LDL-C management in coronary artery disease: Should it begin in the cath lab?

In these short videos, Professors Giuseppe Patti, Ulrich Laufs, Gilles Montalescot, and Marc Bonaca share key insights from their presentations at a satellite symposium at ESC 2026: ‘LDL-C management in coronary artery disease: Should it begin in the cath lab?’, chaired by Prof. Vijay Kunadian, and sponsored by Amgen.  

Topics include: 

• From acute ACS to early lipid intervention: Lessons from ARMYDA and beyond
• What plaque imaging teaches us about early intensive LDL-C lowering
• AMUNDSEN trial results: Contemporary evidence for early LDL-C management
• EVOLVE-MI and real-world evidence: From trial signal to system change

Navigate through the tabs to watch each expert's video update and get their key clinical takeaways.

In these short videos, Professors Giuseppe Patti, Ulrich Laufs, Gilles Montalescot, and Marc Bonaca share key insights from their presentations at a satellite symposium at ESC 2026: ‘LDL-C management in coronary artery disease: Should it begin in the cath lab?’, chaired by Prof. Vijay Kunadian, and sponsored by Amgen.  

Topics include: 

• From acute ACS to early lipid intervention: Lessons from ARMYDA and beyond
• What plaque imaging teaches us about early intensive LDL-C lowering
• AMUNDSEN trial results: Contemporary evidence for early LDL-C management
• EVOLVE-MI and real-world evidence: From trial signal to system change

Clinical takeaways

• Implementing a "strike early and strong" approach by initiating PCSK9 inhibitors within 24 hours of an Acute Coronary Syndrome (ACS) event significantly reduces recurrent cardiovascular events at one year compared to a traditional stepwise strategy
• Early use of PCSK9 inhibitors in the acute setting allows rapid achievement of LDL-C targets
• Upstream initiation of evolocumab prior to primary coronary intervention provides anti-inflammatory benefits that contribute to improved clinical outcomes

In these short videos, Professors Giuseppe Patti, Ulrich Laufs, Gilles Montalescot, and Marc Bonaca share key insights from their presentations at a satellite symposium at ESC 2026: ‘LDL-C management in coronary artery disease: Should it begin in the cath lab?’, chaired by Prof. Vijay Kunadian, and sponsored by Amgen.  

Topics include: 

• From acute ACS to early lipid intervention: Lessons from ARMYDA and beyond
• What plaque imaging teaches us about early intensive LDL-C lowering
• AMUNDSEN trial results: Contemporary evidence for early LDL-C management
• EVOLVE-MI and real-world evidence: From trial signal to system change

Clinical takeaways

• Plaque imaging is essential for detecting plaque extent and composition, particularly for identifying "lipid-rich" plaque, which is modifiable with intensive LDL-lowering therapy
• The VESALIUS-CV study demonstrates that in a lower-risk population (those before their first event, such as patients with diabetes and a prior PCI), lowering LDL-C with evolocumab on top of statins significantly reduces MACE and total mortality compared to standard statin therapy
• Showing plaque images directly to patients is an effective communication strategy to improve patient adherence

In these short videos, Professors Giuseppe Patti, Ulrich Laufs, Gilles Montalescot, and Marc Bonaca share key insights from their presentations at a satellite symposium at ESC 2026: ‘LDL-C management in coronary artery disease: Should it begin in the cath lab?’, chaired by Prof. Vijay Kunadian, and sponsored by Amgen.  

Topics include: 

• From acute ACS to early lipid intervention: Lessons from ARMYDA and beyond
• What plaque imaging teaches us about early intensive LDL-C lowering
• AMUNDSEN trial results: Contemporary evidence for early LDL-C management
• EVOLVE-MI and real-world evidence: From trial signal to system change

Clinical takeaways

• Initiating evolocumab immediately in the hospital for patients with acute myocardial infarction may improve both early and late clinical outcomes compared to waiting or titrating later
• EVOLVE-MI uses a broad patient population and compares the intervention against "usual care" rather than a trial-mandated standard, making the results highly reflective of actual clinical practice
• The data may shift the treatment paradigm from a "titrate over time" approach to a "just give it" strategy, suggesting that immediate therapy for plaque stabilisation may be beneficial irrespective of LDL-C level at presentation