Abstract
Atherosclerosis, respectively cardiovascular disease represents the most common cause of morbidity and mortality. One of the most critical risk factors is LDL cholesterol.
Currently, we are not able to maximally reduce LDL cholesterol using the available hypolipidemic therapy and thereby minimize the cardiovascular risk of all patients. With the onset of new therapy in the form of PCSK-9 (proprotein convertase subtilisin/kexin type 9) inhibition, there is further reduction of LDL cholesterol and cardiovascular risk.
One of the representatives is evolocumab. In the presented FOURIER study, a reduction in LDL cholesterol in the evolocumab treated group was 59 % to 0,78 mmol/l.
The primary outcome, incidence of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization, occurred in 12,6% of the evolocumab group versus 14,6% of the placebo group (p < 0,0001). This finding was consistent among all tested subgroups.
During the study, there was no increase of safety risk in the actively treated group even at very low levels of LDL cholesterol. The study is a breakthrough due to these results and opens up a new future in the area of cardiovascular prevention.