CRISPR-based treatment significantly reduces cholesterol

In a new study, which was published in the New England Journal of Medicine and presented at the meeting on Saturday, researchers found that a CRISPR-based gene editing therapy could significantly reduce levels of low-density lipoprotein (LDL) or "bad cholesterol" and triglycerides in patients with heart disease.

So far, only 15 patients have received the treatment, which is administered as a 4.5-hour infusion. The infusion collects in the liver and alters the DNA of cells by removing a protein called ANPTL3. Of the patients, six received the top two doses.

In the highest-dose group, LDL cholesterol dropped by 49% and triglycerides dropped by 45% — a dramatic decrease. Although patients were only followed for six months, the decrease is expected to last for years or even for life.

"It's early, but the efficacy in this trial represents a new frontier for drug development," said Luke Laffin, a cardiologist and a co-lead author of the study. "When we see patients in clinic and we can tell them to stop smoking, lose weight — those are modifiable risk factors. And we used to say – we still do say – but we can't change our parents. We can't change our genes. We may be entering an era where that's no longer the case and we can change our genes."

During the study, one patient, who had a genetic disease that causes very high cholesterol and had previously had coronary bypass surgery, died, but investigators said that his death was not likely to be related to the treatment.

Some scientists have also questioned whether patients would want to undergo a permanent gene treatment for conditions that could be treated with other medications or changes.

"I don't think this is for everybody," said Steven Nissen, the study's senior author. "I think CRISPR gene editing is for some patients. As it becomes better understood, and safety is well established, there are going to be people who say, 'I can inject a PCSK9 inhibitor every two weeks for the rest of my life, or I can get one injection and I can lower my LDL permanently.'"

How coffee affects AFib

So far, observational studies have not found an increased risk of AFib episodes after drinking coffee, but many people have reported that coffee is a trigger for their own episodes. However, a new trial called DECAF (Does Eliminating Coffee Avoid Fibrillation?) found that people who drank coffee had a lower risk of recurrent AFib episodes than those who didn't drink coffee.

In the trial, researchers analyzed data from 200 participants who had persistent AFib and drank at least one cup of coffee a day over the last five years. The participants were split into two groups, with half drinking at least one cup of coffee a day and half abstaining from any form of caffeine. 

Overall, the risk of recurrent AFib episodes was lower in the group that drank coffee (47%) compared to the group that didn't (64%). According to the researchers, caffeine's ability to block adenosine receptors linked to heart arrhythmias, its anti-inflammatory properties, and its diuretic effect may have all contributed to lowering the risk of AFib.

"Consumption of coffee and other caffeinated products may be reasonably considered in patients with AF," the researchers wrote.

Andrea Russo, from Cooper University Medical Center, said she would like to see larger studies on the effects of different doses of caffeine and other caffeinated products like energy drinks, "but nonetheless, this is great news about coffee."

Women's health is a blind spot in cardiology

During the meeting, Stacey Rosen, executive director of Northwell's Katz Institute for Women's Health and the American Heart Association's volunteer president for 2025-2026, emphasized a need to improve women's health, not only in cardiology but also in healthcare overall.

"In general, health care was designed by men for men," Rosen said, noting that treatments given to women have often only been studied in men. Although the Reconciliation Act of 1993 was designed to increase women's participation in clinical trials, women only made up around 30% of participants in recent cardiovascular research.  

Food as medicine for heart health

Although much of the research presented at the meeting focused on medications, two studies highlighted the effect of food on blood pressure.

In one study, which was published in JAMA, researchers provided Black adults living in food deserts in Boston with home-delivered DASH-style groceries and dietitian counseling. The DASH diet is low in salt and high in fruits, vegetables, whole grains, and low-fat dairy products. It also limits fatty meats, salt, and added sugar.

Participants were either given home-delivered groceries and guidance from dietitians or a $500 stipend every four weeks to purchase their own groceries and plan their own meals. After 12 weeks, people who received groceries and dietitian support had greater improvements in their blood pressure than those who just received the stipend. Those in the DASH group also saw their LDL cholesterol decrease.

However, after participants stopped receiving grocery deliveries or a monthly stipend, their blood pressure and LDL cholesterol returned to their previous levels.

According to Stephen Juraschek, one of the study's authors from the Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital, the study showed that the intervention worked, but there were still questions about how to make it affordable and accessible to people who need it.

"We did not build grocery stores in the communities that our participants were living in. We did not make the groceries cheaper for people after they were free during the intervention," Juraschek said. "We believe that this is essential, that people can be able to access these healthy groceries in order to maintain and appreciate the health benefits associated with them."

In a separate study, researchers provided 80 villages in rural China with regular blood pressure monitoring, low-sodium salt substitutes, and classes about healthy lifestyle habits. Community health workers also helped train "family leaders" on how to monitor blood pressure with a free device.

During the six-month program, participants' systolic blood pressure dropped by an average of 10 mm compared to people not in the program. After the program ended, participants still had better blood pressure than those who were part of the program, but the difference fell to 3.7 mm.

Keith Ferdinand, chair of preventive cardiology at Tulane University, praised the study. "Using a multifaceted approach is actually the correct way to do it," he said. "What was done in China is something that we advocate for in the United States."