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Lipids

Very low achieved LDL-cholesterol levels improve cardiovascular outcomes

Nature Reviews Cardiology volume 14, pages 630–631 (2017)Cite this article

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Although increased LDL-cholesterol concentration is a well-established causal factor for the development of atherosclerosis, the degree to which LDL-cholesterol levels can be safely lowered remains unclear. Findings from a prespecified, secondary analysis of the FOURIER trial, presented at the ESC Congress 2017 and published in The Lancet, support the reduction of LDL-cholesterol levels to below current recommendations for improving cardiovascular outcomes.

In total, 25,982 patients from the randomized, double-blind, placebo-controlled FOURIER trial assigned (1:1) to either subcutaneous evolocumab or placebo were included in the secondary analysis. Cardiovascular outcomes (including the primary end point: a composite of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or unstable angina) and ten prespecified safety events (including serious adverse events, new or recurrent cancer, new-onset diabetes mellitus, and noncardiovascular death) were assessed over a median of 2.2 years, and compared with achieved LDL-cholesterol concentrations.

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References

  1. Giugliano, R. P. et al. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)32290-0 (2017)

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  1. Karina Huynh
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Shapiro, M. D. et al. Dyslipidaemia: the PCSK9 adventure — humanizing extreme LDL lowering. Nat. Rev. Cardiol. 14, 319–320 (2017)

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Huynh, K. Very low achieved LDL-cholesterol levels improve cardiovascular outcomes. Nat Rev Cardiol 14, 630–631 (2017). https://doi.org/10.1038/nrcardio.2017.149

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  • DOI: https://doi.org/10.1038/nrcardio.2017.149

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