Treatment with evolocumab (Repatha; Amgen) within 1 year after a myocardial infarction (MI) was found to be beneficial in reducing the risk of subsequent MI, stroke, or cardiovascular death, according to new data from the FOURIER study. Findings were presented at the American Heart Association Scientific Sessions in Philadelphia, PA. 

In 2017, findings from the FOURIER trial led to the approval of evolocumab for the prevention of MI, stroke, and coronary revascularization in adults with established cardiovascular disease. In this new analysis, study authors investigated the efficacy and safety of evolocumab vs placebo in patients with elevated cardiovascular risk on statin therapy who experienced a recent MI (<1 year). 

Outcomes (cardiovascular death, MI, stroke, unstable angina or coronary revascularization) were compared between patients who experienced an MI within 1 to 12 months of randomization (n=5711) and those with a more distant event (>12 months prior to randomization; n=16,609). 

Results showed a 25% reduction in the risk of experiencing MI, stroke, or cardiovascular death in patients treated with evolocumab within 1 year post MI vs a 15% reduction in those with a more distant MI. “These results demonstrate the importance of intensive lipid-lowering therapy in the first year following a heart attack and provide additional evidence that evolocumab significantly reduces CV risk and improves outcomes for high-risk patients,” said Robert Giugliano, MD, FOURIER executive committee member and a senior investigator at the TIMI Study Group at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School.   

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Evolocumab, a proprotein convertase subtilisin kexin 9 (PCSK9) inhibitor, is currently indicated: to reduce the risk of MI, stroke, and coronary revascularization in adults with established cardiovascular disease; as an adjunct to diet, alone or in combination with other lipid-lowering therapies, in adults with primary hyperlipidemia (including heterozygous familial hypercholesterolemia) to reduce LDL-C; and as an adjunct to diet and other LDL-lowering therapies, in patients with homozygous familial hypercholesterolemia requiring additional lowering of LDL-C.

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