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PCSK9抑制剂在心血管高危患者中的应用价值：一项荟萃分析

Application Value of PCSK9 Inhibitor in Cardiovascular High Risk Patients: A Meta-Analysis.

作者信息

Zhao Liming, Liu Ying, Cao Ziting, Wang Jun, Huo Xin

机构信息

Department of Vascular Surgery, Liu Zhou People's Hospital, Guangxi, 545006, China.

Department of Endocrinology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi, China.

出版信息

Iran J Public Health. 2023 May;52(5):903-912. doi: 10.18502/ijph.v52i5.12707.

DOI:10.18502/ijph.v52i5.12707
PMID:37484718
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10362201/
Abstract

BACKGROUND

Proprotein convertase subtilisin / Kexin type 9 (PCSK9) inhibitors are efficacious lipid-lowering agents. This drug is related to improving the prognosis of patients with cardiovascular disease (CVD). The purpose of this meta-analysis was to systematically analyze the safety and efficacy of PCSK9 inhibitors in all published randomized controlled trials (RCTs).

METHODS

As of October 25, 2021, we searched PubMed, EMBASE, MEDLINE, Cochrane Library and web of science.

RESULTS

From 684 articles, we included 11 trials for meta-analysis, including 52511 participants (26938 in the PCSK9 inhibitor group and 25573 in the control group). In terms of effectiveness, PCSK9 inhibitors reduced the risk of major adverse cardiovascular events(MACE) (OR=0.89, 95% Cl: 0.83-0.95, =0.0009), but did not significantly reduce the risk of cardiovascular death (OR=0.95, 95% Cl: 0.84-1.07, =0.38) or all-cause death (OR=0.93, 95% Cl: 0.85-1.03, =0.18); In terms of safety, PCSK9 did not increase the risk of treatment-emergent adverse events (TEAE)(OR=0.98, 95% Cl: 0.94-1.02, =0.28).

CONCLUSION

PCSK9 inhibitors can significantly reduce the risk of MACE in patients with high cardiovascular risk, which is well tolerated, but the impact on the risk of death is unclear.

摘要

背景

前蛋白转化酶枯草溶菌素/克新9型（PCSK9）抑制剂是有效的降脂药物。该药物与改善心血管疾病（CVD）患者的预后有关。本荟萃分析的目的是系统分析PCSK9抑制剂在所有已发表的随机对照试验（RCT）中的安全性和有效性。

方法

截至2021年10月25日，我们检索了PubMed、EMBASE、MEDLINE、Cochrane图书馆和科学网。

结果

从684篇文章中，我们纳入了11项试验进行荟萃分析，包括52511名参与者（PCSK9抑制剂组26938名，对照组25573名）。在有效性方面，PCSK9抑制剂降低了主要不良心血管事件（MACE）的风险（OR=0.89，95%CI：0.83-0.95，P=0.0009），但未显著降低心血管死亡风险（OR=0.95，95%CI：0.84-1.07，P=0.38）或全因死亡风险（OR=0.93，95%CI：0.85-1.03，P=0.18）；在安全性方面，PCSK9未增加治疗中出现的不良事件（TEAE）风险（OR=0.98，95%CI：0.94-1.02，P=0.28）。

结论

PCSK9抑制剂可显著降低心血管高危患者发生MACE的风险，耐受性良好，但对死亡风险的影响尚不清楚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/0211de71ae16/IJPH-52-903-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/9cf3aafd4b17/IJPH-52-903-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/5b9428faeddc/IJPH-52-903-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/fdc384e644b1/IJPH-52-903-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/5432424a752e/IJPH-52-903-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/0211de71ae16/IJPH-52-903-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/9cf3aafd4b17/IJPH-52-903-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/5b9428faeddc/IJPH-52-903-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/fdc384e644b1/IJPH-52-903-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/5432424a752e/IJPH-52-903-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb7/10362201/0211de71ae16/IJPH-52-903-g005.jpg

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New Trends in Dyslipidemia Treatment.血脂异常治疗的新趋势。
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