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Cardiovascular
Journal Scan

Evolocumab reduces cardiovascular events in patients with metabolic syndrome

Posted on August 19, 2020

Evolocumab significantly reduced cardiovascular events in patients with metabolic syndrome, according to a study published in JAMA Cardiology.  The PCSK9 inhibitor also significantly reduced low-density lipoprotein cholesterol (LDL-C) in these patients.

Metabolic syndrome is a group of conditions that increase the risk of heart disease, stroke, and diabetes.

In this prespecified analysis of the FOURIER randomized clinical trial, 27,342 patients with atherosclerotic CV disease (ASCVD) were included, with 16 361 (59.8%) meeting the criteria for having metabolic syndrome at baseline. When compared with patients without metabolic syndrome, there patients were at a higher risk of cardiovascular events.

All patients treated with evolocumab experienced a similar reduction in low-density lipoprotein cholesterol

For the primary end point of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization, the hazard ratios (95% CI) with evolocumab versus placebo were 0.83 (0.76-0.91) and 0.89 (0.79-1.01) in patients with and without metabolic syndrome (P for interaction  =  0.39).

For the secondary end point of cardiovascular death, myocardial infarction, or stroke, the corresponding hazard ratios (95% CIs) were 0.76 (0.68-0.86) and 0.86 (0.74-1.01) (P for interaction = .23), in patients with and without metabolic syndrome.

No increased risk of new-onset diabetes or other major safety outcomes was found with evolocumab in patients with metabolic syndrome.

Reference
Deedwania P, Murphy SA, Scheen A, et al. Efficacy and Safety of PCSK9 Inhibition With Evolocumab in Reducing Cardiovascular Events in Patients With Metabolic Syndrome Receiving Statin Therapy: Secondary Analysis From the FOURIER Randomized Clinical Trial. JAMA Cardiol. Published online August 12, 2020. doi:10.1001/jamacardio.2020.3151

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