Introduction:

A new target level for low-density lipoprotein cholesterol (LDL-C) has been established in patients at very high cardiovascular risk. However, treatment with evolocumab combined with atorvastatin to attain this target level has not been evaluated.

Objective:

To evaluate the efficacy of evolocumab to achieve the target LDL-C levels in patients with ischemic heart disease at very high cardiovascular risk.

Material and methods:

Twenty patients with ischemic heart disease at very high cardiovascular risk were treated with evolocumab and atorvastatin for 24 weeks. Levels of serum LDL-C, high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides were determined before and after treatment.

Results:

After 24 weeks of treatment, an average percentage reduction of 55% for LDL-C was obtained, and 11 of the 20 patients reached the target levels for LDL-C. No differences were found in the levels of HDL-C or triglycerides.

Conclusions:

evolocumab treatment was safe, effective, and reduced the concentration of LDL-C in all patients. However, the target level for LDL-C was only reached in half of the patients.