{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:56:39Z","timestamp":1790600199590,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"31","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021515","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Low-density lipoprotein cholesterol (LDL-C)-lowering therapies are proven effective in atherosclerotic cardiovascular disease (ASCVD), but real-world evidence for proprotein convertase subtilisin\/kexin type 9 inhibitor (PCSK9i) monoclonal antibodies (mAb) remains limited. This study evaluated their impact in patients with ASCVD without prior ischaemic events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients initiating PCSK9i mAb from January 2016 to December 2022 were identified in the Optum Research Database. A 1:2 propensity score-matched comparator cohort of PCSK9i non-initiators was developed. The primary endpoint was a composite of non-fatal myocardial infarction, non-fatal ischaemic stroke, or all-cause mortality. Key outcomes from the parametric G-formula were 5-year event rates, relative risk reduction (RRR) and absolute risk reduction (ARR), with intention-to-treat (ITT) analysis. Additional outcomes for PCSK9i mAb initiators included absolute and percent LDL-C reduction from baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 19 670 patients met selection criteria (6545 PCSK9i mAb initiators; 13 125 non-initiators). Baseline characteristics were well-balanced. Under ITT, estimated 5-year event rates were 17.5% [95% confidence interval (CI) 15.5%, 19.5%] with PCSK9i mAb vs 25.4% (95% CI 23.6%, 27.1%) without PCSK9i, yielding a RRR of 30.9% and ARR of 7.8%. Individual endpoints showed RRRs of 28.3% for myocardial infarction (P &amp;lt; .0001), 26.4% for ischaemic stroke (P = .02), and 28.5% for all-cause mortality (P &amp;lt; .0001). Among initiators, mean baseline and follow-up LDL-C were 117.8 and 54.7 mg\/dL (on-treatment analysis), respectively, representing an absolute reduction of 63.1 mg\/dL and percent reduction of 53.6%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In ASCVD patients without prior events in clinical practice, PCSK9i mAb treatment was associated with lower ischaemic event and mortality rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehag176","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:39:29Z","timestamp":1771591169000},"page":"4277-4286","source":"Crossref","is-referenced-by-count":4,"title":["PCSK9 inhibitor treatment and outcomes in patients with atherosclerotic cardiovascular disease but without prior ischaemic events: an observational study"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L","family":"Bhatt","sequence":"first","affiliation":[{"name":"Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai , 1 Gustave L. Levy Place, NewYork, NY 10029 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Perrone Filardi","sequence":"additional","affiliation":[{"name":"Federico II University of Naples Department of Advanced Biomedical Sciences, ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-0904","authenticated-orcid":false,"given":"Irfan","family":"Khan","sequence":"additional","affiliation":[{"name":"Sanofi Integrated Evidence Generation, , Morristown, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-0999","authenticated-orcid":false,"given":"Jos\u00e9","family":"Tu\u00f1\u00f3n","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Aut\u00f3noma University Department of Cardiology, , CIBERCV, Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-634X","authenticated-orcid":false,"given":"Nikolaus","family":"Marx","sequence":"additional","affiliation":[{"name":"RWTH Aachen University Department of Internal Medicine I, Cardiology, , Aachen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5164-2082","authenticated-orcid":false,"given":"Manuel","family":"Castro Cabezas","sequence":"additional","affiliation":[{"name":"Franciscus Gasthuis & Vlietland Department of Internal Medicine, Endocrinology, Diabetes and Vascular Medicine, , Rotterdam; Erasmus MC, Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5966-1140","authenticated-orcid":false,"given":"Katherine","family":"Andrade","sequence":"additional","affiliation":[{"name":"Optum Optum Life Sciences, , Eden Prairie, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-306X","authenticated-orcid":false,"given":"Alexandra","family":"Koumas","sequence":"additional","affiliation":[{"name":"Axtria , Berkeley Heights, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhouyang","family":"Lou","sequence":"additional","affiliation":[{"name":"Axtria , Berkeley Heights, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6441-3339","authenticated-orcid":false,"given":"Lale","family":"Tokg\u00f6zo\u011flu","sequence":"additional","affiliation":[{"name":"Hacettepe University Department of Cardiology, , Ankara ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"2026092807570007800_ehag176-B1","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.1056\/NEJMoa1801174","article-title":"ODYSSEY OUTCOMES committees and investigators. 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