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Elevated LDL cholesterol (LDL-C) levels are known to cause atherosclerosis. Statins, owing to their robust LDL-C–lowering ability, have been shown to slow progression of atherosclerosis; inhibitors of proprotein convertase subtilisin–kexin type 9 (PCSK9) have even greater LDL-C–lowering abilities, thus raising hopes for greater slowing of atherosclerosis as well. In a manufacturer-sponsored trial, 968 patients presenting for clinically indicated coronary angiography were randomized to receive the PCSK9 inhibitor evolocumab (420 mg) or placebo subcutaneously each month for 1.5 years. All patients also received statin therapy. Outcomes assessed were change in atheroma volume and plaque regression.
Mean LDL-C levels were significantly lower wit…