AMUNDSEN: immediate evolocumab after heart attack lifts LDL goal rates, misses one-year outcome

The AMUNDSEN study, presented at ESC Congress 2026 in Munich, tested immediate evolocumab before PCI in 2,161 patients with acute heart attack. At 12 months, 82% of the evolocumab group reached the LDL-C goal versus 40% on standard care. The primary intent-to-treat outcome of death or unplanned cardiovascular hospitalization at one year (14.6% versus 15.4%) was not significant, so the study does not show an early outcome benefit.

• 2,161 patients randomized
• LDL-C goal reached by 82% with evolocumab versus 40% with standard care at 12 months
• Primary intent-to-treat outcome: 14.6% versus 15.4%, not significant
• A per-protocol analysis (10.2% versus 14.3%) was described as hypothesis-generating