{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:10:32Z","timestamp":1788829832161,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To describe the characteristics of patients receiving evolocumab in clinical practice across 12 European countries and simulate the association between low-density lipoprotein cholesterol (LDL-C) reduction and cardiovascular (CV) risk reduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The characteristics of hyperlipidaemic patients at initiation of evolocumab and treatment patterns study\u2014HEYMANS (n\u00a0=\u00a01952) is a prospective registry of patients\u00a0\u226518 years old who initiated evolocumab from 1 August 2015 onwards. Mean (standard deviation) age was 60 (10.8), 85% had a prior CV event, 45% were diagnosed with familial hypercholesterolaemia (FH), and 60% had statin intolerance. At evolocumab initiation, 43% were receiving any statin, 16% were receiving ezetimibe without statin, and 41% received no background lipid-lowering therapy (LLT), with LDL-C levels reflecting local proprotein convertase subtilisin\/kexin type 9 inhibitor (PCSK9i) reimbursement criteria. Median LDL-C decreased from 3.98 to 1.63\u00a0mmol\/L within 3 months of evolocumab initiation and was maintained over 24 months. Overall, 58% achieved risk-based 2019 European Society of Cardiology\/European Atherosclerosis Society LDL-C goals but that proportion was higher (68%) in patients receiving background LLT compared with those not receiving background LLT (44%). In patients with atherosclerotic cardiovascular disease without FH, the simulated relative CV risk reduction associated with evolocumab treatment was 34% (25\u201344%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Across Europe, LDL-C levels at evolocumab initiation were three times higher than recommended thresholds for PCSK9i initiation, reflecting disparities between implementation and guidelines. More patients attained risk-based LDL-C goals when receiving evolocumab in combination with LLT vs. those not receiving combination therapy. Population health could be improved and LDL-C goals better attained if LDL-C thresholds for PCSK9i reimbursement were lowered, enabling more patients to receive combination therapy when needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcac009","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T20:28:55Z","timestamp":1644870535000},"page":"447-460","source":"Crossref","is-referenced-by-count":40,"title":["Low-density lipoprotein cholesterol levels exceed the recommended European threshold for PCSK9i initiation: lessons from the HEYMANS study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0508-0954","authenticated-orcid":false,"given":"Kausik K","family":"Ray","sequence":"first","affiliation":[{"name":"Imperial Centre for Cardiovascular Disease Prevention and Imperial Clinical Trials Unit, Imperial , Stadium House, 68 Wood Lane, London W12 7RH, UK"},{"name":"College London , Stadium House, 68 Wood Lane, London W12 7RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafeesa","family":"Dhalwani","sequence":"additional","affiliation":[{"name":"Center for Observational Research, Amgen Ltd, Uxbridge UB8 1DH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahendra","family":"Sibartie","sequence":"additional","affiliation":[{"name":"Amgen (Europe) GmbH , Rotkreuz CH-6343, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Bridges","sequence":"additional","affiliation":[{"name":"International Biostatistics, Amgen Ltd, Uxbridge UB8 1DH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Ebenbichler","sequence":"additional","affiliation":[{"name":"Metabolic Diseases, Medizinische Universit\u00e4t Innsbruck , Innsbruck 6020, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Perrone-Filardi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples 80138, Italy"},{"name":"Mediterranean CardioCentro , Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Villa","sequence":"additional","affiliation":[{"name":"Amgen (Europe) GmbH , Rotkreuz CH-6343, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Vogt","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t M\u00fcnchen , Munich 80366, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Bruckert","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Paris , Paris 75006, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"2022060701393925900_bib1","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1016\/j.jacc.2018.11.002","article-title":"2019 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Grundy","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022060701393925900_bib2","volume-title":"Cardiovascular diseases","author":"World Health Organisation"},{"key":"2022060701393925900_bib3","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1136\/hrt.2003.021287","article-title":"Management of dyslipidaemia","volume":"90","author":"Thompson","year":"2004","journal-title":"Heart"},{"key":"2022060701393925900_bib4","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2020 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"2022060701393925900_bib5","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1056\/NEJMoa1615664","article-title":"Pedersen TR. for the FOURIER Steering Committee and Investigators. 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