An innovative new drug can prevent heart attacks and strokes by cutting bad cholesterol to unprecedented levels, doctors say.
The British Heart Foundation said the findings were a significant advance in fighting the biggest killer in the world, with about 15 million people dying each year from heart attacks or stroke.
Bad cholesterol is the villain in heart world. It leads to blood vessels furring up, becoming easy to block, which fatally starves the heart or brain of oxygen.
That is why millions of people take drugs called statins to reduce the amount of bad cholesterol.
However, new drug evolocumab changes the way the liver works to also cut bad cholesterol.
The results of a large international trial on 27,000 patients paved the way for the drug to become available to millions of people.
The UK section of the trial was organised by Imperial College London professor Peter Sever, with funding from the drug company Amgen.
"It is much more effective than statins," he said.
"The end result was cholesterol levels came down and down and down, and we've seen cholesterol levels lower than we have ever seen before in the practice of medicine."
The patients in the trial were already taking statins, and their risk was cut further by the new therapy.
"They would have another 20 percent reduction in risk, and that is a big effect," Prof Sever said.
"It is probably the most important trial result of a cholesterol-lowering drug in over 20 years."
British Heart Foundation medical director Nilesh Samani said the trial was a significant advance.
"However, the trial was stopped early after only 2.2 years of average follow-up," Sir Nilesh said.
"And therefore it is difficult to be certain about the actual extent of the longer-term benefit, including the impact on dying from heart disease, as well as longer-term safety."
The findings were published in the New England Journal of Medicine and also reported at a meeting of the American College of Cardiology.
The study showed one heart attack or stroke was prevented for every 74 patients taking the drug in the two-year trial.
How does it work?
Evolocumab is an antibody, just like the weapons used by the immune system to fight infection, but has been designed to target a protein in the liver with the name PCSK9.
Ultimately it makes the organ better at taking bad cholesterol from the blood and breaking it down.
Other trials have shown such antibodies have cut bad cholesterol levels by 60 percent, and Amgen is not the only company looking at this approach.
The antibody injected into the skin every two to four weeks.
However, the new drug would be unlikely to replace the current treatment, statins, Prof Sever said.
"There are an awful lot of people with really quite high cholesterol out there and we'll probably need more than one drug to get their levels down."