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oral PCSK9 improves all bad lipids

  A recent study found that the oral PCSK9 inhibitor Enlicitide decreased an array of adverse lipid markers including lipoprotein(a) (referred to as Lp(a)) in the phase-3 CORALreef HeFH study: see   lipid oral PCSK9 lipid effect JAMA2025  in dropbox, or doi:10.1001/jama.2025.20620   Details : -- 303 participants with genetically-confirmed heterozygous familial hypercholesterolemia (HeFH) who were at least 18 years old and were on statin therapy as well as many being on ezetimibe were randomized to the oral PCSK9 inhibitor enlicitide decanoate 20 mg once daily for 52 weeks versus placebo. Patients were instructed to take this medication on an empty stomach 30 minutes prior to eating     -- these patients had either an LDL level of 55 mg/dL or greater and a history of major atherosclerotic cardiovascular disease (ASCVD), or a level of 70 mg/dL or greater without a history of ASCVD -- this trial was conducted in 59 sites across 17 countries, screening pat...

atrial fibrillation: stopping anticoagulation 1 yr after ablation

A recent South Korean study found that some patients who had catheter ablation for atrial fibrillation were able to discontinue anticoagulation therapy, in the ALONE-AF trial (Anticoagulation One year after Ablation of Atrial Fibrillation in Patients with Atrial Fibrillation (see afib ablation stop anticoag after 1 yr JAMA2025 in dropbox, or doi:10.1001/jama.2025.14679) Details: -- 850 adults aged 19 to 80 were enrolled in this open-label randomized controlled trial from 2020 the 2023 at 18 hospitals in South Korea, with follow-up until 2025 -- All enrollees had atrial fibrillation (AF) with catheter ablation and were put on anticoagulation as per usual; they were in intermediate or high risk of thromboembolism with a CHA2DS2-VASc score of at least 1 for men or 2 for women -- All had at least one non-sex-related stroke risk factor as determined by their CHA2DS2-VASc score and no documented recurrence of atrial arrhythmia for at least one year after their catheter ablation for AF ...