Evolocumab – new opportunities for cardiovascular risk management in patients with atherosclerosis and diabetes

Abstract

Cardiovascular diseases of atherosclerotic genesis are the main cause of mortality in patients with type 2 diabetes mellitus, which requires an integrated approach in the treatment of this disease and correction of not only hyperglycemia, but other known risk factors for the development and progression of atherosclerosis, including dyslipidemia. In 2017, the results of the FOURIER study were published showing the possibility of a significant decrease in the level of atherogenic lipids and a decrease in the risk of developing major cardiovascular complications when the PCSK9 inhibitor evolocumab is added to standard lipid-lowering therapy. In that In the same year, within the framework of pre-planned FOURIER subanalyses, the results of two studies were obtained and published, in the first of which the high efficacy of evolocumab was shown in the prevention of cardiovascular events in patients with type 2 diabetes mellitus, and in the second in persons with peripheral atherosclerosis. who also showed a reduced risk of major adverse events associated with the blood supply to the lower extremities. The data obtained strengthened the position of PCSK9 inhibitors in a number of foreign recommendations and formed the basis for an additional reduction in the target levels of atherogenic lipids in very high-risk patients. The purpose of this Expert Council, which brings together representatives of cardiological (NOA, RosOKR), endocrinological (CEA) and X-ray endovascular (RNO SRDL) scientific societies, there was a discussion of the results of the FOURIER study and determination of the place of evolok