AHA Scientific Sessions 2026 AbstractNov 9, 2026, 02:14 GMT

Evolocumab linked to fewer deaths in high-risk adults

Over three years, deaths occurred in 1.4% of evolocumab users versus 2.7% of alirocumab users across 2,610 matched pairs.

Paper by Ahmad Assad, Tala Altarawneh, Abdallah Rayyan, +3Adee Elhamdani · Univ of Central Florida · Marshall Univ Joan C Edwards Schl Med

Artery cross-sections contain plaque and contrasting sparse and dense cholesterol particles, surrounded by small upright, faceless people.

Our read

Interventions

Studied:: Cohort study of adults with atherosclerotic disease or high-risk diabetes, against alirocumab users
What changed:: Death from any cause was lower among evolocumab users: 1.4% versus 2.7% among alirocumab users
The catch:: Health or prescribing differences missed by matching could contribute to the mortality association
In the record:: The 37th paper on evolocumab with results in people; 80 on record in all. Its result on mortality agrees with all 6 other findings on record.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper

Adults aged 50 to 80 with atherosclerotic disease—plaque buildup in arteries—or high-risk diabetes, but no prior heart attack or stroke, were studied in three observational comparisons of electronic health records. The analyses matched over 44,000 users of cholesterol-lowering drugs on recorded characteristics.

Evolocumab was linked to fewer deaths and cardiovascular events than alirocumab or statin plus ezetimibe. Compared with statin plus ezetimibe, evolocumab plus a statin was associated with lower relative risks of acute kidney injury (0.77) and new diabetes (0.66). Evolocumab alone had relative risks of 0.56 for acute kidney injury, 0.63 for new diabetes and 0.50 for severe muscle breakdown. More evolocumab users reached the cholesterol target in each comparison.

Why it matters

Cardiovascular prevention in later life involves choices among cholesterol-lowering drugs. These comparisons add real-world evidence where head-to-head trials of cardiovascular outcomes are lacking.

Caveats

Differences in health or prescribing that matching did not capture may have contributed to the links. These conference-abstract findings do not cover lower-risk adults or people with a previous heart attack or stroke.