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Randomized Controlled Trial
. 2018 Jul 14;39(27):2540-2545.
doi: 10.1093/eurheartj/ehx450.

Reduction of low density lipoprotein-cholesterol and cardiovascular events with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors and statins: an analysis of FOURIER, SPIRE, and the Cholesterol Treatment Trialists Collaboration

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Randomized Controlled Trial

Reduction of low density lipoprotein-cholesterol and cardiovascular events with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors and statins: an analysis of FOURIER, SPIRE, and the Cholesterol Treatment Trialists Collaboration

Brian A Ference et al. Eur Heart J. .
No abstract available

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Figures

Figure 1
Figure 1
Boxes represent effect estimates and lines represent 95% confidence intervals. (A) Effect of evolocumab on the risk of major vascular events [cardiovascular death (CVD), myocardial infarction (MI), stroke or urgent revascularization] plotted on the overall Cholesterol Treatment Trialists (CTT) regression line representing the observed reduction in risk per mmol/L reduction in low density lipoprotein cholesterol (LDL-C) over an average of 5 years of treatment with a statin. (B) Effect of evolocumab and bococizumab as compared to the effect of statins by duration of treatment (red line represents the fitted regression line for a 12% reduction in risk of major vascular events per mmol/L reduction in LDL-C after 1 year of treatment; blue line represents 17% reduction in risk of major vascular events per mmol/L reduction in LDL-C after 2 years of treatment; orange line represents 20% reduction in risk of major vascular events per mmol/L reduction in LDL-C after 3 years of treatment; and grey line represents 22% reduction in risk of major vascular events per mmol/L reduction in LDL-C after 4 or more years of treatment with a statin as estimated by the CTT collaborators). The regression line for each duration of therapy is derived by drawing a line through the estimated benefit of treatment with a statin per mmol/L reduction in LDL-C for any duration of therapy (given in Table 1, column 7) that is forced to pass through the origin. HPS, Heart Protection Study; 4S, Scandinavian Simvastatin Survival Study’ WOSCOPS, West of Scotland Coronary Prevention Study; CARE, Cholesterol and Recurrent Events trial; LIPID, Long-Term Intervention with Pravastatin in Ischaemic Disease trial.
Figure 2
Figure 2
Boxes represent effect estimates and lines represent 95% confidence intervals. (A) Effect of variants that mimic proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors as compared to variants that mimic statins on the risk of various cardiovascular outcomes per 0.25 mmol/L reduction in low density lipoprotein cholesterol (LDL-C). (B) Effect of PCSK9 inhibitors per mmol/L reduction in LDL-C in a meta-analysis of the FOURIER and SPIRE-2 trials during the first year of treatment as compared with the effect of statins during the first year of treatment per mmol/L reduction in LDL-C as reported by the Cholesterol Treatment Trialists (CTT) Collaboration. (C) Effect of PCSK9 inhibitors in the FOURIER trial per mmol/L reduction in LDL-C during the second year of treatment as compared to the effect of statins during the second year of treatment per mmol/L reduction in LDL-C as reported by the CTT.

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