R3i Landmarks
Over the past 15 years, large clinical trials have shown that while statin therapy reduces major cardiovascular events by 25–35%, substantial residual cardiovascular risk remains. Additionally, aggressive multifactorial therapies in type 2 diabetes fail to fully prevent microvascular complications. This section examines these findings, addressing both macro- and microvascular residual risks.
Latest Landmarks
VESALIUS-CV: Adding evolocumab to standard lipid lowering therapy prevents a first major cardiovascular event in high-risk patients
November 2025
Combining the PCKS9 inhibitor evolocumab with standard lipid lowering therapy reduced first major cardiovascular events by 25% in high cardiovascular risk adults (evidence of atherosclerosis or with high-risk diabetes) and no history of heart attack or stroke.
Bohula EA, Marston NA, Bhatia AK, et al. Evolocumab in patients without a previous myocardial Infarction or stroke. N Engl J Med 2025; DOI: 10.1056/NEJMoa2514428.
More Landmarks
2025
Target elevated lipoprotein(a) in patients with acute coronary syndromes
October 2025
Patients with acute coronary syndromes and elevated lipoprotein(a) derive earlier and greater reduction in risk for both major adverse cardiovascular events and adverse limb events with alirocumab: insights from ODYSSEY OUTCOMES.
Ray KK, Szarek M, Bhatt DL, et al. Lipoprotein(a) identifies patients with acute coronary syndromes who derive cardiovascular benefit from alirocumab, particularly for limb events. J Am Coll Cardiol 2025; https://doi.org/10.1016/j.jacc.2025.08.043
STRENGTH trial suggests benefit in Asian patients
September 2025
An exploratory analysis from the neutral STRENGTH trial indicates that treatment with an omega-3 (ω-3) carboxylic acid formulation was associated with significant reduction in major adverse cardiovascular events in Asian patients but not in non-Asian patients at high cardiovascular risk.
Wang TKM, Nicholls SJ, St John J, et al. Differential cardiovascular impact of ω-3 fatty acid in patients at high cardiovascular risk in Asians versus non-Asians: Sub-analysis of the STRENGTH randomized clinical trial. Atherosclerosis 2025; https://doi.org/10.1016/j.atherosclerosis.2025.120228.
REDUCE-IT: Icosapent ethyl reduces cardiovascular risk even with low LDL-C
August 2025
In this analysis from REDUCE-IT, high-dose icosapent ethyl reduced cardiovascular events by 34% among high cardiovascular risk patients with elevated triglycerides, even among those with low-density lipoprotein cholesterol levels below guideline-recommended targets.
Aggarwal R, Bhatt DL, Steg PG, et al. Cardiovascular outcomes with icosapent ethyl by baseline low-density lipoprotein cholesterol: a secondary analysis of the REDUCE-IT randomized trial. J Am Heart Assoc. 2025;14(5):e038656.
More insights from the LoDoCo2 (Low-Dose Colchicine 2) trial
July 2025
This latest analysis supports the use of colchicine in patients with chronic coronary syndrome across the spectrum of baseline risk.
Mohammadnia N, Wesselink BE, Bax WA, et al. Cardiovascular benefit of colchicine in relation to baseline risk: a secondary analysis of the LoDoCo2 Trial. J Am Heart Assoc 2025;14:e038687. DOI: 10.1161/JAHA.124.038687.
Immediate action needed to tackle global obesity in children and adolescents
April 2025
Latest data from the Global Burden of Disease Study 2021 highlight a global epidemic of obesity in children and adolescents. Forecasting data indicate that about one-third of children and adolescents will be overweight or obese by 2050, unless immediate urgent action is taken now.
GBD 2021 Adolescent BMI Collaborators. Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. Lancet 2025; 405: 785–812
2024
Insights from PROMINENT: Pemafibrate reduces the risk of ulcer or gangrene in type 2 diabetes patients
August 2024
These findings from the PROMINENT trial suggest that pemafibrate may offer therapeutic potential
for reducing lower-extremity ischemic ulceration and gangrene in patients with type 2 diabetes.
Marinho LL, Everett BM, Aday AW, et al. Effect of pemafibrate on diabetic foot ulceration and
gangrene. An exploratory analysis from PROMINENT. J Am Coll Cardiol 2024;84:408-410.
REDUCE-IT: Icosapent ethyl in acute coronary syndrome
July 2024
Icosapent Ethyl–Intervention Trial), treatment with icosapent ethyl reduced the risk of ischemic
events in high-risk, statin-treated patients with a recent (<12 months) acute coronary syndrome
(ACS), without excess bleeding.
Sayah N, Bhatt DL, Miller M, et al. Icosapent ethyl following acute coronary syndrome: the REDUCE-IT
trial. Eur Heart J 2024;45: 1173–76.
More from REDUCE-IT: Does lipoprotein(a) modify risk reduction with icosapent ethyl?
27 June 2024
REDUCE-IT: Highest risk greatest benefit from icosapent ethyl
May 2024
Ethyl–Intervention Trial), icosapent ethyl consistently reduced the risk of major adverse
cardiovascular events (MACE) in patients with atherosclerotic cardiovascular disease (ASCVD) and
elevated triglycerides across the range of baseline residual risk. However, absolute treatment effects
were greater in patients with higher residual risk at baseline.
Burger PM, Bhatt DL, Dorresteijn JAN, et al. Effects of icosapent ethyl according to baseline residual
risk in patients with atherosclerotic cardiovascular disease: results from REDUCE-IT. Eur Heart J
Cardiovasc Pharmacother 2024; doi: 10.1093/ehjcvp/pvae030.
