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2019;73:35463.e353

Residual Inflammatory Risk Despite adequate control of risk factors and even achieving the recommended therapeutic goals in secondary prevention, the 10-year risk of recurrence of major cardiovascular events in patients with atherosclerosis is 1030%.61 There are pathophysiological mechanisms that explain a significant part of this residual risk of recurrence that persists even in patients with adequately controlled LDL-C.19 In the FOURIER study, the median rate of events during the 26 months of follow-up in patients receiving evolocumab, who presented a mean LDL-C of 0.78 mmol/l, was 9.8%.62 In the GLAGOV study, up to one-third of the patients receiving combined treatment of evolocumab and statins presented increased atheroma volume despite reaching a mean LDL-C of 0.95 mmol/l.63 These observations suggest that even with the significant reduction in lipid levels achieved by PCSK9 inhibitors there is a residual risk of atherosclerosis progression and recurrence of major cardiovascular events

Petrov et al., 2017)