For women with known autoimmune diseases, how do you approach ASCVD risk stratification when deciding to start a statin or aspirin for primary prevention?

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What are your thoughts on the results from the AQUATIC trial which showed that the addition of aspirin daily + oral anticoagulation in patients > 6 months from PCI and with high atherothrombotic risk was associated with a higher risk of death, MI, stroke, coronary revascularization and acute limb ischemia, compared to oral anticoagulation alone?

Would you consider transitioning patients older than 75 years of age with coronary disease from statins and/or other lipid-lowering agents to PCSK9 inhibitors given concerns for polypharmacy, provided their LDL levels remain at or below goal?

When do you think physicians should seriously consider prescribing PCSK9 inhibitors for the prevention of heart attack and stroke in people with ASCVD or diabetes, based on the results of the VESALIUS-CV trial?

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