Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition with evolocumab: powerful low-density lipoprotein cholesterol (LDL-C) lowering and improved cardiovascular outcomes without an increase in the risk of diabetes mellitus

Cardiovascular disease (CVD) is the leading global cause of death and accounts for approximately 30% of the total annual deaths worldwide (1). In the United States, CVD is very common and affects over one third of the population (2). It is well established that low-density lipoprotein cholesterol (LDL-C) is involved in the pathogenesis of atherosclerosis, and treatment with LDLC- lowering medications has elicited a marked reduction in cardiovascular risk in both primary (3) and secondary (4) prevention.