Evolocumab improves cardiovascular outcomes for patients with a recent MI

Evolocumab is an effective treatment option for patients with a recent myocardial infarction (MI), according to new findings published in JAMA Cardiology.

The study’s authors explored data from a subgroup of 5,711 patients who participated in the FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk) trial. All patients had a MI within 12 months—but exclusions were made if the MI was within 4 weeks.

Participants were randomized to receive either evolocumab or a placebo. The study’s primary end point was cardiovascular death, MI, stroke, unstable angina or coronary revascularization; its secondary end point was cardiovascular death, MI or stroke. The team found that evolocumab reduced a patient’s risk of the primary end point by 19% and the secondary end point by 25%.

The authors also examined how the PCSK9 inhibitor impacted the treatment of study participants who had experienced a remote MI, defined as one that occurred more than 12 months prior to randomization. For those individuals, evolocumab reduced the risk of the primary end point by 8% and the secondary end point by 15%.

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Overall, the absolute risk reductions (ARRs) over three years with evolocumab were 3.7% in patients with a recent MI and 1.1% in patients with a remote MI.

“We found that patients with recent MI as defined by the 2018 American Heart Association/American College of Cardiology Multisociety Guideline on the Management of Blood Cholesterol were at higher risk of cardiovascular events and had a substantial clinical benefit from LDL-C−lowering treatment with evolocumab compared with those with remote MI,” wrote lead author Baris Gencer, MD, Brigham and Women’s Hospital in Boston, and colleagues. “Although patients with recent MI had fewer baseline risk factors in the FOURIER trial, the rates of both the primary and secondary key end points were higher. Such an observation suggests that recent MI identifies patients whose pathobiology is more prone to be significantly modifiable in response to LDL-C lowering.”

Read about more recent research related to evolocumab here.