Trial reportCirculation2023
Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE.
Trial report in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT01764633. Cited by 91 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Double-blind, Randomized, Placebo-controlled, Multicenter Study Assessing the Impact of Additional LDL-Cholesterol Reduction on Major Cardiovascular Events When Evolocumab (AMG 145) is Used in Combination With Statin Therapy In Patients With Clinically Evident Cardiovascular Disease
Open the trial in the graphA Multicenter, Open-label, Single-arm, Extension Study to Assess Long-term Safety of Evolocumab Therapy in Patients With Clinically Evident Cardiovascular Disease
INtensive Cholesterol-Lowering With recatIcimab combiNation in Emergency PCI for Acute Myocardial Infarction: A Randomized Controlled Trial
Who cites it
91 citing papers in PubMed, 1 synthesis or guideline pooled it, 159 citations in OpenAlex.
- Indirect comparison of the efficacy and safety of alirocumab and evolocumab on major cardiovascular events: a systematic review and network meta-analysis.Frontiers in pharmacology · 2025Pooled it
- PCSK-9-inhibitor therapy improves endothelial function in high-risk patients with cardiovascular disease.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Trial
- Efficacy and safety of Tafolecimab in Chinese patients with type 2 diabetes and hypercholesterolemia: a post-hoc analysis of pooled data from three phase 3 trials.Cardiovascular diabetology · 2025Trial
- Effects of Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function and Serum Lipid Metabolomics in Patients With Ischemic Stroke: A Randomized Controlled Study.Brain and behavior · 2025Trial
- Systematic review of clinical guidance for lipid management in adults with or at risk of atherosclerotic cardiovascular disease: A global perspective.International journal of cardiology. Cardiovascular risk and prevention · 2026Review
- Review
- LDL-cholesterol distance to target: A practical tool for guiding lipid-lowering treatment decisions.Atherosclerosis plus · 2026Review
- FAPI PET/CT in post-PCI coronary disease: in-stent restenosis characterization, MACE association, and limited short-term modulation by lipid-lowering therapy: FAPI athero trial.European journal of nuclear medicine and molecular imaging · 2026Observational
- The Impact of PCSK9 Inhibitors on Circulatory Inflammation: Mechanisms, Evidence, and Application Prospects.JACC. Asia · 2026Review
- Reconceptualizing Dyslipidemia: Diversity of Lipid Imbalances and Their Clinical Implications; A Narrative Review.Health science reports · 2026Article
- Association of the Discordance Between Apolipoprotein B and Low-Density Lipoprotein Cholesterol With Cognition.Journal of the American Heart Association · 2026Article
- Lipid lowering in coronary artery disease - not just statins.Clinical medicine (London, England) · 2026Review
- Therapeutic inertia and lipid-lowering treatment modification after acute coronary syndrome: a longitudinal real-world study using a lagged decision-outcome design.Lipids in health and disease · 2026Article
- Lipid Management for Secondary Prevention in Atherosclerotic Cardiovascular Disease: A Scoping Review and Scientific Report.Journal of atherosclerosis and thrombosis · 2026Article
- Advancing Lipid Management: Saudi Heart Association Position Statement on PCSK9-targeted Therapies in the Primary and Secondary Prevention of Cardiovascular Disease.Journal of the Saudi Heart Association · 2026Article
- Intra-coronary imaging and transcriptomics of calcified nodules before and after intensive lipid-lowering therapy: a YELLOW III substudy.European heart journal. Imaging methods and practice · 2026Article
- Observational
- Differential age-related patterns in the associations of LDL-C, TG/HDL-C ratio, and carotid plaque: a large-scale cross-sectional study in a Chinese health check-up population.Frontiers in cardiovascular medicine · 2026Article
- Residual coronary atherosclerotic risk and low LDL-cholesterol in chronic coronary syndromes.European heart journal. Imaging methods and practice · 2026Article
- A narrative review of PCSK9 inhibitors: from evolocumab to novel discoveries.Frontiers in pharmacology · 2026Review
31 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 10 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for atherosclerotic cardiovascular disease. However, the optimal achieved LDL-C level with regard to efficacy and safety in the long term remains unknown.
methodsIn FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk), 27 564 patients with stable atherosclerotic cardiovascular disease were randomized to evolocumab versus placebo, with a median follow-up of 2.2 years. In the open-label extension (FOURIER-OLE), 6635 of these patients were transitioned to open-label evolocumab regardless of initial treatment allocation in the parent trial and were followed for an additional median of 5 years. In this prespecified analysis, we examined the relationship between achieved LDL-C levels (an average of the first 2 LDL-C levels measured) in FOURIER-OLE (available in 6559 patients) and the incidence of subsequent cardiovascular and safety outcomes. We also performed sensitivity analyses evaluating cardiovascular and safety outcomes in the entire FOURIER and FOURIER-OLE patient population. Multivariable modeling was used to adjust for baseline factors associated with achieved LDL-C levels.
resultsIn FOURIER-OLE, 1604 (24%), 2627 (40%), 1031 (16%), 486 (7%), and 811 (12%) patients achieved LDL-C levels of <20, 20 to <40, 40 to <55, 55 to <70, and ≥70 mg/dL, respectively. There was a monotonic relationship between lower achieved LDL-C levels-down to very low levels <20 mg/dL-and a lower risk of the primary efficacy end point (composite of cardiovascular death, myocardial infarction, stroke, hospital admission for unstable angina or coronary revascularization) and the key secondary efficacy end point (composite of cardiovascular death, myocardial infarction, or stroke) that persisted after multivariable adjustment (adjusted
conclusionsIn patients with atherosclerotic cardiovascular disease, long-term achievement of lower LDL-C levels, down to <20 mg/dL (<0.5 mmol/L), was associated with a lower risk of cardiovascular outcomes with no significant safety concerns. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01764633.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.