BACKGROUND: Current guidelines recommend a stepwise strategy to achieve low-density lipoprotein cholesterol (LDL-C) goals after acute coronary syndrome (ACS). Earlier intensive strategies based on a combination of lipid-lowering therapies (LLTs) could be useful from the onset of ACS. However, the role of bempedoic acid in ACS, particularly when combined with high-intensity statins and ezetimibe, remains uncertain. The aim of ES-BempedACS (Efficacy and Security of Bempedoic Acid in Acute Coronary Syndrome) was to compare the efficacy and safety of triple LLT (high-dose, high-intensity statin+ezetimibe+bempedoic acid) versus standard of care (high-dose, high-intensity statin+ezetimibe) after ACS. METHODS: ES-BempedACS is a multicenter, independent, pragmatic, prospective, randomized, open, blinded end point controlled trial conducted in 12 Spanish hospitals between November 2023 and October 2024. The primary end point was the proportion of patients achieving LDL-C <55 mg/dL (<1.4 mmol/L) at 8 weeks after ACS, comparing triple LLT with standard of care. RESULTS: A total of 206 patients (59.5±10.9 years of age [mean±SD]; 21.4% women) were randomized within the first 72 hours of ACS to triple LLT or standard therapy of high-intensity statin+ezetimibe (ie, dual LLT). The baseline LDL-C level was 133.6±28.8 mg/dL. After 8 weeks, the LDL-C level was reduced to 50%) of adequate LDL-C control (<55 mg/dL) at 8 weeks. Adding bempedoic acid to statin–ezetimibe therapy in the setting of ACS is safe but failed to improve the percentage of patients achieving the LDL-C goal (<55 mg/dL) at 8 weeks. Larger, randomized studies are needed to confirm our findings. REGISTRATION: URL: https://www.clinicaltrialsregister.eu ; Unique identifier: 2021-006550-31.

Background/Objectives: Multidisciplinary TAVI programs are focused on improving patient-centred care. We compared outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) within a multidisciplinary programme including a nurse with those of patients in the standard programme. Methods: This single-centre observational retrospective study includes patients with severe aortic valve disease and a TAVI indication, with the goal of comparing a nurse programme with standard practice. In the TAVI nursing programme, the nurse has several key roles: patient and family education, comprehensive assessment and procedure planification, patient and family accompaniment, complications detection during admission and follow-up, and patient experience evaluation in the post-procedure period. Results: 154 patients were included: 87 in the nurse programme and 67 in standard practice groups, respectively. Men comprised 52.6%, with an average age of 81 years. Both groups achieved high procedure success without differences in mortality during admission and follow-up (median 13.4 months). The nurse programme group showed better functional class more frequently and had significantly fewer emergency department visits (11.8% vs. 31.3%) and less frequency of readmission (1.2% vs. 23.4%). The TAVI nurse group reported significantly higher overall satisfaction with the process (9.8 vs. 8.9 scores), with the information received and the nurse treatment being the best rated items. Conclusions: A multidisciplinary programme for patients undergoing TAVI, coordinated by nurses and based on comprehensive attention that places the patients at the centre of the process, is feasible and shows high patient satisfaction.

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