Curative effect of an early intensive lipid-lowering on patients with high-risk acute coronary syndrome and its influence on serum levels of CTRP5,ApoB and Lp(a)

ZHEN Shengda; QIAO Fubin; ZHANG Na

doi:10.3969/j.issn.1002-7386.2025.03.010

Abstract：Objective To investigate the curative effect of an early intensive lipid-lowering on patients with high-risk acute coronary syndrome(ACS)and its influence on serum levels of C1q/tumor necrosis factor-related protein 5(CTRP5),apolipoprotein B(ApoB)and lipoprotein a(Lp[a]).Methods A total of 138 high-risk ACS patients admitted to Xingtai General Hospital of North China Medical and Health Group from January 2021 to January 2022 were selected as the study objects.They were divided into control group 1,control group 2 and combination group according to different lipid lowering schemes,with 46 cases each.Patients in the control group 1 only were treated with statins at a standard dosage,and those in control group 2 were given statins at a standard dosage plus evolocumab injections once every 4 weeks.Patients in the combination group were given statins at a standard dosage plus evolocumab injections once every 2 weeks.The treatment lasted for 6 months.Lipid-lowering effect,safety and major adverse cardiovascular events(MACE),serum CTRP5,ApoB and Lp(a)levels before and after treatment were compared among the three groups.Results Total cholesterol(TC),triglycerides(TG)and low-density lipoprotein cholesterol(LDL-C)in the combination group were significantly lower than those of control group 1 and control group 2,and they were significantly lower in the control group 2 than control group 1(P＜0.05).The LDL-C reduction level in combination group was significantly higher than that in control group 1 and control group 2,and the LDL-C reduction range and the proportion of patients with LDL-C＜1.4mmol/L were significantly greater than those in control group 1 and control group 2,especially in the control group 2(P＜0.05).After treatment,serum CTRP5,ApoB and Lp(a)levels in the three groups significantly decreased,which were significantly lower in the combination group than control group 1 and control group 2,and significantly lower in control group 2 than control group 1(P＜0.05).There were no significant differences in serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and serum creatinine(Scr)before and after treatment in all the three groups(P＞0.05).After 6 months of follow-up,the total incidence of MACE in the combination group(4.35％)and control group 2(6.52％)was significantly lower than that in control group 1(21.74％)(P＜0.05),which was comparable between combination group and control group 2(P＞0.05).Conclusion A early use of statins combined with evolocumab in an intensive lipid-lowering regimen can effectively reduce blood lipid levels in high-risk ACS patients,increase the LDL-C compliance rate,reduce serum CTRP5,ApoB and LP(a)levels,and improve their prognosis with high safety.