How a Cholesterol-Lowering Medication Could Reduce Heart Attack Risk

A recent study conducted at Cedars-Sinai Medical Center sheds light on how evolocumab, a drug that significantly lowers cholesterol, may help prevent heart attacks in individuals with coronary artery disease. Coronary artery disease occurs when cholesterol deposits accumulate along the walls of heart arteries, leading to the formation of plaques. These plaques often start as inflammatory regions, and as they grow, they become susceptible to rupture, potentially causing a heart attack.

Evolocumab belongs to a class of medications known as PCSK9 inhibitors, which are highly effective at reducing bad cholesterol levels in the blood. The study focused on patients with substantial noncalcified plaque buildup, a type of softer, more rupture-prone plaque considered at higher risk than calcified variants.

To assess the drug's impact, researchers utilized advanced imaging techniques such as positron emission tomography (PET) with radioactive sodium fluoride and coronary computed tomography angiography (CCTA), coupled with new artificial intelligence tools to measure inflammation and plaque volume. Patients received evolocumab, and after 18 months, scans revealed a significant reduction in inflammation and plaque size.

Dr. Daniel S. Berman, the study’s lead investigator, emphasized that beyond cholesterol reduction, evolocumab appears to lower arterial inflammation—a key factor in plaque instability. This inflammation decrease could be a crucial mechanism by which the drug reduces the risk of heart attacks.

The findings suggest that PCSK9 inhibitors like evolocumab not only control cholesterol levels but might also directly stabilize vulnerable plaques within the coronary arteries, providing a dual benefit in cardiovascular disease management.

This research advances our understanding of how targeted therapies can mitigate heart attack risk and highlights the importance of inflammation in coronary artery disease development. Further studies are ongoing to confirm and expand these results.

Source: https://medicalxpress.com/news/2025-05-cholesterol-drug-heart.html