Recurrence risk
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MI and stroke survivors face a high risk of recurrent events

People who survive a myocardial infarction or stroke are at increased risk for further CV events.2 The risk is highest within the first year, therefore preventive measures should be initiated as early as possible.3

Risk of recurrent CV events

EUROASPIRE V revealed poor risk-factor control among MI survivors
The EUROASPIRE V survey showed that 71% of patients with dyslipidaemia and coronary heart disease had not achieved the 2016 ESC Guideline recommended LDL-C level of <70 mg/dl (<1.8 mmol/l) despite lipid-lowering therapy.*6
The survey also revealed a high prevalence of unhealthy lifestyles and inadequate use of cardioprotective drug therapies among these very-high-risk patients.6
The ESC recently published lower LDL-C targets which recommend LDL-C <55 mg/dl (<1.4 mmol/l) and at least a 50% reduction for very-high-risk patients.7 To achieve this more intensive LDL-C reduction, the 2019 Guidelines recommend the addition of PCSK9 inhibitors like Repatha® in patients who have not achieved their LDL-C goals on optimised lipid-lowering therapy.7
Read more about the 2019 Guidelines here.

Risk factor control of coronary patients across Europe*6

*Data from the EUROASPIRE V survey involving 8261 patients from 131 centres in 27 European countries. Patients aged <80 years with coronary disease who had undergone CABG, PCI or an ACS were identified from hospital records and interviewed.
In patients on lipid-lowering medication. 84% of interviewed coronary patients were on lipid-lowering therapy. 80% were taking statins and 50% of those on lipid-lowering drugs were taking high-intensity lipid-lowering drugs or drug combinations.
In patients who were smoking at the time of their event.
§In patients on blood pressure-lowering medication.
In patients with self-reported diabetes.
In the study, 2690 recent MI patients received Repatha®, 2254 of whom achieved LDL-C levels <55 mg/dl.
**25% RRR reported as the key secondary endpoint: composite of cardiovascular death, MI or stroke. HR: 0.75; 95% CI: 0.62-0.91; p=0.003. ARR: 3.2%; 95% CI: 1.2-5.2.
ACS = Acute coronary syndrome; ARR = Absolute risk reduction; CABG = Coronary artery bypass surgery; CV = Cardiovascular; EAS = European Atherosclerosis Society; ESC = European Society of Cardiology; EUROASPIRE = European Action on Secondary and Primary Prevention by Intervention to Reduce Events; EVOPACS = EVOlocumab for Early Reduction of LDL-cholesterol Levels in Patients With Acute Coronary Syndromes; LDL-C = Low-density lipoprotein cholesterol; HbA1c = Glycated haemoglobin; MI = Myocardial infarction; PCI = Percutaneous coronary intervention; PCSK9 = Protein convertase subtilisin/kexin type 9; RRR = Relative risk reduction.
  1. European Cardiovascular Disease Statistics 2017. Fifth Edition: February 2017. European Heart Network, Brussels.
  2. Bhatt DL, et al. JAMA. 2010;304:1350-7.
  3. Smolina K, et al. Circ Cardiovasc Qual Outcomes. 2012;5:532-40.
  4. Mohan KM, et al. Stroke. 2011;42:1489-94.
  5. Jernberg T, et al. Eur Heart J. 2015;36:1163-70.
  6. Kotseva K, et al. Eur J Prev Cardiol. 2019;26:824-35.
  7. Mach F, et al. Eur Heart J. 2020;41:111-88.
  8. Gencer B, et al. JAMA Cardiol. 2020;5(8):1-6. Main paper & Supplementary appendix.

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