Add Evolocumab to high risk patient with 62 mg/dl LDL ?:  e-MedCase Discussion

A 65 Y male Patient with ACS 2 y ago, treated well  for diabetes  (HbA1c 7.1%) , for hypertension (130/80) , aspirin+prasugrel. He is on Atorvastatin 20 mg + ezetimibe and his LDL is 62 mg/dl. Attempt to increase Atorvastatin dose did'nt succeed because of muscle pain he suffered from.

 He also had a life style change with mediterian diet & daily physical activity but I still rank him as high risk patient, being over weight and in high emotional stress.  

After viewing the result of the new FOURIER study with Evolocumab I consider to add Evolocumab to his treatment although the guidelines as far as I understand does not support it yet. I'll be glad to get here your thoughts and recommendations…