The APAC Recap: Dyslipidemia at CAPP Live 2024 with Viet Le, DMSc, PA-C

In this episode of The APAC Recap, Laura Ross, PA-C, president of the Academy of Physician Associates in Cardiology (APAC), welcomed Viet Le, DMSc, PA-C, immediate past president of APAC, to recap his presentations at the inaugural Cardiology Advanced Practice Providers (CAPP) Live 2024 conference. Le, a preventive cardiology PA at Intermountain Health, shares insights from his sessions covering lipid management, metabolic dysfunction, liver disease, and chest pain guidelines, focusing particularly on lipid strategies for the APAC audience.

One major point he discussed is the 2022 American Heart Association (AHA)/American College of Cardiology (ACC) expert consensus pathway for non-statin therapies, emphasizing the importance of reclassifying high-risk patients with atherosclerotic cardiovascular disease (ASCVD). Le advised cardiology PAs and NPs to recognize those with very high-risk ASCVD profiles and to aim for an LDL-cholesterol target (LDL-C) of ≤55 mg/dL, beyond standard statin therapy, using options like ezetimibe, bempedoic acid, and PCSK9 inhibitors.

A highlight from Le’s presentation was his advice on managing statin intolerance, a common referral reason in preventive cardiology. He discussed the benefits of pitavastatin, a lesser-known statin with a high success rate in patients who experience myalgia on other statins. Le explained that pitavastatin’s unique formulation, originating from research by a Japanese pharmaceutical company, makes it an effective alternative for lipid lowering in statin-intolerant patients, reducing LDL-C levels by 30–49% when used at 2 or 4 mg, especially when combined with ezetimibe or bempedoic acid.

To conclude, Le reviewed the 2022 expert consensus on non-statin therapies and discussed the importance of risk-enhancing factors, particularly in women with conditions like preeclampsia or premature menopause, which are often overlooked yet critical in risk assessment. Their discussion emphasizes practical, evidence-based approaches to lipid management, equipping cardiology providers to optimize patient care.

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