Does Intensive LDL Lowering with a PCSK9 Inhibitor Affect Patient-Reported Cognition?

A subanalysis of a randomized, controlled trial of evolocumab finds no adverse effects on patient-reported neurocognitive function at 2 years.

Observational data have shown possible associations between very low LDL levels and impaired cognitive function. In the manufacturer-sponsored FOURIER trial, which randomized patients with atherosclerotic cardiovascular disease (age range, 40–85) to evolocumab or placebo in addition to ongoing statin therapy, patients completed a 23-item version of the Everyday Cognition (ECog) questionnaire at their final visit. Patients assessed changes in their memory and executive functioning (planning, organization, and divided attention) on a 4-point scale, with scores ≥2 indicating self-reported cognitive decline.

At a median of 2.2 years of follow-up, 22,655 patients completed the survey (82% of all trial participants). Similar proportions of patient…

Reviewing Author

Fatima Rodriguez, MD, MPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardNovoNordisk; HealthPals; Novartis; Amgen

EquityHealthPals; Carta

Grant/Research SupportNational Institutes of Health/National Heart, Lung, and Blood Institute; American Heart Association–Robert Wood Johnson Foundation

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