Heart failure & cardiomyopathiesRandomised controlled trial
Evolocumab has no Effects on Heart Failure with Reduced Ejection Fraction Injury Biomarkers: The EVO-HF Trial
- Randomised controlled trial
- multicentre
- prospective
- pilot
Authors' conclusion
This prospective randomized pilot trial, although with the limitation of the small sample size, does not support the benefit of evolocumab in reducing troponin levels in patients with elevated LDL-C levels, history of coronary artery disease, and stable HFrEF.
Study context
- Population
- Stable CAD with left ventricular ejection fraction (LVEF) <40%, ischaemic aetiology, NYHA class II, NT-proBNP ≥400 pg/ml, high-sensitivity troponin T (hs-TnT) >10 pg/ml, low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dl
- Participants
- 17 vs 22
- Comparison
- Evolocumab plus guideline-directed medical therapy (GDMT) vs GDMT alone
- Evolocumab + GDMTn = 17
- GDMT alonen = 22reference
- Primary endpoint
- Change in hs-TnT concentration
- Follow-up
- 1 year
Primary result
As reported in the abstract
Change in hs-TnT
- No significant changes in hs-TnT levels in any group
Secondary outcomes
NT-proBNP and ST2 · 1 year
- NT-proBNP decreased with evolocumab + GDMT
- P = 0.045
- ST2 decreased with evolocumab + GDMT
- P = 0.008
High-sensitivity C-reactive protein (hs-CRP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein receptor (LDLR) · 1 year
- No changes in hs-CRP, HDL-C or LDLR
Total cholesterol and LDL-C · 1 year
- Decreased in both groups, significantly more in the intervention group
- P = 0.003
PCSK9 levels · 1 year
- Increased in the intervention group
Original publication
Evolocumab has no Effects on Heart Failure with Reduced Ejection Fraction Injury Biomarkers: The EVO-HF Trial. Eur J Heart Fail. Published 27 June 2023. doi:10.1002/ejhf.2932
Summarised from the published abstract; every number is checked against it