Deedwania P, Murphy SA, Scheen A, et al. - In the FOURIER randomized clinical trial, the PCSK9 inhibitor evolocumab was identified reducing low-density lipoprotein cholesterol and cardiovascular events. Increased cardiovascular risk is identified in patients with metabolic syndrome (MetS). Researchers conducted this prespecified analysis of the FOURIER randomized clinical trial of patients with atherosclerotic cardiovascular disease receiving statin with the aim to determine outcomes with evolocumab in patients with and without MetS. Risk for cardiovascular events was noted to be higher in 16,361 individuals with MetS relative to 10,981 patients without MetS. These high-risk patients exhibited significant reduction in low-density lipoprotein cholesterol and cardiovascular risk in correlation with receiving evolocumab, vs placebo, with no increase in the risk of safety events, new-onset diabetes, or worsening glycemic control. Data thereby suggest the safety and efficacy of adding evolocumab to statin therapy in patients with atherosclerotic cardiovascular disease and MetS for reducing residual cardiovascular risk.