A short but sweet paper in Circulation summarizing the current pharmacological toolbox for dealing with residual CVD risk. I really like the figure from this paper (see figure below). It references pretty much all of the recent CVOT achievements (in blue) and those pending (in green). Interestingly, apabetalone has been shown in various studies to elicit beneficial effects in most, if not all, of these categories: lipoproteins (HDL, not LDL), inflammation, metabolism, platelets, coagulation. Wouldn't it be nice to see apabetalone added to the list(s)?

 A Conceptual Framework for Addressing Residual Atherosclerotic Cardiovascular Disease Risk in the Era of Precision Medicine, by Kershaw V. Patel, Ambarish Pandey, James A. de Lemos of U of University of Texas Southwestern Medical Center, Dallas.

https://www.ncbi.nlm.nih.gov/pubmed/29643058

http://circ.ahajournals.org/content/early/2018/04/10/CIRCULATIONAHA.118.035289

Here is the text of the figure legend:

"We propose five broad residual risk targets for secondary prevention of atherosclerotic cardiovascular disease and identify therapies either shown to be effective in large randomized trials (blue), or available for clinical use but not yet demonstrated to lower ASCVD risk (green). Precision medicine tools are proposed for each category (in many cases highly speculative) that could be used to guide selection among the potential therapies. Abbreviations - PCSK9: proprotein convertase subtilisin/kexin 9; LDL: low-density lipoprotein; HDL: high-density lipoprotein; TG: triglycerides; Lp(a): lipoprotein (a); hs-CRP: high-sensitivity C-reactive protein; DM: diabetes mellitus; Hb A1c: glycated hemoglobin; HOMA-IR: homeostatic model assessment for insulin resistance; BMI: body mass index; DAPT: Dual Antiplatelet Therapy;PARIS: Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients; PRECISE DAPT: PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy; VTE: venous thromboembolism."