CONGRESS ABSTRACT

Background: cardiovascular diseases (CVDs) remain the leading global cause of morbidity and mortality, driven by risk factors such as dyslipidemia, which needs effective lipid-lowering strategies. Bempedoic acid, a novel non-statin lipid-lowering agent, acts by inhibiting ATP citrate lyase, reducing low-density lipoprotein cholesterol (LDL-C) synthesis. Many clinical trials have demonstrated its efficacy and safety, particularly in patients intolerant to statins or those requiring additional LDL-C reduction to achieve guideline-recommended targets. Methods: this monocentric, real-world study analyzed 67 patients on maximally tolerated lipid-lowering therapy with LDL-C levels above the European Society of Cardiology (ESC) targets, who initiated bempedoic acid.  Results: after three months of treatment, 42% of patients achieved LDL-C targets, with an average LDL-C reduction of 33%. Patients on concomitant statin therapy achieved target levels in 31% of cases compared to 46% of those without statins, with mean LDL-C reductions of 24% and 37%, respectively. Additionally, patients receiving PCSK9 inhibitors (PCSK9i) reached LDL-C targets in 48.5% of cases versus 35% in those without PCSK9i, with mean LDL-C reductions of 36% and 30%, respectively. Conclusions: these findings confirm the efficacy of bempedoic acid in lowering LDL-C and achieving guideline-recommended targets, highlighting its utility as part of individualized lipid-lowering regimens in real-world settings. However, the conclusions of the study are limited by the small size and heterogeneity of the sample, as well as the retrospective nature of the study, which does not allow for statistically significant results to be obtained.