Evolocumab in Patients With Multivessel Coronary Disease After Acute Myocardial Infarction: A Target Trial Emulation

Effect of Evolocumab on Non-culprit Coronary Lesions in Patients With Multivessel Disease Following Acute Myocardial Infarction: A Target Trial Emulation

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT06740552

Acronym

EVEREST

Enrollment

1862

Registered

2024-12-18

Start date

2021-01-01

Completion date

2025-10-31

Last updated

2026-02-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Multivessel Coronary Artery Disease, Acute Myocardial Infarction (AMI)

Keywords

evelocumab, non-culprit vessel, multivessel coronary artery disease, acute myocardial infarction, outcome, target trial emulation

Brief summary

The goal of this Target Trial Emulation (TTE) study is to evaluate the effect of evolocumab on clinical prognosis in patients with multivessel disease (MVD) following acute myocardial infarction (AMI) who have deferred non-culprit vessel. The main question it aims to answer is: Does evolocumab lower risks of major adverse cardiovascular events (MACE) in patients with deferred non-culprit vessel after AMI?

Detailed description

This study aims to investigate the potential prognostic benefits of evolocumab in patients with MVD after AMI at 2-year follow-up. The primary endpoint is MACE, defined as a composite of cardiac death, myocardial infarction, stroke, angina-driven coronary revascularization, and rehospitalization for heart failure. This is a multicentre, cohort-based TTE study and the target RCT is the FOURIER trial.

Interventions

DRUGEvolocumab

Evolocumab 140mg every two weeks

DRUGLipid Lowering Medication

Any lipid lowering medication, including statin, ezetimibe, fibrates and etc.

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Age ≥18 years old; * Acute myocardial infarction diagnosed at hospital admission; * Multivessel coronary artery disease diagnosed at primary invasive coronary angiography; * Culprit vessel successfully revascularized; * At lease 1 non-culprit vessel with ≥50% stenosis and deferred at the opinion of the operator, and no staged revascularization within 6 months.

Exclusion criteria

* Cardiac shock, hemodynamically unstable, or severe heart failure (Killip IV) * Any cardiac surgery within 6 weeks prior to screening; * Moderate to severe renal dysfunction, defined as an estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73m\^2 at screening; * Contraindication or allergy to iodinated contrast agent; * Malignancy except non-melanoma skin cancers, cervical, or breast ductal carcinoma in situ within the last 5 years; * Female subject is pregnant or breastfeeding or planning to become pregnant or breastfeed in short term.

Design outcomes

Primary

Measure	Time frame	Description
MACE	2 years	A composite of cardiac death, myocardial infarction, and rehospitalization for heart failure.

Secondary

Measure	Time frame	Description
Death	2 years	All-cause death
Myocardial infarction	2 years	Myocardial infarction denotes the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia, according to the Fourth Universal Definition of Myocardial Infarction (2018).
Rehospitalization for heart failure	2 years	Readmissions due to symptoms from clinically diagnosed heart failure with or without reduced left ventricular ejection fraction.

Countries

China

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026