Effect of Evolocumab on Atherogenic Lipoproteins During the Peri- and Early Postinfarction Period
Thorsten M. Leucker, Michael J. Blaha, Steven R. Jones, Michael Vavuranakis, Marlene S. Williams, Hong Lai, Thomas H. Schindler, Jacqueline Latina, Steven P. Schulman, Gary Gerstenblith
Abstract
secondary prevention E levated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of adverse ischemic outcomes in the early post-acute coronary syndrome (ACS) period. he EVACS trial (Evolocumab in Acute Coronary Syndrome; ClinicalTrials.gov, Unique identifier: NCT03515304) enrolled patients with non-ST-segment-elevation myocardial infarction and troponin I of 5ng/mL and randomly assigned them in a 1:1 ratio to a single dose of evolocumab SQ 420 mg or matching placebo within 24 hours of presentation. We present here the LDL-C, the primary, and other atherogenic lipid outcomes, and interpret them in the clinical context by reporting the proportion of patients in each group achieving LDL-C AHA/ACC (<70 mg/dL) and ESC (<55 mg/dL for very high risk) targets at hospital discharge and 30-day follow-up. All patients received high-intensity statins unless contraindicated and were treated in accordance with current ACS guidelines. An independent Data Safety and Monitoring Board monitored the progress of the study, which was approved by the Johns Hopkins Institutional Review Board. All participants gave informed consent.