Evolocumab cut five-year VESALIUS-CV deaths from 9.7 per cent to 7.9 per cent
VESALIUS-CV at ESC 2026 and Circulation found five-year mortality of 7.9 per cent with evolocumab versus 9.7 per cent with placebo among 12,257 patients, median 4.6 years. One report writes 20 per cent lower deaths; the other gives 434 versus 539 deaths and HR 0.80 (P = 0.0005). Curves separated after 1.5 years; landmark HR 0.99 in the first 1.5 years then a 27 per cent cut (HR 0.73). Authors leave the finding exploratory.
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Five-year VESALIUS-CV deaths were 7.9 per cent versus 9.7 per cent
A prespecified analysis of the VESALIUS-CV trial, presented at ESC Congress 2026 and published in Circulation, found all-cause mortality 20 per cent lower among 12,257 high-risk participants given evolocumab on top of optimised lipid-lowering therapy, Medical Xpress reports. Five-year mortality was 7.9 per cent with evolocumab against 9.7 per cent with placebo, over a median follow-up of 4.6 years. AJMC writes the same comparison as 434 deaths versus 539, a hazard ratio of 0.80 (95 per cent CI 0.70–0.91; P = 0.0005), and says 973 patients (7.9 per cent) died in follow-up. AJMC places the presentation in a late-breaking session in Munich and dates the Circulation paper to online publication on 31 August 2026.[1], [2]
The curves separated at 1.5 years; the landmark was 0.99 then 0.73
Medical Xpress writes that the two curves began to separate after about 1.5 years. AJMC reports a landmark analysis: no mortality difference in the first 1.5 years (HR 0.99), then a 27 per cent relative reduction after 1.5 years (HR 0.73; P for interaction = 0.039). AJMC also writes that cardiovascular mortality was lower (HR 0.79; 95 per cent CI 0.64–0.98).[1], [2]
The dose was 140 mg every 2 weeks; the mortality finding stayed exploratory
AJMC describes the trial as 12,257 high-risk patients without prior myocardial infarction or stroke, randomised to evolocumab 140 mg subcutaneously every 2 weeks or placebo; median age was 66 years and 43 per cent were women. Medical Xpress says the trial enrolled patients whose LDL cholesterol stayed elevated despite optimised lipid-lowering treatment. Robert P. Giugliano of the Mass General Brigham Heart and Vascular Institute and Harvard Medical School, who led the analysis, says intensive LDL cholesterol lowering with evolocumab on top of standard therapy tracks with lower risk of heart attack and stroke and with improved survival. The authors describe the mortality finding as exploratory and say the analysis cannot definitively prove the effect came from evolocumab rather than another factor.[1], [2]
