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在 ACS 患者中的 PCSK9 抑制剂的院内应用：证据表明了什么？

In-Hospital Use of PCSK9 Inhibitors in the Post ACS Patient: What Does the Evidence Show?

机构信息

CPC Clinical Research, 2115 N Scranton Street #2040, Aurora, CO, 80045-7120, USA.

Division of Cardiology, Department of Medicine, University of Colorado, 12631 East 17th Avenue, B130, Aurora, CO, 80045, USA.

出版信息

Curr Atheroscler Rep. 2023 Jul;25(7):381-389. doi: 10.1007/s11883-023-01112-3. Epub 2023 May 24.

DOI:10.1007/s11883-023-01112-3
PMID:37223853
Abstract

PURPOSE OF REVIEW: The purpose of this review is to analyze and discuss the most recent data on in hospital prescription of Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitors in patients with acute coronary syndrome (ACS). RECENT FINDINGS: Recent randomized clinical trials (RTCs) have demonstrated a beneficial effect of monoclonal antibodies (mAb) PCSK9i prescription in patients with ACS on rapid reduction of low-density lipoprotein cholesterol (LDL-C) and on coronary atherosclerosis assessed by intracoronary imaging. Additionally, the safety profile of mAb PCSK9i was confirmed in all RTCs. Available RCTs show the effectiveness and rapid achievement of LDL-C levels according to American College of Cardiology/American Heart Association and European Society of Cardiology guidelines for ACS patients. However, RCTs addressing cardiovascular outcomes of PCSK9i in-hospital initiation in ACS patients are currently ongoing.

摘要

目的综述：本综述旨在分析和讨论急性冠状动脉综合征（ACS）患者住院时开具前蛋白转化酶枯草溶菌素/糜蛋白酶 9（PCSK9）抑制剂的最新数据。

最新发现：最近的随机临床试验（RCT）表明，ACS 患者使用单克隆抗体（mAb）PCSK9i 处方可迅速降低 LDL-C，通过冠状动脉内成像评估冠状动脉粥样硬化，具有有益作用。此外，mAb PCSK9i 在所有 RCT 中的安全性特征得到了证实。现有的 RCT 表明，根据美国心脏病学会/美国心脏协会和欧洲心脏病学会的 ACS 患者指南，mAb PCSK9i 可有效且快速降低 LDL-C 水平。然而，目前正在进行 RCT 以评估 ACS 患者住院时开始使用 PCSK9i 的心血管结局。

相似文献

[1]
In-Hospital Use of PCSK9 Inhibitors in the Post ACS Patient: What Does the Evidence Show?

Curr Atheroscler Rep. 2023-7

[2]
New LDL-cholesterol lowering therapies: pharmacology, clinical trials, and relevance to acute coronary syndromes.

Clin Ther. 2013-8-8

[3]
Impact of early initiation of proprotein convertase subtilisin/kexin type 9 inhibitors in patients with acute coronary syndrome: A systematic review meta-analysis.

Indian Heart J. 2023

[4]
Lipid management in ACS: Should we go lower faster?

Atherosclerosis. 2018-6-22

[5]
Lipid-lowering treatment up to one year after acute coronary syndrome: guidance from a French expert panel for the implementation of guidelines in practice.

Panminerva Med. 2023-6

[6]
Proprotein convertase subtilisin/kexin type 9 inhibition after acute coronary syndrome or prior myocardial infarction.

Curr Opin Lipidol. 2022-6-1

[7]
Pharmacological rationale for the very early treatment of acute coronary syndrome with monoclonal antibodies anti-PCSK9.

Pharmacol Res. 2022-10

[8]
Low-Density Lipoprotein Cholesterol After an Acute Coronary Syndrome: How Low to Go?

Curr Cardiol Rep. 2019-6-27

[9]
Effect of alirocumab, a monoclonal antibody to PCSK9, on long-term cardiovascular outcomes following acute coronary syndromes: rationale and design of the ODYSSEY outcomes trial.

Am Heart J. 2014-8-7

[10]
Early administration of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis.

BMC Cardiovasc Disord. 2024-7-30

本文引用的文献

[1]
Proprotein convertase subtilisin/kexin type 9 inhibition after acute coronary syndrome or prior myocardial infarction.

Curr Opin Lipidol. 2022-6-1

[2]
Statin intolerance: how common is it and how do we work with patients to overcome it?

Eur Heart J. 2022-9-7

[3]
Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol.

N Engl J Med. 2020-3-18

[4]
Cost-effectiveness analysis of PCSK9 inhibitors in cardiovascular diseases: a systematic review.

Heart Fail Rev. 2020-11

[5]
Effect of Alirocumab on Coronary Atheroma Volume in Japanese Patients With Acute Coronary Syndrome　- The ODYSSEY J-IVUS Trial.

Circ J. 2019-8-20

[6]
PCSK9 and inflammation: a review of experimental and clinical evidence.

Eur Heart J Cardiovasc Pharmacother. 2019-10-1

[7]
Lipoprotein(a), PCSK9 Inhibition, and Cardiovascular Risk.

Circulation. 2019-3-19

[8]
2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

J Am Coll Cardiol. 2019-6-25

[9]
Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome.

N Engl J Med. 2018-11-7

[10]
Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease: Insights From the FOURIER Trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk).

Circulation. 2017-11-13

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