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 cardiovascular death by 34% compared to placebo, with a hazard ratio of 0.66 and a 5-year event rate of 2.6% versus 3.7%.

A drug blocks a protein that normally destroys liver receptors that remove bad cholesterol from the blood. With more receptors available, cholesterol levels drop sharply. Lower cholesterol stops new fatty deposits from forming in artery walls and calms inflammation in existing plaques. These stabilized plaques are less likely to rupture and trigger blood clots that block heart arteries, preventing sudden death from heart attacks.