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Evolocumab and clinical outcomes in patients with cardiovascular disease - The New England Journal of Medicine - 2017

Brief Summary:

Among patients with clinical atherosclerotic disease and LDL > 70 despite high- or moderate-intensity statin therapy (70% high intensity), the addition of evolocumab resulted in an absolute 1.5% reduction in major cardiovascular events (cardiovascular death, MI, stroke, hospitalization for unstable angina, or coronary revascularization) at median follow-up 26 months, driven primarily by reductions in nonfatal MI, stroke, and revascularization. There was no overall or CV-specific mortality benefit with evolocumab. Other than a modest 2% incidence in injection-site reactions, there was no increase in key adverse events including new-onset diabetes or neurocognitive effects in patients receiving evolocumab.

Reference: http://www.ncbi.nlm.nih.gov/pubmed/28304224

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𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚

𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚 in Patient with AF and acute IS/TIA European Heart Association Guideline recommends: • 1 days after TIA • 3 days after mild stroke • 6 days after moderate stroke • 12 days after severe stroke Early anticoagulation can decrease a risk of recurrent stroke and embolic events but may increase a risk of secondary hemorrhagic transformation of brain infarcts. The 1-3-6-12-day rule is a known consensus with graded increase in delay of anticoagulation between 1 and 12 days after onset of ischemic stroke or transient ischemic attack(TIA), according to neurological severity based on European expert opinions. However, this rule might be somewhat later than currently used in a real-world practical setting.

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