Federico II Study – Vanvitelli: the data attests that 1 in 5 people who survive a heart attack have a recurrence within the year. How the therapy works
An Italian TA target-IT study coordinated by Prof. Pasquale Perrone Filard was presentedi (in the photo), director of the School of Specialization in Cardiovascular Diseases of the “Federico II” University of Naples and president of Sic – Italian Society of Cardiology, with the participation also of the Cardio-Vascular Department of the relevant hospital national Sant’Anna and San Sebastiano di Caserta directed by Prof. Paolo Calabrò. According to the results of the study, which involved 771 post-heart attack patients treated in 22 Italian centers, published in the European Journal of Preventive Cardiology, demonstrate the effectiveness of the “hit early, hit hard” approach: intervening immediately after the heart attack, intensively with PCSK9 inhibitor monoclonal antibodies, lowers LDL cholesterol levels by up to 70%.
68% of patients reached the recommended LDL-C target (55 mg/dL) already at the first check-up, thus offering effective and safe protection in the delicate post-infarction phase. “Patients who have had a heart attack are considered very high risk. European guidelines recommend reaching LDL levels below 55 mg/dL, and even below 40 mg/dL for those who have had multiple cardiovascular events – explains Prof. Pasquale Perrone Filardi – All post-heart attack patients should have a follow-up after 4 weeks of anti-lipid therapy to verify the effectiveness of the treatment and if the LDL levels are still not optimal, it is necessary to modify and optimize the therapy”.
The Italian AT target-IT registry demonstrates for the first time in clinical practice a clear correlation: the lower the LDL level, the lower the risk of new cardiovascular events, with evident benefits already after 11 months. Patients who achieved the LDL goal of less than 55mg/dL saw a significant decrease in risk compared to those who have not achieved it and who they have higher levels. The benefit proved to be even greater for those with LDL cholesterol levels below 43 mg/dL and maximum for those below 23 mg/dL.
The results confirm that intensively lowering LDL cholesterol immediately after a heart attack is safe and effective with significant benefits for reducing the risk of recurrence. The data from the study at a national level mark important goals and are confirmed by the survey at a local level. “The experience of our centre, which involved around 150 patients in the AT TARGET-IT study, confirms the excellent results highlighted at a national level” – declares Prof. Paolo Calabrò – We have been using in clinical practice, PCSK9-inhibiting monoclonal antibodies for people defined as high risk and the timely use of these therapies has immediately demonstrated high efficacy in allowing 70-80% of patients to reach target LDL-C levels of 55mg/dL”.
The effectiveness of the “hit early, hit hard” approach also depends significantly on adherence to therapy. According to scientific literature, only approximately 5 out of 10 patients (45.9%) at very high risk and 3 out of 10 (30.2%) at medium risk regularly follow traditional lipid-lowering therapy. “Adherence to therapy with PCSK9 inhibitor monoclonal antibodies is very high, over 90% with an optimal persistence of 95% in the 12 and 18 month follow up months – explains Calabrò – A recent publication by our working group also highlighted that adherence to inhibitory monoclonal antibodies PCSK9 also leads to greater adherence to statins, an important result for a better effectiveness of lipid-lowering therapy. It is necessary to highlightfinally, the approach of the Campania Region which was the first to promote access to these innovative therapies, also providing forms of distribution that allow patients to collect the drug from local pharmacies, as well as in hospital. This virtuous policy has a direct and positive impact on patient adherence rates.” In addition to maintaining consistent adherence to treatments, patients can play an active role in their secondary prevention. For post-heart attack patients, it is essential that if their LDL cholesterol levels do not reach recommended targets, they consult with their specialist. This allows us to optimize the therapeutic strategy and guarantee maximum protection against future cardiovascular events.
