Secondary analysis

Evolocumab in Patients With Prior Percutaneous Coronary Intervention and No Prior Myocardial Infarction: Results From the VESALIUS-CV Trial

CirculationPublished

  • Prespecified subgroup analysis of the VESALIUS-CV randomised trial
  • placebo-controlled

Authors' conclusion

Evolocumab reduced the risk of major cardiovascular events in stable patients with prior PCI but no MI.

Study context

Population
Patients with prior percutaneous coronary intervention (PCI) and no prior myocardial infarction (MI) or stroke (atherosclerosis or high-risk DM, LDL-C ≥90 mg/dL)prior PCI, of 12,257 randomized
Participants
3,627 patients
Comparison
Evolocumab vs placebo
Primary endpoint
Dual primary: 3-point MACE (CHD death, MI or ischemic stroke) and 4-point MACE (plus ischemia-driven revascularization)
Follow-up
Median 4.6 years

Primary result

As reported in the abstract

3-point and 4-point MACE, prior PCI subgroup · 5-year Kaplan-Meier rates

Evolocumab

7.0%

3-point MACE · 4-point MACE 17.9%

Placebo

9.5%

3-point MACE · 4-point MACE 21.7%

Evolocumab vs PlaceboHazard ratio (95% CI)P value
3-point MACE
0.70(0.56–0.89)
P = 0.004
4-point MACE
0.82(0.71–0.96)
P = 0.012

Further findings

LDL-C (lipid substudy) · 48 weeks

P < 0.0001

OutcomeEvolocumabPlaceboHR (95% CI)P value
MI · effect apparent as soon as 6 months after randomization3.0%6.1%0.50 (0.36–0.70)P < 0.001
Urgent coronary revascularization0.61 (0.46–0.80)P < 0.001
CV death · nominally lower2.6%3.7%0.66 (0.45–0.96)P = 0.030
All-cause death · nominally lower8.2%10.2%0.76 (0.60–0.95)P = 0.016

Original publication

Evolocumab in Patients With Prior Percutaneous Coronary Intervention and No Prior Myocardial Infarction: Results From the VESALIUS-CV Trial. Circulation. Published 19 May 2026. doi:10.1161/circulationaha.126.080616

Summarised from the published abstract; every number is checked against it