PCSK9 inhibitor treatment and outcomes in patients with atherosclerotic cardiovascular disease but without prior ischaemic events: an observational study.
PCSK9 inhibitor monoclonal antibodies reduced major cardiovascular events by 31% versus standard care in people with atherosclerotic cardiovascular disease but without prior ischemic events. Real-world observational study using US claims data, 19,670 patients followed for 5 years with propensity score matching. This provides the first large-scale real-world evidence for PCSK9 inhibitors in primary prevention within high-risk ASCVD populations, extending beyond the clinical trial evidence that has driven current guidelines. The observational design limits causal inference compared to randomized controlled trials.