Some discussions of apabetalone and coronary artery calcium scoring appeared this weekend on the other boards, so I am re-posting this post from December on this same issue to add to the discussion.

BearDownAZ

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From the discussion section of the latest Resverlogix publication on vascular calcification:

"Future studies will determine if apabetalone affects biomarkers or coronary artery calcium score in patients at risk of VC and its complications."

I've been noticing a lot of talk about the utility of widespread screening/testing for coronary artery calcium score (CACS) to identify patients most at risk for cardiovascular disease. There is also growing evidence that elevated serum alkaline phosphatase levels are positively associated with an elevated CACS. It will be great if BETonMACE confirms that apabetalone reduces alkaline phosphatase levels (pre-specified secondary endpoint) as previously shown in post-hoc of SUSTAIN/ASSURE. If so, the next question is whether apabetalone improves the CACS. Perphaps in addition to BETonRENAL, they can do a BETonCACS trial in patients with high baseline CACS? I wonder if the docs obtained a baseline CACS in the BETonMACE patients so that they can measure change in CACS between baseline and end of study in BETonMACE?

Association between serum alkaline phosphatase and coronary artery calcification in a sample of primary cardiovascular prevention patients.

Coronary Artery Calcium Scoring: Who Should Be Tested, and What Comes Next?

Impact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium Scoring

CAC scoring, biomarkers may help CVD risk prediction