Abstract

A new group of hypolipidemic substances, i.e. PCSK9 protein inhibitors, is now coming into use in clinical practice, to what extent a high residual cardiovascular risk remains also in patients treated with statins. The FOURIER study (Further cardiovascular OUtcomes Research with PCSK9 Inhibition subjects with Elevated Risk) is the first event study which has shown that evolocumab (PCSK9 antibody) further significantly reduces serum LDL cholesterol and subsequently also cardiovascular morbidity and mortality: (a) composite primary goal (cardiovascular mortality, incidence of heart attacks, strokes, hospitalizations for unstable angina, coronary revascularization) by 15 % (p < 0.001), (b) secondary goal (cardiovascular mortality, incidence of heart attacks, strokes) by 20 % (p < 0.001), (c) the treatment effect increased with length of treatment, and (d) the treatment was safe. The study has therefore confirmed that further reduction of serum LDL cholesterol by means of evolocumab significantly reduces incidence of cardiovascular events in patients with elevated risk. This treatment is primarily needed for individuals with elevated cardiovascular risk.Key words: atherosclerosis - evolocumab - cardiovascular diseases - LDL cholesterol - PCSK9 inhibitors.

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