{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T18:10:40Z","timestamp":1788027040492,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","funder":[{"name":"Amgen, Inc"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The clinical benefit of intensive LDL cholesterol (LDL-C) lowering with evolocumab in patients with prior percutaneous coronary intervention (PCI) but without a prior myocardial infarction (MI) is not established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>VESALIUS-CV (The Effect of Evolocumabin Patients at High Cardiovascular Risk Without Prior Myocardial Infarction or Stroke) randomized patients with atherosclerosis or high-risk diabetes but without prior MI or stroke and with LDL-C \u226590 mg\/dL to evolocumab versus placebo. The median follow-up was 4.6 years. The dual primary end points were coronary heart disease death, MI, or ischemic stroke (3-point major adverse cardiovascular event [MACE]) and the same composite plus ischemia-driven revascularization (4-point MACE). For this prespecified subgroup analysis, patients were categorized by whether they had undergone PCI at any time before trial enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 12 257 randomized patients, 3627 (29.6%) had undergone prior PCI with a median time between PCI and enrollment of 4 years. Their median age was 66 years, and 30.7% were women. The median LDL-C in a lipid substudy at 48 weeks was 41.5 (26.0\u201367.0) mg\/dL versus 107.0 (84.0\u2013135.0) mg\/dL in the evolocumab versus placebo arms (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001). Evolocumab reduced the relative rate of 3-point MACE by 30% (5-year Kaplan-Meier rates 7.0% versus 9.5%; hazard ratio [HR], 0.70 [95% CI, 0.56\u20130.89];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004) and 4-point MACE by 18% (17.9% versus 21.7%; HR, 0.82 [95% CI, 0.71\u20130.96];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.012) as well as both MI by 50% (3.0% versus 6.1%; HR, 0.50 [95% CI, 0.36\u20130.70];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), with the effect apparent as soon as 6 months after randomization, and urgent coronary revascularization by 39% (HR, 0.61 [95% CI, 0.46\u20130.80];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). There were nominally lower rates of cardiovascular death (2.6% versus 3.7%; HR, 0.66 [95% CI, 0.45\u20130.96];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.030) and all-cause death (8.2% versus 10.2%; HR, 0.76 [95% CI, 0.60\u20130.95];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.016) with evolocumab.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Evolocumab reduced the risk of major cardiovascular events in stable patients with prior PCI but no MI. These findings support intensive LDL-C lowering in patients who have undergone PCI even in the absence of prior MI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT03872401.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.126.080616","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:00:11Z","timestamp":1779195611000},"page":"28-36","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Evolocumab in Patients With Prior Percutaneous Coronary Intervention and No Prior Myocardial Infarction: Results From the VESALIUS-CV Trial"],"prefix":"10.1161","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4360-7606","authenticated-orcid":true,"given":"Brian A.","family":"Bergmark","sequence":"first","affiliation":[{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (B.A.B., E.A.B., N.A.M., J-G.P., J.F.K., S.A.M., R.P.G., M.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-8172","authenticated-orcid":true,"given":"Erin A.","family":"Bohula","sequence":"additional","affiliation":[{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (B.A.B., E.A.B., N.A.M., J-G.P., J.F.K., S.A.M., R.P.G., M.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-4617","authenticated-orcid":true,"given":"Nicholas A.","family":"Marston","sequence":"additional","affiliation":[{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (B.A.B., E.A.B., N.A.M., J-G.P., J.F.K., S.A.M., R.P.G., M.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-1747","authenticated-orcid":true,"given":"Jeong-Gun","family":"Park","sequence":"additional","affiliation":[{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (B.A.B., E.A.B., N.A.M., J-G.P., J.F.K., S.A.M., R.P.G., M.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia F.","family":"Kuder","sequence":"additional","affiliation":[{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (B.A.B., E.A.B., N.A.M., J-G.P., J.F.K., S.A.M., R.P.G., 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