Effect of evolocumab on acute arterial events across all vascular territories : results from the FOURIER trial
Primary result · First acute arterial eventsResult — go to the resultHazard ratio 0.81 95% CI 0.74–0.88Authors' conclusion
The addition of the PCSK9 inhibitor evolocumab to statin therapy reduced acute arterial events across all vascular territories with a robust effect over time, indicating a pan-vascular impact of aggressive lipid-lowering therapy on these acute and clinically meaningful events.
Study context
- Population
- Patients with stable atherosclerotic cardiovascular disease on statin therapy2,210 first acute arterial events
- Participants
- 27,564 patients
- Comparison
- Evolocumab vs placebo
- Primary endpoint
- First acute arterial events: composite of acute coronary (CHD death, MI or urgent coronary revascularization), cerebrovascular (ischaemic stroke, TIA or urgent cerebral revascularization) or peripheral vascular (acute limb ischaemia, major amputation or urgent peripheral revascularization) events
Primary result
First acute arterial events
Hazard ratio
0.81
95% CI 0.74–0.88
P < 0.001
Evolocumab vs Placebo
HR 0.81 (95% CI 0.74–0.88); P < 0.001
As reported in the abstract
- First events: coronary
- 74%
- First events: cerebrovascular
- 22%
- First events: peripheral vascular
- 4%
Further findings
| Outcome | Estimate | |
|---|---|---|
| Acute arterial events by vascular territoryEvolocumab vs Placebo · acute coronary | HR 0.83 (CI 0.75–0.91) | |
| Acute arterial events by vascular territoryEvolocumab vs Placebo · cerebrovascular | HR 0.77 (CI 0.65–0.92) | |
| Acute arterial events by vascular territoryEvolocumab vs Placebo · peripheral vascular | HR 0.58 (CI 0.38–0.88) | |
| Total acute arterial events (first plus recurrent)24% reduction; 3437 total events | IRR 0.76 (CI 0.69–0.85) | |
| Acute arterial events over timeEvolocumab vs Placebo · first year; 16% reduction | HR 0.84 (CI 0.75–0.95) | |
| Acute arterial events over timeEvolocumab vs Placebo · after first year; 24% reduction | HR 0.76 (CI 0.67–0.85) | |
| 0.20.5125Ratio (log scale) |
Original publication
Effect of evolocumab on acute arterial events across all vascular territories : results from the FOURIER trial. Eur Heart J. Published 19 September 2021. doi:10.
Summarised from the published abstract; every number is checked against it