Forecast horizon — calibration-scored at resolution.
The cardiovascular benefit of evolocumab will be shown to persist or increase with longer follow-up beyond the 2.2-year median observed in the FOURIER trial.
TL;DR · AI-generated
In this trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events.
Author-implied confidence
62%
Current probability
Status
DRAFT
Your probability this resolves TRUE
0% (impossible)
50%
100% (certain)
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Evidence stream
1 event · 1 snapshot
posterior drift
80% → 80% (0pp · 1 point)
Peer-reviewed paper
Apr 18, 2026
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Source publication
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.
· openalex W2596179513 · s2 993698dd
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Evolocumab added to statin therapy significantly reduced the composite primary endpoint of cardiovascular death, MI, stroke, unstable angina hospitalization, or coronary revascularization (HR 0.85; 95% CI 0.79–0.92) in ASCVD patients over a median 2.2-year follow-up.
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Evolocumab significantly reduced the key secondary composite endpoint of cardiovascular death, MI, or stroke (HR 0.80; 95% CI 0.73–0.88) compared with placebo in ASCVD patients receiving background statin therapy.
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The cardiovascular benefit of PCSK9 inhibition with alirocumab will be confirmed as a class effect applicable to other PCSK9 inhibitors in post-ACS patients on maximally tolerated statin therapy.
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Patients with atherosclerotic cardiovascular disease whose baseline LDL cholesterol is in the lowest quartile (median ~74 mg/dL) still derive cardiovascular benefit from further LDL lowering with evolocumab.
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Recent follow-up analyses of ISCHEMIA are confirming the original effect size in real-world data.
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In patients with atherosclerotic cardiovascular disease on statin therapy, evolocumab reduced LDL cholesterol by 59% at 48 weeks, from a median of 92 mg/dL to 30 mg/dL, compared with placebo.