Choi Seung Woo, Kim Joan, Jang Gyeong Won, Lee Young Shin, Park Jin Sun, Lee Jung Myung, Kim Hyung Oh, Chung Hyemoon, Woo Jong Shin, Kim Woo Shik, Kim Weon
Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul 02447, Korea.
Department of Medicine, Graduate School of Medicine, Kyung Hee University, Seoul 02447, Korea.
J Cardiovasc Dev Dis. 2022 Mar 27;9(4):101. doi: 10.3390/jcdd9040101.
Background: Several studies have shown that high plasma lipoprotein(a) concentrations are associated with an increased risk of arteriosclerotic cardiovascular disease. Thus, Lp(a) has emerged as a new therapeutic target. Circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are new lipid-lowering agents that reduce low-density lipoprotein cholesterol as well as Lp(a). Methods: We analyzed the short-term effects of one-time administration of evolocumab (a PCSK9 inhibitor) on the lipid profiles (especially Lp(a)) and inflammatory markers in Korean patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). Sixty-four patients with CAD who underwent PCI were enrolled in this trial. Evolocumab (140 mg) was administered to patients within 24 h after PCI. Lipid profiles and inflammatory marker levels were measured at baseline and 2 weeks later. Results: The PCSK9 inhibitor significantly reduced the baseline levels of Lp(a) (−9.2 mg/dL, p < 0.001), but high-sensitivity C-reactive protein (+0.07 mg/dL, p = 0.272) was not significantly different after 2 weeks. In patients with an Lp(a) level of 50 mg/dL or more, the Lp(a) level decreased significantly by approximately 30%, from 95.6 mg/dL to 67.0 mg/dL (p < 0.001). Conclusions: One-time PCSK9 inhibitor treatment may be effective in lowering Lp(a) levels in Korean patients in the short term.
多项研究表明，高血浆脂蛋白(a)浓度与动脉粥样硬化性心血管疾病风险增加相关。因此，脂蛋白(a)已成为一个新的治疗靶点。循环中的前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂是新型降脂药物，可降低低密度脂蛋白胆固醇以及脂蛋白(a)。方法：我们分析了一次性给予依洛尤单抗（一种PCSK9抑制剂）对接受经皮冠状动脉介入治疗（PCI）的韩国冠心病（CAD）患者血脂谱（尤其是脂蛋白(a)）和炎症标志物的短期影响。64例接受PCI的CAD患者纳入本试验。依洛尤单抗（140mg）在PCI术后24小时内给予患者。在基线和2周后测量血脂谱和炎症标志物水平。结果：PCSK9抑制剂显著降低了脂蛋白(a)的基线水平（-9.2mg/dL，p<0.001），但2周后高敏C反应蛋白升高（+0.07mg/dL，p=0.272），差异无统计学意义。在脂蛋白(a)水平为50mg/dL及以上的患者中，脂蛋白(a)水平显著降低约30%，从95.6mg/dL降至67.0mg/dL（p<0.001）。结论：一次性PCSK9抑制剂治疗可能在短期内有效降低韩国患者的脂蛋白(a)水平。
