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 major adverse cardiovascular events (coronary death, myocardial infarction, or ischemic stroke) by 30% compared to placebo, with a 5-year Kaplan-Meier event rate of 7.0% versus 9.5%.

A drug blocks a protein that normally removes LDL-clearing receptors from the liver, so more receptors stay on liver cells and pull more bad cholesterol out of the blood. With less cholesterol in the blood, it stops building up inside artery walls. This makes existing fatty plaques less inflamed and more stable, so they don't crack open and trigger blood clots that cause heart attacks or strokes.