Acute effect of proprotein convertase subtilisin/kexin type 9 inhibitor on oxidized low-density lipoprotein and lipid profile in patients at cardiovascular risk

被引:0
作者
Li, Yiming [1 ]
Sun, Minni [2 ]
Li, Ran [1 ]
Dou, Min [1 ]
Dong, Haozhe [1 ]
Xue, Liqi [1 ]
Sun, Guoju [1 ]
机构
[1] Zhengzhou Univ, Affiliated Hosp 1, Dept Cardiovasc Med, Zhengzhou 450000, Henan, Peoples R China
[2] Zhengzhou Univ, Affiliated Hosp 1, Dept Emergency internal Med, Zhengzhou 450000, Henan, Peoples R China
关键词
PCSK9; inhibitor; Oxidized low-density lipoprotein; very high-risk atherosclerotic cardiovascular; lipid-lowering treatment; LDL-CHOLESTEROL; DISEASE; METAANALYSIS; EFFICACY; SAFETY;
D O I
10.3164/jcbn.23-45
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: 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. For the very high-risk Atherosclerotic cardiovascular disease (ASCVD) patients, guidelines propose stricter blood lipid control targets to reduce the recurrence of cardiovascular events.Methods: The clinical data of 290 very high-risk 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), apolipoproteinAl (apoA1), apolipoprotein B-100 (apoB), lipoprotein (a) (Lp(a)), and high-sensitivity reactive protein (hs-CRP) levels were collected and used as baseline data. The above mentioned indexes were collected from the outpatient chart approximately 2 weeks after discharge. We compared the lipid profiles and inflammatory markers between baseline and two weeks later.Results: After two weeks of treatment, TC, TG, LDL-C, apoB, and ox-LDL in the evolocumab group and statin monotherapy group were significantly lower than those before treatment (p<0.05). The decrease of TC, TG, LDL-C, apoB, and ox-LDL in the evolocumab group was more than in the stain monotherapy group (p<0.05). In the evolocumab group, the LDL-C levels decreased by approximately 64.49%. The oxLDL levels also decreased by 68.09%. The levels of TC and TG decreased 54.49% and 17.60%, respectively. The ApoB levels decreased 51.04%. However, the HDL-C and ApoAl levels were not significantly different, regardless of evolocumab administration. hs-CRP level in each group was higher than the baseline and the difference was statistically significant.Conclusion: PCSK9 inhibitors reduce ox-LDL levels in very high-risk ASCVD patients in a short time.
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收藏
页码:249 / 254
页数:6
相关论文
共 41 条
[11]   LDL oxidation by platelets propagates platelet activation via an oxidative stress-mediated mechanism [J].
Carnevale, Roberto ;
Bartimoccia, Simona ;
Nocella, Cristina ;
Di Santo, Serena ;
Loffredo, Lorenzo ;
Illuminati, Giulio ;
Lombardi, Elisabetta ;
Boz, Valentina ;
Del Ben, Maria ;
De Marco, Luigi ;
Pignatelli, Pasquale ;
Violi, Francesco .
ATHEROSCLEROSIS, 2014, 237 (01) :108-116
[12]   Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from 174 000 participants in 27 randomised trials [J].
Fulcher, Jordan ;
O'Connell, Rachel ;
Voysey, Merryn ;
Emberson, Jonathan ;
Blackwell, Lisa ;
Mihaylova, Borislava ;
Simes, John ;
Collins, Rory ;
Kirby, Adrienne ;
Colhoun, Helen ;
Braunwald, Eugene ;
La Rosa, John ;
Pedersen, T. R. ;
Tonkin, Andrew ;
Davis, Barry ;
Sleight, Peter ;
Franzosi, Maria Grazia ;
Baigent, Colin ;
Keech, Anthony ;
de Lemos, J. ;
Blazing, M. ;
Murphy, S. ;
Downs, J. R. ;
Gotto, A. ;
Clearfield, M. ;
Holdaas, H. ;
Gordon, D. ;
Koren, M. ;
Dahloef, B. ;
Poulter, N. ;
Sever, P. ;
Knopp, R. H. ;
Fellstroem, B. ;
Holdaas, H. ;
Jardine, A. ;
Schmieder, R. ;
Zannad, F. ;
Goldbourt, U. ;
Kaplinsky, E. ;
Colhoun, H. M. ;
Betteridge, D. J. ;
Durrington, P. N. ;
Hitman, G. A. ;
Fuller, J. ;
Neil, A. ;
Wanner, C. ;
Krane, V. ;
Sacks, F. ;
Moye, L. ;
Pfeffer, M. .
LANCET, 2015, 385 (9976) :1397-1405
[13]   Impact of Lipids on Cardiovascular Health JACC Health Promotion Series [J].
Ference, Brian A. ;
Graham, Ian ;
Tokgozoglu, Lale ;
Catapano, Alberico L. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2018, 72 (10) :1141-1156
[14]   Proprotein convertase subtilisin kexin type 9 and high-density lipoprotein metabolism: experimental animal models and clinical evidence [J].
Ferri, Nicola ;
Corsini, Alberto ;
Macchi, Chiara ;
Magni, Paolo ;
Ruscica, Massimiliano .
TRANSLATIONAL RESEARCH, 2016, 173 :19-29
[15]   Long-Term Safety and Efficacy of Lowering Low-Density Lipoprotein Cholesterol With Statin Therapy 20-Year Follow-Up of West of Scotland Coronary Prevention Study [J].
Ford, Ian ;
Murray, Heather ;
McCowan, Colin ;
Packard, Chris J. .
CIRCULATION, 2016, 133 (11) :1073-1080
[16]   Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE [J].
Gaba, Prakriti ;
O'Donoghue, Michelle L. ;
Park, Jeong-Gun ;
Wiviott, Stephen D. ;
Atar, Dan ;
Kuder, Julia F. ;
Im, KyungAh ;
Murphy, Sabina A. ;
De Ferrari, Gaetano M. ;
Gaciong, Zbigniew A. ;
Toth, Kalman ;
Gouni-Berthold, Ioanna ;
Lopez-Miranda, Jose ;
Schiele, Francois ;
Mach, Francois ;
Flores-Arredondo, Jose H. ;
Lopez, J. Antonio G. ;
Elliott-Davey, Mary ;
Wang, Bei ;
Monsalvo, Maria Laura ;
Abbasi, Siddique ;
Giugliano, Robert P. ;
Sabatine, Marc S. .
CIRCULATION, 2023, 147 (16) :1192-1203
[17]   Statins and PCSK9 inhibitors: A new lipid-lowering therapy [J].
Gallego-Colon, Enrique ;
Daum, Aner ;
Yosefy, Chaim .
EUROPEAN JOURNAL OF PHARMACOLOGY, 2020, 878
[18]   Association Between Circulating Oxidized LDL and Atherosclerotic Cardiovascular Disease: A Meta-analysis of Observational Studies [J].
Gao, Shen ;
Zhao, Dong ;
Wang, Miao ;
Zhao, Fan ;
Han, Xueyu ;
Qi, Yue ;
Liu, Jing .
CANADIAN JOURNAL OF CARDIOLOGY, 2017, 33 (12) :1624-1632
[19]   A Century of Cholesterol and Coronaries: From Plaques to Genes to Statins [J].
Goldstein, Joseph L. ;
Brown, Michael S. .
CELL, 2015, 161 (01) :161-172
[20]  
Grundy SM, 2019, J AM COLL CARDIOL, V73, P3168, DOI [10.1016/j.jacc.2018.11.003, 10.1016/j.jacc.2018.11.002, 10.1161/CIR.0000000000000625]