Clinical efficacy analysis of PCSK9 inhibitors in the treatment of patients with the lower extremity arteriosclerosis obliterans

Tuo Shaoyong; Cui Ruoyu; Zhu Bolong; Zhao Zhenying; Cao Yuejuan

doi:10.26939/j.cnki.CN11-9353/R.2024.12.003

Abstract：Objective To explore the effect of early application of proprotein convertase subtilisin/kexin type 9(PCSK 9)inhibitor on atherosclerotic plaques in patients with arteriosclerosis obliterans(ASO)of the lower extremities who underwent percutaneous transluminal angioplasty(PTA).Methods A total of 100 patients,who were diagnosed with ASO(femoropopliteal segment)and underwent PTA in Tianjin Union Medical Center from December 2022 to December 2024,were included.According to the principle of random grouping,they were divided into the control group(52 cases,treated with atorvastatin)and the experimental group(48 cases,treated with PCSK9 inhibitor combined with atorvastatin).After 1 month,6 months and 12 months of treatment,the clinical efficacy of the two groups of patients was compared and analyzed,including lipid profile indicators,mainly triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDLc)and lipoprotein(a)(Lp(a));inflammatory factor indicators,mainly high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6);and vascular function-related indicators,mainly ankle brachial index(ABI),the minimum diameter of the target blood vessel,and peak systolic velocity(PSV).Results After treatment,the levels of TG,TC,LDLc and Lp(a)in the experimental group were significantly lower than those in the control group(P<0.05).Similarly,the levels of hs-CRP,TNF-α and IL-6 in the experimental group were also significantly lower than those in the control group(P<0.05).In addition,the ABI value of the experimental group after treatment was significantly higher than that of the control group(P<0.05).In terms of vascular ultrasound-related indicators,the PSV of the experimental group after treatment was significantly lower than that of the control group,the minimum lumen diameter was larger than that of the control group,and these differences were statistically significant(P<0.05).Conclusion The combined application of PCSK9 inhibitor in ASO patients can effectively inhibit the progression of plaques,and reduce the expression of inflammatory factors,thereby reduce the risk of postoperative vascular restenosis in ASO patients and improve the long-term patency rate of blood vessels,which has important clinical promotion value.