Scientists at Mass General Brigham found that the medicine evolocumab can greatly lower the chance of a first heart problem for people with diabetes who are at high risk but do not yet have plaque in their arteries. The results were shared at a big heart‑health meeting and appeared in a medical journal.
Why Cutting Bad Cholesterol Helps
Heart disease kills more people than any other illness. Lowering low‑density lipoprotein, or LDL, often called “bad cholesterol,” is one of the best ways to stay safe. Evolocumab belongs to a group called PCSK9 inhibitors and can drop LDL by about 60%. Doctors usually give it together with statins, the standard cholesterol pills. People who have high risk but no plaque often only get statins, if any medicine at all.
The data come from a side analysis of the VESALIUS‑CV trial, which was paid for by Amgen. The study looked at 3,655 adults who had diabetes for at least ten years, needed daily insulin, or had tiny blood‑vessel damage, but who did not have major plaque.
Participants received either an evolocumab shot every two weeks or a harmless placebo. Everyone kept taking their usual cholesterol pills, like statins or ezetimibe.
Big Drop in Cholesterol Numbers
After about one year, the group getting evolocumab had LDL levels roughly half of those in the placebo group—about 52 mg/dL versus 111 mg/dL.
Lower Chance of First Heart Attack or Stroke
During almost five years of follow‑up, people on evolocumab plus their regular medicines were 31 % less likely to have a first major heart event. These events included death from heart disease, a heart attack, or an ischemic stroke.
At the five‑year mark, 5 % of the evolocumab group had an event compared with 7.1 % of the placebo group.
Safety and Next Steps
Serious side effects happened at about the same rate in both groups, showing the drug is generally safe.
Scientists say more research is needed to see if the same benefits appear in other high‑risk people who have not yet built up plaque.
Funding for the trial came from Amgen Inc.