Assessment of eligibility for residual risk reduction strategies and the potential for event reduction in patients with chronic coronary disease in a tertiary center in Brazil

Abstract

Since 2014, a series of clinical trials involving new therapeutic approaches to reduce residual risk in patients with chronic coronary disease (CCD) have been published, demonstrating a significant reduction in cardiovascular events in this population. These therapies involve medications to control LDL-cholesterol, such as PCSK-9 inhibitors, medications for glycemic control such as GLP-1 agonists and SGLT-2 inhibitors, or medications to reduce inflammation such as colchicine. There are no studies demonstrating the eligibility of the Brazilian population with CCD for these strategies. This study aims to evaluate the eligibility and risk reduction potential of residual risk reduction strategies in a Brazilian population with CCD being followed at a tertiary center. This prospective observational study will select patients with CCD defined as: previous acute coronary syndrome; or previous myocardial revascularization; or previous percutaneous coronary intervention; or angina/ischemia associated with coronary lesion greater than 50% on angiography or coronary tomography angiography. The eligibility of these patients for secondary prevention studies with new medications in patients with chronic ischemic heart disease whose medications have already been approved by ANVISA and are available for purchase in Brazil will be verified. The risk reduction potential of each of these strategies will also be evaluated. Patients will be followed for at least 1 year, with a follow-up objective of 5 years. The primary outcome will be the composite of death from all causes, non-fatal acute myocardial infarction and non-fatal stroke. (AU)