impact on cardiovascular events remains uncertain.

Mitiperstat, a myeloperoxidase inhibitor, showed no significant improvement in quality of life or functional capacity in heart failure patients with mid-range to preserved ejection fraction in the ENDEAVOR trial. However, it reduced heart failure hospitalizations by 36%, suggesting further exploration in larger trials.

Open-label extension data from ATTRibute-CM study shows sustained benefit of acoramidis on cardiovascular outcomes, including a statistically significant reduction in ACM within 36 months.

Two new drugs, an siRNA and an oral agent, reduced Lp(a) by 80% in phase II studies. Zerlasiran, the siRNA, lowered Lp(a) by 85% over 36 weeks, while muvalaplin, the oral agent, reduced Lp(a) by 70% with a traditional assay and over 85% with an intact assay. Both therapies offer potential for treating cardiovascular disease, with muvalaplin providing an oral alternative to injectables.

Silence Therapeutics presented Phase 2 ALPACAR-360 study data on zerlasiran, showing >80% mean time-averaged placebo-adjusted reductions in Lp(a) concentrations over 36 weeks, with maximum reductions exceeding 90%. No safety concerns emerged, and reductions persisted at 60 weeks post-initial administration.

Muvalaplin, an oral drug, significantly reduced lipoprotein(a) (Lp[a]) by 70% in a traditional blood test and 85.5% in a new test, according to a phase 2 study presented at the 2024 AHA Scientific Sessions. The drug, developed by Eli Lilly, targets Lp(a), a genetically driven variant of LDL cholesterol linked to cardiovascular disease, with no current treatments. Muvalaplin disrupts the bonding of apo(a) to apoB, preventing Lp(a) formation, and also reduced oxidized phospholipids. The study involved doses of 10 mg, 60 mg, and 240 mg over 12 weeks, with 97% of participants achieving Lp(a) levels below 125 nmol/L. Phase 3 trials and cardiovascular outcomes trials are next steps before market potential.

Muvalaplin, an oral medication, safely and effectively lowered high lipoprotein(a) [Lp(a)] levels in the KRAKEN clinical trial, with reductions of up to 70% and 85.5% as measured by traditional and new tests, respectively. The study, published in JAMA, highlights muvalaplin as the first oral agent to target Lp(a), an inherited risk factor for cardiovascular disease.

Zerlasiran, an siRNA drug, reduced lipoprotein(a) levels by over 80% in a 36-week trial, suggesting potential for preventing heart disease in those with high Lp(a). The trial, presented at the American Heart Association’s Scientific Sessions 2024, showed minimal side effects and persistent reductions up to 60 weeks post-administration.