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PCSK9 inhibition

Alirocumab slows cardiac graft vasculopathy only when LDL-C and Lp(a) are both raised, CAVIAR trial (JACC Heart Fail 2026)

Original title: Elevated LDL-C and Lipoprotein(a) Modify Alirocumab Effects on CAV: Insights From the CAVIAR Trial

JACC Heart Fail · · 6

Terada K, Takahashi K, Khush KK, Nishi T, Knowles JW, Skoda A, Varr B, Woo C, Honda Y, Fearon WF

In the CAVIAR trial, heart transplant recipients treated with the PCSK9 inhibitor alirocumab showed slower progression of cardiac allograft vasculopathy (CAV), but only among those with concomitantly elevated LDL-C and lipoprotein(a). The authors frame this as support for lipid-phenotype-guided risk stratification: identifying which heart-transplant recipients are most likely to benefit from PCSK9 inhibition based on their combined LDL-C and Lp(a) status, rather than treating all recipients uniformly.

Read the paper (DOI)PubMed

Original abstract

In heart transplant recipients, alirocumab attenuated cardiac allograft vasculopathy progression only in patients with concomitantly elevated LDL-C and lipoprotein(a). Lipid phenotype–guided risk stratification may identify those most likely to benefit from PCSK9 inhibition after heart transplantation. #PCSK9inhibition #CAV #HeartTransplantation

PCSK9 inhibitiontherapy

Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.