Obesity, ASCVD and PCSK9 Inhibition: What FOURIER Really Shows
Pablo Corral, Pharmacology Professor at FASTA University, Past President of Argentine Lipid Society, shared on LinkedIn:
”Obesity, ASCVD and PCSK9 Inhibition: What FOURIER Really Shows
Obesity = higher cardiovascular risk. In the placebo arm, every +5 BMI units above 30 kg/m² increased MACE risk by 11%.
Benefit of evolocumab grows as BMI increases.
•BMI <30: 11% RRR, ARR 1.4%
•BMI 30–34.9: 14% RRR, ARR 1.8%
•BMI ≥35: 29% RRR, ARR 5.7%, NNT = 17 at 3 years
LDL-C lowering remains equally powerful across all BMI categories (≈–56% to –61%). Obesity didn’t blunt the lipid response.
Inflammation amplifies risk. Highest MACE rates occurred in patients with both obesity and elevated hsCRP (>3 mg/L) – and this group also derived the largest benefit from evolocumab.
Key insight: Obesity appears to create an “atherogenic + inflammatory” residual-risk phenotype that is highly modifiable with intensive LDL-C lowering.
Clinical message: For ASCVD patients with obesity – particularly those with class 2–3 obesity or high hsCRP – PCSK9 inhibition is not optional; it’s essential.
Open access.”
Title: Obesity-Associated Cardiovascular Risk and Benefit From PCSK9 Inhibition: A Prespecified Analysis From FOURIER
Authors: Yu Mi Kang, Robert P. Giugliano, Anthony C. Keech, J. Antonio G. López, Maria Laura Monsalvo, E. Magnus Ohman, Xinhui Ran, Sabina A. Murphy, Marc S. Sabatine, and Michelle L. O’Donoghue
Stay updated with Hemostasis today.
-
Mar 17, 2026, 18:11Ossama Mansour: Landmark MENA Guidelines for Acute Ischemic Stroke Management
-
Mar 17, 2026, 17:48Andrea Van Beek: Improving DOAC Adherence Saves Lives
-
Mar 17, 2026, 17:43Soumen Bhattacharyya: Microangiopathic Hemolytic Anemia Is Often a Hematologic Clue to Underlying Malignancy
-
Mar 17, 2026, 17:37Peter Bou Dib: New Insights on Factor VIII and the Musculoskeletal System
-
Mar 17, 2026, 17:31Armghan Ans: The 2026 Stroke Guidelines Are Excellent, Now the Hard Part
-
Mar 17, 2026, 17:26Danny Hsu: Navigating a Rebalanced Hemostatic State in Decompensated Cirrhosis
-
Mar 17, 2026, 17:21Matías J Alet on Acute Ischemic Stroke With Low NIHSS at NeuroQuality
-
Mar 17, 2026, 17:16S1PR4 Controls Platelet Fibrinogen Binding and Thrombus Formation – JTH
-
Mar 17, 2026, 15:55Mostafa Faisal Mohammed Saleh: Evidence-Based Recommendations for Hodgkin Lymphoma Management in LMICs