Prevention & lipidsSecondary analysis
Obesity-Associated Cardiovascular Risk and Benefit From PCSK9 Inhibition
- Secondary analysis of the FOURIER randomised trial
- subgroup analysis by body mass index (BMI)
Authors' conclusion
Individuals with obesity and atherosclerotic cardiovascular disease face an elevated risk of MACE compared with those without obesity, and evolocumab helps to attenuate this risk.
Study context
- Population
- Patients with stable atherosclerotic CVD
- Participants
- 27,564 patients
- Comparison
- Evolocumab vs placebo, by BMI category
- Primary endpoint
- CV death, MI, stroke, hospitalization for unstable angina or coronary revascularization
- Follow-up
- Kaplan-Meier rates at 3 years; median 2.2 years
Primary result
As reported in the abstract
Primary endpoint by BMI subgroup
Evolocumab vs PlaceboHazard ratio (95% CI)
BMI <30 kg/m²; ARR 1.4%
0.89(0.81–0.98)
BMI 30 to <35 kg/m²; ARR 1.8%
0.86(0.75–0.98)
BMI ≥35 kg/m²; ARR 5.7%
0.71(0.59–0.86)
Further findings
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| Primary endpoint risk per 5-unit-higher BMI above 30 kg/m² (placebo) | 1.11 (1.02–1.21) | |
| 0.512Adjusted hazard ratio (log scale) |
Obesity prevalence
- BMI ≥30 kg/m²
- 10,942 (40%)
- BMI ≥35 kg/m²
- 3,446 (13%)
Original publication
Obesity-Associated Cardiovascular Risk and Benefit From PCSK9 Inhibition. J Am Coll Cardiol. Published 10 December 2025. doi:10.1016/j.jacc.2025.10.036
Summarised from the published abstract; every number is checked against it