Acute Coronary Syndrome (EVOPACS study)


Repatha® in Acute Coronary Syndrome

  • 77% LDL-C reduction at 8 weeks2
  • 90% of patients achieved LDL-C <55 mg/dl2
  • Well tolerated, with no excess of adverse events or serious adverse events versus placebo2

Mean LDL-C reduction from baseline at 8 weeks2

EVOPACS evaluated the value of Repatha® for early reduction of LDL-C levels in patients with Acute Coronary Syndrome (ACS).2
The study included 308 patients in the acute first 72-hour phase of ACS.*2 Patients were randomised to receive Repatha® SC 420 mg QM or placebo; all patients also received atorvastatin 40 mg QD.2

*Study patients had ACS, defined as non-ST-elevation myocardial infarction or unstable angina <72 hours or ST-segment-elevation myocardial infarction <24 hours; LDL-C levels were ≥70 mg/dl in patients previously on stable treatment with high-intensity statin, or ≥90 mg/dl in patients previously on stable treatment with low or moderate-intensity statin, or ≥125 mg/dl in statin-naïve patients or patients not on stable statin treatment.
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; CV = Cardiovascular; EAS = European Atherosclerosis Society; ESC = European Society of Cardiology; EVOPACS = EVOlocumab for Early Reduction of LDL-cholesterol Levels in Patients With Acute Coronary Syndromes; LDL-C = Low-density lipoprotein cholesterol; MI = Myocardial infarction; PCSK9 = Protein convertase subtilisin/kexin type 9; QD = Every day; QM = Every month; RRR = Relative risk reduction.
  1. Repatha® (evolocumab) Summary of Product Characteristics. Last revised: 31 March 2021.
  2. Koskinas KC, et al. J Am Coll Cardiol. 2019;74:2452-62.
  3. Gencer B, et al. JAMA Cardiol. 2020;5(8):1-6. Main paper & Supplementary appendix.