The VESALIUS-CV trial demonstrated that the PCSK9 inhibitor evolocumab significantly reduced the risk of a first major cardiovascular event in patients with diabetes who had no known significant atherosclerosis. These findings challenge current clinical practice, where PCSK9 inhibitors are typically reserved for secondary prevention in patients with prior heart attack or stroke. Importantly, the results support earlier, more proactive lipid-lowering intervention, showing benefit even before overt atherosclerotic disease is evident. This paradigm shift underscores the opportunity to intensify preventive strategies and reduce cardiovascular risk earlier in high-risk populations.

In this interview, Nanette Kass Wenger MD, MACC and Nicholas Marston, MD discuss the VESALIUS-CV Trial.

Related References:

1. Bohula EA, Marston NA, Bhatia AK, et al. Evolocumab in Patients without a Previous Myocardial Infarction or Stroke. N Engl J Med. 2026;394(2):117-127. doi:10.1056/NEJMoa2514428