I will be discussing my take on the recently announced failure of Pelacarsen to lower cardiac events in patients with elevated Lp(a) If you are unable to attend LIVE and want to ask a question, then please leave the question in the comments of this posts and I will answer it We will see how a hybrid of asynchronous questions with Live questions work to increase the volume of questions and educational opportunities for this group's members

The Lp(a) story continues to be one of the most exciting developments in preventive cardiology, and this week brought fresh pipeline context: • Muvalaplin (Eli Lilly) — oral Lp(a)-lowering agent, Phase 2 data complete, Phase 3 underway at UC Health and other centers • Lepodisiran (诺华/Novartis) — siRNA agent, single injection showing reductions of ~90%+ in Phase 1/2; ACCLAIM-Lp(a) trial active • Olpasiran (安进/Amgen) — siRNA, similar efficacy profile • Pelacarsen (Ionis/AstraZeneca) — ASO agent, earliest in development The HORIZON trial — first dedicated cardiovascular outcomes trial for an Lp(a)-lowering agent — is expected to report before end of 2026. This is the data that will tell us whether lowering Lp(a) actually reduces events the way LDL lowering does. If HORIZON is positive, Lp(a) screening moves from "interesting but untreatable" to "actionable cardiovascular risk factor" — a massive shift in preventive cardiology practice. Source: UCHealth Today, August 4 · [Family Heart Foundation / ACC/AHA 2026 Guideline]

https://calroy.com/education/2026-guide-to-supporting-vascular-health-by-targeting-the-endothelial-glycocalyx/

This week at ESC Congress 2026 (Munich, August 28–31), researchers from the University of Tokyo and Institute of Science Tokyo presented data showing that AI analysis of facial videos can detect undiagnosed hypertension and diabetes with remarkable accuracy — no blood test, no cuff, no clinic visit required. Here's how it works: a high-speed spectroscopic camera records a 30-second video of your face and palms. A machine-learning algorithm extracts pulse-wave dynamics (arterial stiffness markers), skin blood flow patterns, and the spectral characteristics of skin coloring — all of which correlate with blood pressure and blood sugar regulation. The numbers: • Hypertension detection: 95% accuracy from a 30-second recording • Still 90.3% accurate from just a 5-second video • Diabetes detection: similarly high accuracy using facial blood flow patterns This isn't speculative — it's a prospective clinical study. And the implication is significant: a world where cardiovascular risk screening happens through a phone camera at the pharmacy counter, at a wellness clinic, or at a routine eye exam. For preventive cardiology, this is the future of population-level risk stratification — finding the undiagnosed 30-79 year olds with hypertension (there are ~1.4 billion globally) who never come in for a clinic visit because they feel fine. Source: Medical Xpress / ESC Congress, August 26, 2026

August marks a pivotal moment in preventive cardiology — a new guideline settling into practice, a major anti-inflammatory trial disappointment, a breakthrough therapy for a neglected condition, and one of cardiology's largest congresses about to unfold. Here's everything worth knowing. ─── 1. The 2026 Dyslipidemia Guideline Is Here — And It Changes Everything The ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia dropped in March 2026, and August is when clinicians are actually starting to apply it. The core shift: treat earlier, target lower. The guideline introduces the "CPR" model for every patient encounter: • *C*alculate — Use the new PREVENT score to get 10-year and 30-year risk estimates • *P*ersonalize — Factor in risk enhancers the calculator doesn't capture: family history, Lp(a), hsCRP, reproductive history, chronic inflammatory conditions • *R*eclassify — Use the CAC score to reclassify and potentially escalate or de-escalate therapy The LDL-C targets are concrete now — not just percent reductions: | Risk Level | LDL-C Goal | Non-HDL-C Goal | | --------------------------------- | ---------- | -------------- | | High (≥10% 10-yr PREVENT) | <70 mg/dL | <100 mg/dL | | Borderline / Intermediate (3–10%) | <100 mg/dL | <130 mg/dL | Lp(a) gets its first-ever universal screening recommendation from ACC/AHA — measure it at least once in every adult. This is a major upgrade from prior guidance. Values >125 nmol/L carry ~1.4× ASCVD risk; >250 nmol/L carry ≥2× risk. One blood test. Lifetime implications forcascade screening. ─── 2. ZEUS Trial: The Anti-Inflammatory Hypothesis Takes a Hit Novo Nordisk's ziltivekimab — a monoclonal antibody targeting interleukin-6 (IL-6), the inflammation cytokine thought to be a central driver of residual cardiovascular risk — failed to reduce major adverse cardiovascular events in the phase 3 ZEUS trial. Despite ziltivekimab demonstrating robust biological activity — significant drops in IL-6 and CRP — the primary MACE endpoint (MI, stroke, CV death) was not met. HR 0.99. Neutral.