In adults with prior percutaneous coronary intervention but no prior myocardial infarction and LDL cholesterol ≥90 mg/dL, treatment with evolocumab for a median of 4.6 years reduces the risk of urgent coronary revascularization by 39% compared to placebo, with a hazard ratio of 0.61.

A drug blocks a protein that normally removes LDL-clearing receptors from the liver, so more receptors stay on liver cells to pull LDL cholesterol out of the blood. Lower LDL cholesterol stops new fatty deposits from forming in artery walls and calms inflammation in existing plaques. This makes the plaques less likely to crack open and trigger blood clots that block coronary arteries, preventing the need for emergency procedures to restore blood flow.