ESPR Not so modest in primary prevention population. Especially interesting it shows all cause mortality and cardiac mortality benefit in primary prevention population. Problem with the trial is allowing cross in therapy of psk9/ezetimibe/low dose statin for placebo arm. Much more secondary prevention patients are on concurrent therapy diluting the effect of bempedoic acid. It also suggests when your ldl is already low getting even lower is a diminishing return. This is probably why psk9 when added to statin did not produce the predicted CV risks lowering based on its LDL reduction number