Evolocumab reduced total cardiovascular events in high-risk patients
Evolocumab reduced the combined rate of coronary heart disease deaths, heart attacks and strokes caused by blocked blood flow by 27% versus placebo.
Placebo-controlled
Limit: Separate effects on coronary deaths, heart attacks, and strokes were not reported
Edited by Boris Djordjevic · AgingResearch.News
In a randomized trial, 12,257 patients had atherosclerosis—plaque buildup in arteries—or high-risk diabetes, no prior heart attack or stroke, and low-density lipoprotein cholesterol of at least 90 milligrams per deciliter on optimized cholesterol-lowering therapy. Researchers assigned them to evolocumab or placebo, with median follow-up of 4.6 years.
One combined outcome counted deaths from disease of the heart’s arteries, heart attacks and ischemic strokes, caused by blocked blood flow. Evolocumab reduced the risk of first events by 25%, repeat event rates by 37% and total event rates by 27% versus placebo. For every 1,000 patients treated for five years, it prevented 20 first events, 5 repeat events and 25 total events. A broader outcome added procedures to restore arterial blood flow because of inadequate blood supply. Evolocumab reduced these total events by 20%, preventing 55 events per 1,000 patients treated for five years.
Why it matters
Counting repeat cardiovascular events addresses the overall burden of disease beyond a first event. The findings support intensive cholesterol lowering to reduce that burden in patients meeting the trial’s high-risk criteria.
Caveats
The reported reductions apply to combined outcomes, not necessarily to each type of event separately. These conference-abstract findings concern patients meeting the trial’s high-risk and cholesterol criteria, not lower-risk people or those with a prior heart attack or stroke.
Evolocumab is part of Bryan Johnson's Blueprint
The paper
Instituto do Coracao FMUSP; Brigham and Women's Hospital
ESC Congress 2026 Abstract, Oct 26, 2026
Presented at ESC Congress 2026
