{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:44:50Z","timestamp":1792028690079,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atherosclerotic cardiovascular disease is a leading cause of morbidity and mortality, and many high\u2010risk patients fail to reach LDL\u2010cholesterol (LDL\u2010C) targets on statins alone. Evolocumab, a PCSK9 inhibitor, offers potent LDL\u2010C lowering, but a synthesis of its lipid and clinical benefits in secondary prevention is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta\u2010analysis of randomised controlled trials evaluating evolocumab in adults with established cardiovascular disease. PubMed, Embase, Scopus, Cochrane CENTRAL, and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      were searched through April 2025. Outcomes included lipid parameters, major adverse cardiovascular events (MACE), individual cardiovascular endpoints, and safety, with pooled risk ratios (RR) and mean differences calculated using random\u2010effects models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine trials enrolling 67,662 patients were included. Evolocumab significantly reduced LDL\u2010C (mean difference \u221257.73\u2009mg\/dL), total cholesterol (\u221252.27\u2009mg\/dL), triglycerides (\u221221.21\u2009mg\/dL), and lipoprotein(a) (\u221210.99\u2009mg\/dL), while increasing HDL\u2010cholesterol (3.69\u2009mg\/dL). Evolocumab was associated with lower MACE (RR 0.53; 95% CI 0.40\u20130.71), though this estimate should be interpreted cautiously given heterogeneity in endpoint definitions and study designs. Myocardial infarction (RR 0.74) and coronary revascularisation (RR 0.80) were significantly reduced, while cardiovascular mortality and stroke showed no statistically definitive reduction. Serious adverse events and neurocognitive effects were comparable between groups, though injection\u2010site reactions were more frequent with evolocumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with established cardiovascular disease, evolocumab provides substantial lipid lowering and reduces ischemic events without major safety concerns, supporting its use as an adjunct to statin therapy in secondary prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70355","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:35:56Z","timestamp":1791520556000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Evolocumab on LDL\u2010Cholesterol and Cardiovascular Outcomes in Patients With Established CVD: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4631-8113","authenticated-orcid":false,"given":"Anika","family":"Goel","sequence":"first","affiliation":[{"name":"Kakatiya Medical College  Warangal Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9230-6569","authenticated-orcid":false,"given":"Muhammad Abdullah","family":"Naveed","sequence":"additional","affiliation":[{"name":"Dow Medical College  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5165-9493","authenticated-orcid":false,"given":"Hemeesh","family":"Tandel","sequence":"additional","affiliation":[{"name":"C U Shah Medical College  Surendranagar Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1309-578X","authenticated-orcid":false,"given":"Affaf","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College  Lahore Punjab Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2330-183X","authenticated-orcid":false,"given":"Muhammad","family":"Mukhlis","sequence":"additional","affiliation":[{"name":"Ayub Medical College  Abbottabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Sai Varun","family":"Reddy","sequence":"additional","affiliation":[{"name":"Kakatiya Medical College  Warangal Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Kumar","family":"Maloth","sequence":"additional","affiliation":[{"name":"Kakatiya Medical College  Warangal Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3834-144X","authenticated-orcid":false,"given":"Anchit","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Maulana Azad Medical College  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5122-8200","authenticated-orcid":false,"given":"Ameer","family":"Awashra","sequence":"additional","affiliation":[{"name":"Department of Medicine An\u2010Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2499-4874","authenticated-orcid":false,"given":"Amogh","family":"Verma","sequence":"additional","affiliation":[{"name":"SR Sanjeevani Hospital  Siraha Nepal"},{"name":"Dr. D. Y. Patil Medical College Hospital and Research Centre Dr. D. Y. Patil Vidyapeeth (Deemed\u2010to\u2010be\u2010University)  Pune Maharashtra India"},{"name":"Dr. D. Y. Patil Dental College and Hospital Dr. D. Y. 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