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The VESALIUS-CV trial showed us that the proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor evolocumab lowered adverse cardiovascular events in primary prevention patients who had documented atherosclerosis or diabetes but no previous cardiovascular events. Now, researchers report results of a subgroup analysis of 3655 patients (mean age, 65) with diabetes but no documented atherosclerosis (i.e., no prior arterial revascularization, no coronary stenosis ≥50%, and no coronary artery score ≥100).
Nearly 90% of these patients had hypertension, and their median baseline LDL cholesterol level was 132 mg/dl. About 85% were receiving statin therapy, roughly two thirds were on a high-intensity regimen, and few were on ezetimibe. …