Evolocumab and Cardiovascular Events in Patients With Diabetes Without Known Significant Atherosclerosis

To the Editor To me, the principal unanswered question raised by the Effect of Evolocumab in Patients at High Cardiovascular Risk Without Prior Myocardial Infarction or Stroke (VESALIUS-CV) trial is whether that trial supports use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition for primary prevention in high-risk patients or whether its findings are partly driven by incomplete optimization of conventional lipid-lowering therapy. In this study, 84% to 85% of participants recei...