VESALIUS-CV: Evolocumab cuts first MACE 31% in high-risk primary prevention
Key Questions
What were the main results of the VESALIUS-CV trial for evolocumab?
Evolocumab achieved a 31% relative risk reduction in first MACE events among high-risk primary prevention patients without prior ASCVD. LDL levels dropped to 44-52 mg/dL with an absolute risk reduction of 1.8-2.8%.
How does the trial support PCSK9 inhibitors in primary prevention?
Results bolster guideline recommendations for PCSK9 use in high-risk primary prevention populations. Subanalyses showed additional benefits in plaque volume reduction seen in prior GLAGOV data.
What benefits were observed in post-PCI patients without prior MI?
A 30% reduction in 3-point MACE and 26-39% drop in revascularization occurred in stented patients without previous myocardial infarction. LDL levels around 40 mg/dL were achieved in these subgroups.
Amgen/ACC.26: 31% RRR/1.8-2.8% ARR high-risk no ASCVD (LDL→44-52); bolsters PCSK9 primary per guideline; plaque vol GLAGOV; ties Lp(a) residual/ApoB; practical use details for evolocumab. New subanalysis: 30% 3-pt MACE reduction post-PCI no prior MI (LDL~40), 26-39% revasc drop.