Effect of PCSK9 inhibitor on plaque stability in patients with acute coronary syndrome undergoing interventional therapy
Liu Qingli
Yang Li
Niu Shaoqiong
Liu Silei
Abstract：Objective To preliminarily investigate the effect of theproprotein convertase subtilisin/kexin type 9(PSCK9)inhibitor(Evolocumab)on plaque stability in patients with acute coronary syndrome(ACS)undergoing interventional therapy.Methods This is a retrospective,single center,observational cohort study.From January 2021 to December 2022,90 ACS patients who underwent percutaneous coronary intervention were included.All patients began receiving rosuvastatin 10 mg/day at least 24 hours after the onset of ACS.Patients in the combination therapy group received Evolocumab(140 mg every 2 weeks)treatment one week after the onset of ACS.Patients in the statin monotherapy group only took rosuvastatin.Optical coherence tomography(OCT)was performed 4 and 12 weeks after emergency PCI to assess the effect of Evolocumab on fiber cap thickness(FCT)and atherosclerotic plaque progression.Results At 12 weeks of follow-up,low-density lipoprotein cholesterol(LDL-C)was lower and high-density lipoprotein cholesterol(HDL-C)was higher in the combination therapy group compared with the statin monotherapy group(P＜0.05).Compared with the statin monotherapy group,the reduction values of total cholesterol(TC)and LDL-C(δ TC and δ LDL-C)were lower in the combination therapy group,but the increase values of HDL-C(δ HDL-C)were higher(P＜0.05).OCT analysis showed a greater minimum FCT at 4 weeks of follow-up in the combination group compared with the statin monotherapy group(P＜0.05).At 12 weeks of follow-up,the minimum FCT in the combination group was greater than that in the statin monotherapy group,while the maximum lipid arc and lipid plaque length were lower than those in the statin monotherapy group(P＜0.05).Conclusion Adding PCSK9 inhibitors to statin therapy may lead to an increase in FCT and the regression of lipid rich plaques,and the decrease in LDL-C levels is more significant.
Keywords：Acute coronary syndromeEvolocumabPlaque stabilityFiber cap thicknessLow density lipoprotein cholesterol
Publication Date：2025-02-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 180-184 )