Peter Attia was initially skeptical that the Fourier trial would succeed because patients had a low baseline LDL of approximately 70 mg/dL, even with heavy medication, making it difficult to show a difference with PCSK9 inhibitors.

“I thought the trial would fail because the patients were coming in this was also secondary prevention so a very similar patient population to Prevail these people have an average LDL cholesterol of something like 70 milligrams per deciliter on the way in so you're taking people who are heavily drugged to LDL cholesterol of 70 milligrams per deciliter randomizing them to pcsk9 inhibitor versus placebo my thought was you can't do that study long enough to see a difference”