Video Series

1 expert is featured in this series.

For the first time, the 2026 ACC/AHA guideline provides strong, evidence-based recommendations for patients who cannot tolerate statins—a group historically underserved by prior guidance. Outcome data now support bempedoic acid (from the CLEAR trial), PCSK9 monoclonal antibodies, ezetimibe, and inclisiran as viable alternatives. Rather than defaulting to high-intensity statin doses, clinicians can consider combination strategies such as a moderate-intensity statin paired with ezetimibe—a pairing shown in the RACING trial to match the cardiovascular event reduction of high-intensity monotherapy while improving tolerability and LDL goal achievement. The "rule of sixes"—where doubling a statin dose yields only an additional 6% LDL reduction versus 18% from adding ezetimibe—further reinforces early combination thinking.

1 expert is featured in this series.

The 2026 update to the ACC/AHA guideline for dyslipidemia management represents a meaningful shift in how and when clinicians should begin lipid-lowering therapy, Erin D. Michos, MD, MHS, professor of medicine, director of Women's Cardiovascular Health and associate director of Preventive Cardiology in the Division of Cardiology at Johns Hopkins University School of Medicine, explains.

In this episode, ‘Assessing Clinical and Economic Factors in Treatment Selection and Payer Decision-Making,’ the panelists explore the key clinical and economic considerations that drive therapy selection across the three available ATTR-CM treatments. Dr. Alexander opens by emphasizing shared decision-making as a foundational principle, noting that in the absence of head-to-head data, patient preferences carry significant weight alongside clinical judgment. He outlines several practical factors influencing treatment choice, including route of administration, as vutrisiran is a quarterly injection given in a healthcare setting, acoramidis is a twice-daily oral pill, and tafamidis is a once-daily oral pill, each presenting distinct advantages depending on patient circumstances such as pill burden or transportation access.