Li Yiming, Sun Minni, Li Ran, Dou Min, Dong Haozhe, Xue Liqi, Sun Guoju
Department of Cardiovascular Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450000, China.
Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450000, China.
J Clin Biochem Nutr. 2023 Nov;73(3):249-254. doi: 10.3164/jcbn.23-45. Epub 2023 Sep 1.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new class of potent lipid-lowering drugs. Oxidized low-density lipoprotein (ox-LDL) is the key pathogenic factor leading to atherosclerosis. However, its effect on ox-LDL levels has not been clinically reported. The clinical data of 290 very high-risk atherosclerotic cardiovascular disease (ASCVD) patients diagnosed in the First Affiliated Hospital of Zhengzhou University from May 2022 to October 2022 were collected retrospectively. According to whether evolocumab (a PCSK9 inhibitor) was used after percutaneous coronary intervention (PCI), they were divided into evolocumab group (153 cases) and statin monotherapy group (137 cases). At hospital admission, ox-LDL, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoproteinA1 (apoA1), apolipoprotein B-100 (apoB), lipoprotein (a) [Lp(a)], and high-sensitivity reactive protein (hs-CRP) levels were collected and used as baseline data. After two weeks of treatment, ox-LDL in the evolocumab group and statin monotherapy group were significantly lower than those before treatment (<0.05). The decrease of ox-LDL in the evolocumab group was more than in the stain monotherapy group (<0.05). In conclusion, PCSK9 inhibitors reduce ox-LDL levels in very high-risk ASCVD patients in a short time.
前蛋白转化酶枯草溶菌素/kexin 9型(PCSK9)抑制剂是一类新型强效降脂药物。氧化型低密度脂蛋白(ox-LDL)是导致动脉粥样硬化的关键致病因素。然而,其对ox-LDL水平的影响尚未见临床报道。回顾性收集了2022年5月至2022年10月在郑州大学第一附属医院确诊的290例极高危动脉粥样硬化性心血管疾病(ASCVD)患者的临床资料。根据经皮冠状动脉介入治疗(PCI)后是否使用依洛尤单抗(一种PCSK9抑制剂),将患者分为依洛尤单抗组(153例)和他汀类单药治疗组(137例)。入院时,收集ox-LDL、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B-100(apoB)、脂蛋白(a)[Lp(a)]和高敏反应蛋白(hs-CRP)水平作为基线数据。治疗两周后,依洛尤单抗组和他汀类单药治疗组的ox-LDL均显著低于治疗前(<0.05)。依洛尤单抗组ox-LDL的下降幅度大于他汀类单药治疗组(<0.05)。综上所述,PCSK9抑制剂可在短时间内降低极高危ASCVD患者的ox-LDL水平。