Immediate evolocumab after a heart attack improves LDL-cholesterol goals but not early cardiovascular outcomes
Immediate initiation of evolocumab after a heart attack significantly improved low-density lipoprotein cholesterol (LDL-C) goal achievement, but an early reduction in all-cause death or unplanned cardiovascular hospitalization was not observed compared with standard care. These were the main findings of the AMUNDSEN trial presented in a Hot Line session at ESC Congress 2026 and published…
The AMUNDSEN trial, presented at ESC Congress 2026, investigated whether administering evolocumab, a PCSK9 inhibitor, immediately after a heart attack could improve low-density lipoprotein cholesterol (LDL-C) targets and provide early cardiovascular benefits. Of the 2,161 high-risk patients, immediate evolocumab before percutaneous coronary intervention achieved LDL-C goals in 82% at 12 months, compared to 40% in the standard care group.
While achievement of LDL-C goals occurred faster in the evolocumab group (9 weeks vs 19 weeks), there was no significant difference in all-cause death or unplanned cardiovascular hospitalizations at one year between the two groups.
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