BC 074 – Évolocumab chez les patients à risque cardiovasculaire élevé (étude VESALIUS-CV)

Épisode de BaladoCritique - club de lecture médical par Dr Luc Lanthier et collaborateurs · 17 décembre 2025 · 50 min

Dans cette 74e baladodiffusion, les Drs Alexandre Mutchmore et Luc Lanthier discutent de l’efficacité de l’évolocumab, un inhibiteur des PCSK9, chez les sujets à haut risque cardiovasculaire, en plus de réviser la littérature médicale d’octobre et novembre 2025.

Quiz clinique (4 min 16), présentation principale (5 min 28), critique (27 min 19), retour sur le cas clinique (37 min 43), autres articles (40 min 32), réponse au quiz clinique (45 min 45).

Référence principale :

Bohula EA, Marston NA, Bhatia AK, De Ferrari GM, Leiter LA, Nicolau JC, et al; VESALIUS-CV Investigators. Evolocumab in Patients without a Previous Myocardial Infarction or Stroke. N Engl J Med. 2025 Nov 8. doi: 10.1056/NEJMoa2514428. Epub ahead of print. PubMedPMID: 41211925.

Articles associés :

Ibanez B, Latini R, Rossello X, Dominguez-Rodriguez A, Fernández-Vazquez F, Pelizzoni V, et al. Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction. N Engl J Med. 2025;393(19):1889-1900. PubMed PMID: 40888702.

Munkhaugen J, Kristensen AMD, Halvorsen S, Holmager T, Olsen MH, Bakken A, et al. Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. N Engl J Med. 2025;393(19):1901-1911. PubMed PMID: 40888716.

Rossello X, Prescott EIB, Kristensen AMD, Latini R, Fuster V, Fagerland MW, et al. β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials. Lancet. 2025;406(10508):1128-1137. PubMed PMID: 40897190.

Kristensen AMD, Rossello X, Atar D, Yndigegn T, Kimura T, Latini R, et al; Beta-Blocker Trialists’ Collaboration Study Group.. Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction. N Engl J Med. 2025 Nov 9. doi: 10.1056/NEJMoa2512686. Epub ahead of print. PubMed PMID: 41211954.

Deanfield J, Lincoff AM, Kahn SE, Emerson SS, Lingvay I, Scirica BM, et al.

Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial. Lancet. 2025;406:2257-2268. PubMed PMID: 41138739.

Ndumele CE, Blumenthal RS. VESALIUS and the Anatomy of High-Risk Prevention. N Engl J Med. 2025;393(19):eEditorial. doi:10.1056/NEJMe2515447. PubMed PMID: 41211946.

Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, et al; FOURIER Steering Committee and Investigators. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376(18):1713-1722. PubMed PMID: 28304224.

Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, et al; ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379(22):2097-2107. PubMed PMID: 30403574.

Autres articles d’intérêt récent :

Kim D, Shim J, Choi EK, Oh IY, Kim J, Lee YS, et al. Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial. JAMA. 2025;334(14):1246-1254. PubMed PMID: 40886309.

Lemesle G, Didier R, Steg PG, Simon T, Montalescot G, Danchin N, et al. Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation: The AQUATIC Trial. N Engl J Med. 2025;393(16):1578-1588. PubMed PMID: 40888725.

Flack JM, Azizi M, Brown JM, Dwyer JP, Fronczek J, Jones ES, et al. Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension. N Engl J Med. 2025;393(14):1363-1374. PubMed PMID: 40888730.

McLaughlin VV, Hoeper MM, Badesch DB, Ghofrani HA, Gibbs JSR, Gomberg-Maitland M, et al. Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis. N Engl J Med. 2025;393(16):1599-1611. PubMed PMID: 41025556.

Wharton S, Aronne LJ, Stefanski A, Alfaris NF, Ciudin A, Yokote K, et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. N Engl J Med. 2025;393(18):1796-1806. PubMed PMID: 40960239.

Guimarães PO, Franken M, Tavares CAM, Antunes MO, Silveira FS, Andrade PB, et al. Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes. N Engl J Med. 2025;393(21):2095-2106. PubMed PMID: 40888723.

Tarantini G, Honton B, Paradies V, Lemesle G, Range G, Godin M, et al. Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction. N Engl J Med. 2025;393(21):2083-2094. PubMed PMID: 40888726.

Fitz-Patrick D, McVinnie DS, Jackson LA, Crowther G, Geevarughese A, Cannon KD, et al; Pfizer C4781004 Trial Investigators. Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine. N Engl J Med. 2025;393(20):2001-2011. PubMed PMID: 41259756.

Guides de pratique :

Virani S, Zieroth S, Aleksova N, Anderson K, Clarke B, Ducharme A, Ezekowitz JA, Foroutan F, Giannetti N, Jain R, et al. Canadian Cardiovascular Society/Canadian Heart Failure Society 2025 Guideline Update for Pharmacologic Management of Heart Failure With Nonreduced Ejection Fraction (LVEF > 40%). Can J Cardiol. 2025;41(10):1857-74. PubMed PMID: 41110921.

Shih AW, Schnell G, Belley-Côté E, Lett R, Peretz-Larochelle M, Tinmouth A. Canadian Cardiovascular Society and National Advisory Committee on Blood and Blood Products Joint Statement on Blood Utilization and Transfusion for Patients With Acute Coronary Syndromes. Can J Cardiol. 2025;41(10):1875–1884. PubMed PMID: 41110922.

Schulz-Menger J, Collini V, Gröschel J, Adler Y, Brucato A, Christian V, Ferreira VM, Gandjbakhch E, Heidecker B, Kerneis M, et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis: Developed by the task force for the management of myocarditis and pericarditis of the European Society of Cardiology (ESC) endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2025;46(40):3952-4041. PubMed PMID: 40878297.

Staller K, Parkman HP, Greer KB, Leiman DA, Zhou MJ, Singh S, Camilleri M, Altayar O; AGA Clinical Guidelines Committee. AGA Clinical Practice Guideline on Management of Gastroparesis. Gastroenterology. 2025;169(5):828-61. PubMed PMID: 40976635.

Kidney Disease: Improving Global Outcomes (KDIGO) IgAN and IgAV Work Group. KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). Kidney Int. 2025;108(4S):S1–S71. PubMed PMID: 40975564.

Praz F, Borger MA, Lanz J, Marin-Cuartas M, Abreu A, Adamo M, et al. 2025 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2025;46(44):4635-4736. PubMed PMID: 40878295.

Mach F, Koskinas KC, Roeters van Lennep JE, Tokgözoğlu L, Badimon L, Baigent C, Benn M, Binder CJ, Catapano AL, De Backer GG, et al. 2025 Focused Update of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2025;46(42):4359-78. PubMed PMID: 40878289.

Wani S, Zhou MJ, Sawas T, Rubenstein JH, Eluri S, Leiman DA, Sultan S, Singh S, Inadomi J, Thrift AP, Katzka DA, Davitkov P. AGA Clinical Practice Guideline on Surveillance of Barrett’s Esophagus. Gastroenterology. 2025;169(6):1184-1231. PubMed PMID: 41125322.

Référence du quiz clinique :

Gallant RC, Cameron L, Mithoowani S. Copper deficiency. CMAJ. 2025;197(16):E456. PubMed PMID: 40294944.

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