Study on the effect of alirocumab on pericoronary adipose tissue,pericoronary fat attenuation index(fai)and inflammatory factors in patients with acute coronary syndrome

Zhou Qiang; Fan Xiaodan; Wang Lili; Miao Hao; Wang Lele; Wang Jing; Zhang Qingdui; Hao Ji; Qi Chunmei

doi:10.3969/j.issn.1674-4055.2024.11.19

Abstract：Objective To investigate the impact of Alirocumab on pericoronary adipose tissue(PCAT)and the pericoronary adipose tissue attenuation index(FAI)in patients with acute coronary syndrome(ACS),as well as its relationship with inflammatory factors.Methods A total of 120 ACS patients admitted to our hospital from January 2022 to January 2023 were selected.They were divided into the observation group(60 cases)and the control group(60 cases)based on whether they received Alirocumab treatment.Both groups received conventional medication,and the observation group additionally received subcutaneous injections of Alirocumab at a dose of 75 mg every two weeks for a continuous treatment period of 36 weeks.Clinical data,lipid levels,PCAT ratio,FAI,serum inflammatory factor levels,and the occurrence rate of major adverse cardiovascular events(MACE)during the 36-week follow-up were compared between the two groups before and after treatment.Results There were no statistically significant differences in clinical data between the two groups before treatment(P＞0.05).After treatment,both groups showed improved lipid levels,but the observation group had significantly lower levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C),and higher levels of high-density lipoprotein cholesterol(HDL-C)compared to the control group(P＜0.05).The PCAT ratio and FAI in the observation group were lower than those in the control group,with statistical significance(P＜0.05).The levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-1 β(IL-1[3),interleukin-6(IL-6),and serum tumor necrosis factor-α(TNF-α)]in the observation group were lower than those in the control group,with statistical significance(P＜0.05).The occurrence rate of MACE in the observation group was 3.3％,significantly lower than the 15.0％in the control group(P＜0.05).The PCAT ratio was positively correlated with serum hs-CRP,IL-1 β,IL-6,and TNF-α levels(r=0.612,r=0.481,r=0.578,r=0.543,P＜0.05).Conclusion Alirocumab effectively lowers LDL-C levels in ACS patients,improves the metabolic state of pericoronary adipose tissue,enhances coronary function,inhibits inflammatory reactions,and thereby reduces the risk of cardiovascular events.