Shamir Mehta

It’s standard practice to give patients who’ve experienced a STEMI (acute heart attack with a completely blocked coronary artery) high doses of statins – a group of drug used to lower blood fats. However, a significant number of STEMI patients never achieve optimal LDL cholesterol (‘bad cholesterol’) levels with statins.

PHRI Senior Scientist Shamir Mehta and team conducted a trial to determine the effect of acute, rapid lowering of LDL cholesterol with the PCSK9-inhibitor medicine, alirocumab, added to high-dose statin therapy in patients with STEMI undergoing a cardiac procedure known as primary PCI.

The EPIC-STEMI trial team found that routine, early administration of alirocumab – regardless of baseline LDL levels or prior statin use – had the potential to substantially reduce morbidity and mortality globally after high-risk acute coronary syndromes by further reducing LDL beyond statins in a much greater number of high-risk patients than is currently treated with these agents.

Mehta presented on EPIC STEMI today at the TCT Conference 2022 in Boston, MA. (Download his TCT22 slides – PDF.)

The findings were simultaneously published in EuroIntervention Journal. Mehta’s coauthors include PHRI Senior Scientists Guillaume Paré and Eva Lonn, PHRI Scientist Sanjit Jolly, and Hamilton, Ontario’s Natalia Pinilla, James Velianou, and Matt Sibbald.

“Use of alirocumab comparatively reduced LDL-cholesterol by 22 percent at 6 weeks on a background of high-intensity statin therapy, in a manner that appears feasible and safe,” says Mehta. “As such, a large outcomes trial evaluating this simplified strategy is needed.”

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