Clinical effect of proprotein convertase subtilisin/kexin type 9 inhibition in patients undergoing coronary artery bypass surgery

Objectives: To evaluate whether adding evolocumab to statin plus ezetimibe in patients undergoing coronary artery bypass grafting improves lipid control and reduces clinical events. Methods: This retrospective study included 254 patients with dyslipidemia undergoing coronary artery bypass grafting. Of these, 111 received statin + ezetimibe plus evolocumab, whereas 143 received only statin + ezetimibe. The 2 groups were compared for lipid levels and cardiovascular outcomes. Cox regression analysis identified significant predictors of events, including treatment group, hypertension, European System for Cardiac Operative Risk Evaluation II, and previous stroke. Results: < .001), compared to the control group. Conclusions: Evolocumab added early to standard therapy after coronary artery bypass grafting achieved greater lipid lowering and was associated with fewer hard cardiovascular events during midterm follow-up.