- Academic Editor
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†These authors contributed equally.
Background: Evolocumab has been demonstrated to significantly reduce
ischemic cardiovascular events in patients with stable coronary heart disease.
However, it is currently unclear whether this benefit extends to patients with
acute coronary syndrome (ACS) and multivessel disease (MVD) undergoing
percutaneous coronary intervention (PCI). The objective of this study was to
assess the safety, efficacy and feasibility of the early addition of evolocumab
to statin treatment for ACS patients with MVD undergoing PCI. Methods:
The authors conducted a multicenter, retrospective cohort study involving 1199
ACS patients with MVD undergoing PCI and with elevated low-density lipoprotein
cholesterol (LDL-C) levels. Patients were divided into an evolocumab group or a
standard-of-care group based on evolocumab use or not. The 18-month primary
efficacy endpoint was a composite of ischemic stroke, death from cardiac causes,
recurrent myocardial infarction (MI), unplanned coronary revascularization or
unstable angina requiring hospitalization. The principal secondary efficacy
endpoint was a composite of ischemic stroke, death from cardiac causes or
recurrent MI. Results: After propensity score matching, the addition of
evolocumab to statin treatment lowered LDL-C levels by 42.62% compared with
statin therapy alone at 18 months, from a mean baseline level of 3.37–0.75
mmol/L (p