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前蛋白转化酶枯草溶菌素 9(PCSK9)抑制剂在主动脉瓣狭窄中的应用——这是否是主动脉瓣狭窄患者的一线曙光?

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in aortic stenosis - Is this the light at the end of the tunnel for patients with aortic stenosis?

机构信息

VMMC and Safdarjung Hospital, New Delhi, India.

VMMC and Safdarjung Hospital, New Delhi, India.

出版信息

Indian Heart J. 2021 Mar-Apr;73(2):249-252. doi: 10.1016/j.ihj.2021.01.017. Epub 2021 Jan 16.


DOI:10.1016/j.ihj.2021.01.017
PMID:33865531
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8065365/
Abstract

The exploratory analysis of FOURIER trial has offered a ray of hope for patients with nonrheumatic aortic stenosis (AS). At present, the only definitive treatment of severe AS is aortic valve replacement (AVR). Despite transaortic valvular replacement revolutionizing the treatment of AS, it still remains a progressive condition, with no disease-modifying pharmacotherapy. Angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, eplerenone, nitrates and statins all have been tried previously but failed to slow down the progression of aortic stenosis. Recently, there has been an emerging role of lipoprotein A [Lp(a)] in the pathogenesis of AS. This raises the possibility that long-term therapy with specific emphasis on Lp(a) reduction may reduce or slow the progression of AS.

摘要

FOURIER 试验的探索性分析为非风湿性主动脉瓣狭窄(AS)患者带来了一线希望。目前,严重 AS 的唯一确定性治疗方法是主动脉瓣置换术(AVR)。尽管经主动脉瓣置换术彻底改变了 AS 的治疗方法,但它仍然是一种进行性疾病,没有疾病修饰的药物治疗。血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、依普利酮、硝酸盐和他汀类药物以前都曾尝试过,但未能减缓主动脉瓣狭窄的进展。最近,脂蛋白 A [Lp(a)] 在 AS 的发病机制中的作用引起了关注。这就提出了一种可能性,即长期的、特别强调降低 Lp(a)的治疗可能会减少或减缓 AS 的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3147/8065365/a746649f472b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3147/8065365/a746649f472b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3147/8065365/a746649f472b/gr1.jpg

相似文献

[1]
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in aortic stenosis - Is this the light at the end of the tunnel for patients with aortic stenosis?

Indian Heart J. 2021

[2]
An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial.

JAMA Cardiol. 2020-6-1

[3]
Lp(a) in the Pathogenesis of Aortic Stenosis and Approach to Therapy with Antisense Oligonucleotides or Short Interfering RNA.

Int J Mol Sci. 2023-10-6

[4]
PCSK9 R46L Loss-of-Function Mutation Reduces Lipoprotein(a), LDL Cholesterol, and Risk of Aortic Valve Stenosis.

J Clin Endocrinol Metab. 2016-9

[5]
Proprotein convertase subtilisin/kexin type 9 levels and aortic valve calcification: A prospective, cross sectional study.

J Int Med Res. 2016-8

[6]
AMG145, a monoclonal antibody against proprotein convertase subtilisin kexin type 9, significantly reduces lipoprotein(a) in hypercholesterolemic patients receiving statin therapy: an analysis from the LDL-C Assessment with Proprotein Convertase Subtilisin Kexin Type 9 Monoclonal Antibody Inhibition Combined with Statin Therapy (LAPLACE)-Thrombolysis in Myocardial Infarction (TIMI) 57 trial.

Circulation. 2013-7-24

[7]
Dyslipidemia and aortic valve disease.

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[8]
Apolipoprotein(a) phenotype determines the correlations of lipoprotein(a) and proprotein convertase subtilisin/kexin type 9 levels in patients with potential familial hypercholesterolemia.

Atherosclerosis. 2018-10

[9]
Serum Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) is Independently Associated with Insulin Resistance, Triglycerides, Lipoprotein(a) Levels but not Low-Density Lipoprotein Cholesterol Levels in a General Population.

J Atheroscler Thromb. 2021-4-1

[10]
Predictors of functional and morphological arterial wall properties in coronary artery disease patients with increased lipoprotein (a) levels before and after treatment with proprotein convertase subtilisin-kexin type 9 inhibitors.

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引用本文的文献

[1]
Lipoprotein(a) in Cardiovascular Diseases: Insight From a Bibliometric Study.

Front Public Health. 2022

本文引用的文献

[1]
Etiology and distribution of isolated aortic stenosis in Indian patients - A study from a large tertiary care hospital in north India.

Indian Heart J. 2020

[2]
An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial.

JAMA Cardiol. 2020-6-1

[3]
Precision Medicine for Aortic Stenosis: The Future of Cardiology Today.

JACC Cardiovasc Imaging. 2019-2

[4]
Novel pharmacological targets for calcific aortic valve disease: Prevention and treatments.

Pharmacol Res. 2018-8-24

[5]
Bicuspid Aortic Valve Stenosis and the Effect of Vitamin K2 on Calcification Using F-Sodium Fluoride Positron Emission Tomography/Magnetic Resonance: The BASIK2 Rationale and Trial Design.

Nutrients. 2018-3-21

[6]
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.

N Engl J Med. 2017-3-17

[7]
Medical Treatment of Aortic Stenosis.

Circulation. 2016-11-29

[8]
PCSK9 R46L Loss-of-Function Mutation Reduces Lipoprotein(a), LDL Cholesterol, and Risk of Aortic Valve Stenosis.

J Clin Endocrinol Metab. 2016-9

[9]
Calcific aortic stenosis.

Nat Rev Dis Primers. 2016-3-3

[10]
How Does Elevated Lipoprotein(a) Cause Aortic Valve Stenosis?

J Am Coll Cardiol. 2015-9-15

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