{"id":"23a02700bded","type":"article","url":"https://hartvaat.nl/2026/04/10/vroege-evolocumab-na-hartinfarct-verlaagt-mace-bij-uitgestelde-randstenosen/","title":"Vroege evolocumab na hartinfarct verlaagt MACE bij uitgestelde randstenosen","title_en":"Evolocumab in patients with multivessel coronary disease after acute myocardial infarction: A target trial emulation.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog"],"tags":["aperitif-trial","farmaco-economie","myocardinfarct","newton-cabg"],"journal":"Atherosclerosis","doi":"https://www.atherosclerosis-journal.com/article/S0021-9150(26)00098-5/fulltext","source_url":"https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00098-5/fulltext","authors":["Jinying Zhou","Xiaoning Guo","Wei Gao","Yan Xia","Rende Xu","Jiatian Cao","Leilei Ma","Zhangwei Chen","Juying Qian","Chenguang Li","Junbo Ge"],"significance":7,"published":"2026-05-25","source_date":"2026-04-10","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/pcsk9-mechanisme/"],"congress":"","summary_en":"Target trial emulation in a multicenter Chinese registry (Shanghai, 2021-2022) of 1,862 patients with acute myocardial infarction and successful culprit-vessel revascularization but ≥1 deferred non-culprit intermediate lesion. Early in-hospital evolocumab initiation (n=174) was compared with standard care (n=1,688). Over 2 years, MACE occurred in 5.9% of evolocumab-treated lesions versus 11.9% in controls. The full 2-year hazard ratio was 0.72 (95% CI 0.48-1.09), but a 30-day landmark analysis showed a significant reduction (HR 0.35; 95% CI 0.16-0.74). Findings support early PCSK9 inhibition in the acute phase after AMI, including in deferred non-culprit lesions.","created":"2026-07-03T10:32:56Z","updated":"2026-07-03T18:39:33Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Target trial emulation op een multicenter Chinees register (Shanghai, 2021-2022) van 1.862 patiënten met een acuut myocardinfarct en succesvolle behandeling van de culprit-laesie, maar met ≥1 uitgestelde niet-culprit-laesie van intermediair belang. Vroege start van evolocumab tijdens de indexopname (n=174) werd vergeleken met standaardzorg (n=1.688). Over 2 jaar trad MACE op bij 5,9% van de evolocumab-laesies versus 11,9% in de controlegroep. De HR over de volledige 2-jaarsperiode was 0,72 (95%-BI 0,48-1,09), maar in een landmark-analyse vanaf 30 dagen bleek een significante reductie (HR 0,35; 95%-BI 0,16-0,74). De bevindingen ondersteunen vroege PCSK9-remming in de acute fase na een hartinfarct, ook bij laesies die niet direct worden gerevasculariseerd.","abstract_original":"The proprotein convertase subtilisin/kexin type 9 inhibitors, i.e. evolocumab, promote coronary plaque regression in patients with acute myocardial infarction (AMI). However, its clinical benefit for non-culprit intermediate lesions deferred for revascularization remains uncertain. This study evaluated whether early evolocumab initiation improves outcomes in this specific population."}