Risk reduction of ASCVD attributed to lowering of remnant cholesterol from statins, fibrates, APOC3 inhibitors, and ANGPTL3 inhibitors: a cohort study

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

Paperzilla title

New Cholesterol Drugs Could Be a Game Changer (But More Research Is Needed)

This observational study suggests that lowering remnant cholesterol, as seen with new APOC3 and ANGPTL3 inhibitors, could reduce 10-year ASCVD risk by 2.7-4.1% in statin users and 1.4-2.1% in statin non-users with high remnant cholesterol. However, randomized controlled trials are needed to confirm these findings and establish causality.

Possible Conflicts of Interest

Anne Langsted received honoraria/consultancies from Amarin and Novartis and is currently employed by Novo Nordisk. Anette Varbo is also employed by Novo Nordisk. Børge G. Nordestgaard reports consultancies/talks for AstraZeneca, Sanofi, Ionis, Amgen, Amarin, Novartis, Novo Nordisk, Esperion, Lilly, Arrowhead, and Marea.

Identified Weaknesses

Observational study

Observational studies show correlation, but randomized trials are necessary to demonstrate causality and eliminate potential confounders.

Limited generalizability

The study population is limited to white Europeans, so results may not apply to other ethnicities.

Potential for residual confounding

Residual confounding could be present even after adjusting for known risk factors.

Rating Explanation

Strong methodology using a large cohort and registry data, but limitations inherent to observational studies prevent a higher rating. The declared conflicts of interest are also a concern.

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Topic Hierarchy

Domain:

Health Sciences

Field:

Medicine

Subfield:

Cardiology and Cardiovascular Medicine

File Information

Original Title:

Risk reduction of ASCVD attributed to lowering of remnant cholesterol from statins, fibrates, APOC3 inhibitors, and ANGPTL3 inhibitors: a cohort study

File Name:

paper_465.pdf

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August 20, 2025 at 08:05 PM

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