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The Study

Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes

In simple terms

This study is like a fair test where people were randomly given either a medicine or a fake version (placebo) to see if the medicine helps prevent heart problems. Because it was fair and well-run, we can say the medicine probably helped lower the chance of heart attacks or strokes in people with diabetes who didn’t already have serious heart disease.

80%

Analysis score

80/ 90

Maximum 90 for a randomized controlled trial.

Where the score came from

Reporting0
Methodology100
Publication100
Statistical100
Study type (basis of the score)
Randomized Controlled Trial
Level 1b - Individual RCT
What’s the bottom line?

Doctors wanted to see if adding a drug called evolocumab to regular cholesterol medicine helps protect people with diabetes from having their first heart attack, stroke, or other heart problem when they don’t already have heart disease.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
80

80 / 100

Quality score

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

Can establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes, this result is important because it shows the drug can prevent serious heart problems before they happen in high-risk people.
  2. 2Out of 100 similar patients, about 10 had a heart problem with usual treatment, but only 7 did when they also took evolocumab.
  3. 3The drug also lowered bad cholesterol from 111 to 52 mg/dL.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

JAMA

Year

2026

Authors

N. Marston, E. Bohula, Ajay K Bhatia, Gaetano M. De Ferrari, L. Leiter, José C. Nicolau, Jeong-Gun Park, Sabina A. Murphy, E. Walsh, L. Liu, Subodh Verma, N. Sattar, Stephen J. Nicholls, J. Lopez-Sendon, I. Gouni-Berthold, L. Tokgozoglu, R. Blankstein, M. Cyrille, Gabriel Paiva da Silva Lima, R. P. Giugliano, Marc S. Sabatine, A. Lorenzatti, M. L. Litvak Bruno, Ignacio J. Mackinnon, E. Alaguibe, G. Giunta, Oscar Romano Montaña, Daniel Vogel, Jorgelina Sala, D. Besada, Angela Romero Zarante, M. Vico, T. S. Smith Casabella, Patricia del C. Gonzalez Colaso, E. Montenegro, C. Zaidman, M. De Salvo, E. Perna, C. Majul, R. G. Garcia Duran, M. Hominal, S. Hermida, Carolina Chacón, A. P. Serrano, Juan P. Albisu Di Gennaro, W. Stoermann, M. Mansilla, M. Koretzky, Leonardo P. Novaretto, Lilia Schiavi, Andrés Orlandini, F. Botto, Elizabeth Gelersztein, E. Blumberg, Stephen J. Nicholls, John Amerena, W. Abhayaratna, Philip Roberts-Thomson, M. Worthley, Christopher Judkins, F. Bisshop, A. Begg, David Colquhoun, K. Kostner, Ktut Arya, David Cross, A. Conradie, Jamie Morton, Peter Purnell, A. Hamilton, W. van Gaal, A. Safaa, D. Eccleston, C. Ebenbichler, Peter Fasching, U. Hanusch, B. Ludvik, Lukas Holzinger, C. Saely, Konstantin Krychtiuk, A. Kautzky-Willer, T. Stulnig, Peter Sinnaeve, Stephane Carlier, M. De Meulemeester, B. Wollaert, A. Peeters, B. Scott, P. Vanduynhoven, J. Verwerft, T. Sarens, Luis A. Tavares Russo, Celia R. Echeverria Sampaio, Roberto Giraldez, P. Pimentel Filho, Joao L. Cunha Borges, Miguel Nasser Hissa, Jose A. Ribas Fortes, R. Cerci, L. Nigro Maia, A. Kormann, Flavia Arantes, Gilmar Reis, José F. K. Saraiva, D. Bertolim Precoma, P. R. Ferreira Rossi, F. Giorgeto, A. Pereira, L. C. Bodanese, M. Vidotti, Raphael A. Barreto da Silva, Krassimir Cvetkov, Georgi V Todorov, V. Gelev, I. Vasilev, H. Benov, A. Goudev, A. Postadzhiyan, A. Koundurdjiev, Krastyu Penchev, V. Zhelev, M. Tokmakova, M. Milanova, Snezhanka Tisheva- Gospodinova, Valentina M Mincheva, M. Tzekova, Bojidar I Dimov, K. Hristova-Tselova, Elena Dotcheva, K. Kichukov, R. Schlosser, D. Mazer, Christian Constance, H. Bajaj, A. Baass, Jason M. Burstein, Sorin Beca, S. Henein, George M. Tsoukas, Jean Bergeron, D. Gaudet, M. Hartleib, Michael Heffernan, James Cha, Sean Peterson, C. Tailor, Hani Alasaad, I. Bata, G. Vallieres, R. Bourgeois, D. Okeefe, B. Ajala, V. Woo, Derek Yung, H. Khandwala, D. Manyari, Milan Gupta, E. Lonn, J. Udell, Y. Khaykin, P. Frana, S. Zemek, L. Sknouril, A. Schee, L. Pazdera, P. Kolečkář, E. Zidkova, Juraj Bujdák, J. Kvasnička, Vladimir Blaha, R. Urbánek, P. Reichert, I. Podpera, Petr Ďulíček, Martina Machkova, N. Fiserová, Sylva Brtnikova, Z. Pozdíšek, M. Cepelak, Vladimir Cech, M. Homza, J. Škrobáková, Lubomír Elbl, Petr Kala, L. Raclavska, Jiri Vesely, K. Sochor, Radim Kryza, D. Bartášková, J. Krupička, Jiri Matuska, Jakub Hron, M. Pirchala, L. Busak, D. Kučera, Lukáš Zlatohlávek, M. Houra, Vit Reznicek, J. Brotánek, R. Polášek, I. Pařenicová, Lumír Francek, Milan Sepsi, J. Václavík, P. Kukla, L. Kuchař, I. Karen, R. Miklik, Zbynek Kosek, N. Krarup, Henrik Kjaerulf Jensen, P. Søgaard, Tem Bendix Salkvist Jorgensen, Kristian Korsgaard Thomsen, P. Rossing, Morten Bøttcher, N. Eldrup, Elgina Kamil Thomsen, Annette Hoi Justesen, S. R. Nielsen, Jørn M. Jepsen, B. Husøy, Ivo Valter, A. Rosenthal, Liina Viitas, Marika Paumets, S. Nieminen, Joni Suomi, A. Koski, J. Kuusisto, J. Putaala, K. Nyman, Kari Kervinen, T. Rissanen, J. Hukkanen, J. Taurio, T. Strandberg, G. Montalescot, G. Lemesle, Franck Boccara, Grégory Ducrocq, M.-A. Sevestre, B. Farah, T. Fourme, F. Paillard, E. Messas, G. Barone Rochette, Alexandre Canville, Meyer Elbaz, P. Poustis, G. Cayla, Jean-Louis Georges, Fitsum Guebre Egziabher, F. Chagué, Victor Buzura, S. Charrière, P. Khanoyan, G. Rangé, E. Ferrari, B. Cariou, F. Roubille, F. Beygui, Sébastien Caudmont, I. Weigmann, Isabelle Schenkenberger, Manuela Licka, M. Marks, Katrin Borucki, Andreas J. Rieth, K. Appel, U. Kassner, U. Laufs, Andreas Wilke, C. Axthelm, F. Schaper, Martin Bergmann, K. Stach-Jablonski, J. Simon, M. Fischer, S. Leggewie, J. Taggeselle, S. Cremer, K. Gebauer, W. Koenig, G. Kahrmann, P. Bosiljanoff, J. Placke, M. Kollum, B. Winkelmann, K. Tsioufis, S. Patsilinakos, Georgios Liamis, Konstantinos Tziomalos, Ioannis H. Styliadis, G. Ntaios, E. Tsougos, A. Protogerou, K. Stamatelopoulos, G. Giannakoulas, Katerina K Naka, A. Karavidas, N. Katsiki, A. Milkas, E. Mavrokefalou, T. Filippatos, R. Kiss, B. Merkely, M. Harangi, K. Tóth, I. Ungi, János Tomcsányi, Zoltán Csanádi, Dániel Aradi, László Márk, Z. Zimmermann, András Papp, G. Lupkovics, A. Papp, B. Benczur, Andrea Hornyik, F. Lakatos, J. Mucsi, L. Nagy, Imre Szakál, A. Mohácsi, I. Reiber, Jozsef Lippai, László Konyves, C. Hajdu, S. Hamar, Balázs Sármán, A. Szilágyi, P. Danos, G. Nagy, T. Bárány, I. Berhes, A. Nagy, P. Merlini, Giovanni Licciardello, M. D. Baldassarre, S. Berti, E. Rinaldi, G. Tocci, S. De Rosa, Andrea Palermo, N. Galiè, R. Trevisan, Gaetano M. De Ferrari, D. Trabattoni, Inga Morozova, Dace Teterovska, A. Erglis, I. Veze, I. Jasinkevica, J. Badarienė, L. Vencevičienė, R. Šlapikas, G. Urbonas, Valdas Dobilas, Danutė Strazdienė, Nora Kupstytė-Krištaponė, R. Kavaliauskiene, Enrique C. Morales Villegas, F. Aguilera Almazán, Vicente E. Ruiz Ruiz, M. A. Alcocer Gamba, Raymundo García Reza, M. O. de los Ríos Ibarra, Ismail Aksoy, F. Kauer, R. M. van de Wal, A. O. Oude Ophuis, F. Prins, Walter R M Hermans, F. Janse, S. Koudstaal, M. Emans, P. Hoogslag, G. Louis Bartels, T. Wildbergh, M. Meijs, E. Ronner, I. Westendorp, L. Kleijn, P. Dijkmans, L. Pos, S. Rasoul, J. Schaap, M. Asselman, Margriet Feenema-Aardema, R. Groutars, P. Nierop, H. Swart, Erik A. Badings, M. V. D. van der Zee, W. Remkes, J. Herrman, P. van Bergen, E. Stroes, S. Hartong, Adriaan Kooy, J. Post, M. A. van de Ree, W. Bax, F. Visseren, H. Monajemi, S. El Messaoudi, Ravee Rambharose, T. van Bemmel, Catharina R G M Daemen-Gubbels, Mazin Alhakim, B. Rensing, Rien Dekkers, A. Adiyaman, V. Paradies, R. Bemelmans, Boudewijn A Hoek, R.M.F. Verkleij, Z. Bednarkiewicz, Janusz Spyra, M. Tomaszewski, M. Zabowka, W. Telec, Z. Pijanowski, Mariusz Kafara, M. Piepiorka, J. Kopaczewski, B. Grzegorzewski, Grzegorz Kania, Lukasz Wojnowski, A. Budaj, Iwona Woźniak, J. Kiełtucki, Wojciech Czochra, Lidia Pawłowicz, A. Włodarczak, E. Dułak, P. Staneta, J. Bednarski, B. Busz-Papież, B. Wożakowska-Kapłon, P. Rozpondek, M. Broncel, T. Czerski, M. Zabojszcz, K. Cieślik, Robert Glowka, Krzysztof Saminski, M. Skórski, Dariusz Surman, J. Niegowska, Piotr Napora, Piotr Karaś, E. Mirek-Bryniarska, L. Artyszuk, M. Tomaszewska-Kiecana, Joanna Biegajlo, Maciej Banach, G. Skonieczny, M. Loster, Krzysztof Chlebus, E. Jaźwińska-Tarnawska, Aleksander Żurakowski, Grzegorz Drelich, Dariusz Dudek, A. Klecha, Adam Deres, M. Dąbrowska, Jerzy Cygler, C. Aguiar, P. Matos, Helder H Pereira, Pedro Monteiro, C. Gavina, P. Azevedo, M. Vieira, R. Ferreira, Olga Azevedo, Gabriela E. Stanciulescu, Constantin Militaru, D. Vinereanu, C. Podoleanu, M. Spiridon, Dana Cosma, E. Pintilei, C. Crișan, L. Andrei, O. Averkov, E. Yu. Radchenko, Yulia A. Argunova, S. Berns, A. Bykov, Mikhail I Voevoda, I. Gordeev, D. Dronov, N. Veselovskaya, D. Duplyakov, M. Ezhov, K. Zrazhevskiy, Mikhail Zykov

Open Access
5 citations
Analysis v5

Related Content

Claims (10)

Assertion

Taking a drug called evolocumab can lower the chance of having a first major heart problem by 25% in people at high risk who’ve never had a heart attack or stroke before.

Causal
Read analysis
Assertion

Evolocumab lowers the risk of first major heart or blood vessel events by 25% in high-risk patients who have not had a heart attack or stroke, and does not increase side effects over 4.6 years of use.

Quantitative
Read analysis
Assertion

For people with diabetes who are at high heart risk but don’t yet have major artery blockages, adding a drug called evolocumab to their usual cholesterol medicine cuts their chance of heart attack, stroke, or heart-related death by about a third over nearly 5 years.

Causal
Read analysis
Assertion

In adults with diabetes who do not have advanced artery disease, a medication called evolocumab lowers the chance of having a heart attack, stroke, or needing a procedure to restore blood flow over five years.

Causal
Read analysis
Assertion

In adults with diabetes who do not have advanced artery disease, a medication called evolocumab is associated with a reduction in the risk of death from any cause over five years, from 10.1% to 7.8%.

Causal
Read analysis
Assertion

In adults with diabetes who do not have advanced artery disease, the drug evolocumab lowers the chance of having a heart attack, stroke, or needing a procedure to restore blood flow over five years, compared to a placebo.

Causal
Read analysis
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