Effect of evolocumab on myocardial ischemia-reperfusion injury in patients with acute myocardial in-farction
Li Li
Meng Fantong
Han Bing
Abstract：Objective To study the effect of evolocumab on myocardial ischemia-reperfusion injury(MIRI)in patients with acute myocardial infarction(AMI).Methods AMI patients(n=244)undergone emergency percutaneous coronary intervention(PCI)were retrospectively chosen from Central Hospital of Xuzhou City from June 2020 to June 2023,and divided,according to medicinal administration,into routine group(n=146)and evolocumab group(n=98).The routine group was treated with routine medicinal after PCI,and evolocumab group was additionally given hypodermic injection of evolocumab in loading dose once(420 mg)10 min before PCI,and in standard dose(140 mg/time)after 2 weeks for 3 months.The changes of blood fat,inflammatory factors,vascular endothelial function,myocardial injury indexes,heart function indexes and electrocardiogram(ECG),and the total occurrence rates of adverse events related to MIRI were recorded in 2 groups before and after PCI.Results After PCI for 6 h,the levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein-cholesterol(LDL-C)were lower,and kevel of high-density lipoprotein-cholesterol(HDL-C)was higher in evolocumab group than those in routine group after PCI for 6 h(P＜0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were lower in evolocumab group than those in routine group(P＜0.05).The levels of serum endothelin-1(ET-1)and von Willebrand factor(vWF)was lower,and level of nitric oxide(NO)was higher in evolocumab group than those in routine group(P＜0.05).The levels of creatine kinase-MB isoenzyme(CK-MB),cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular end-diastolic diameter(LVEDD)were lower,and left ventricular ejection fraction(LVEF)and stroke volume(SV)were higher in evolocumab group than those in routine group(P＜0.05).The amplitude of ST-segment elevation was lower in evolocumab group than that in routine group 10 min after PCI(P＜0.05).After PCI for 3 months,the total occurrence rates of adverse events related to MIRI were lower in evolocumab group than those in routine group(4.08％vs.11.64％).Conclusion Evolocumab can effectively reduce blood fat level,down-regulate inflammatory factors,protect vascular endothelial function,improve heart function recovery and relieve MIRI in AMI patients.
Keywords：Acute myocardial infarctionMyocardial ischemia-reperfusion injuryEvolocumabAdverse events
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1394-1397,1405 )