Atherosclerotic cardiovascular disease remains a leading cause of morbidity, and PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors are typically reserved for patients with established atherosclerosis, yet their role in primary prevention remains uncertain. To address this gap, a study evaluated whether evolocumab could reduce the risk of a first major adverse cardiovascular event in patients without known significant atherosclerosis, involving 3,655 participants. The study found that evolocumab significantly reduced median LDL-C levels at 48 weeks to 52 mg/dL, compared with 111 mg/dL with placebo.
Evolocumab lowered the risk of coronary heart disease death, myocardial infarction, or ischemic stroke (3-point MACE) (5.0% vs 7.1%; HR, 0.69) and 3-P MACE plus ischemia-driven arterial revascularization (4-P MACE) (7.6% vs 10.5%; HR, 0.69) over five years. All-cause mortality…
