Efficacy and safety of PCSK9i in treatment of coronary atherosclerotic plaques:A Meta-analysis
HU Shuwen
WANG Jiangfeng
QIAO Xuan
ZHANG Shanshan
BAI Ming
NIU Xiaowei
Abstract：Objective To determine the efficacy and safety of proprotein convertase subtilisin/kexin type 9 inhibitors(PCSK9i)in treatment of coronary atherosclerotic plaques by applying a systematical evaluation method.Methods The databases of PubMed,Web of Science,Cochrane Library,EmBase,CNKI,WanFang Data,VIP and CBM were retrieved with computer from the inception of the databases until Mar.2023.All literature were screened according to inclusion and exclusion criteria,data was extracted and quality of included studies was reviewed by 2 independent evaluators.A Meta-analysis was conducted by using RevMan 5.4 software and Stata 16.0 software.Results There were totally 6 RCT included involved 2003 patients with coronary heart disease(CHD).The percent atheroma volume(PAV),(MD=-1.02,95%CI:-1.34～-0.69,P<0.001)and maximum lipid arc(MD=-11.25,95%CI:-22.39～-0.11,P=0.050)decreased,and the minimum fiber cap thickness(FCTmin),(MD=20.33 mm3,95%CI:10.73～29.93,P<0.001)and mean FCT(FCTmean),(MD=27.74,95%CI:4.56～50.91,P<0.050)increased in statin+PCSK9i therapy group compared with statin therapy group.The differences in neurocognitive impairment,new-onset diabetes and myalgia had no statistical significance between statin+PCSK9i therapy group and statin therapy group(P>0.050).The results of subgroup analysis showed that different treatment time,PCSK9i types and CHD subtypes had no significant impact on PAV results(P>0.050).The results of sensitivity analysis showed no any studies influencing PAV results(P>0.050).The results of funnel plot and Egger's test indicated no obvious publication bias.Conclusion PCSK9i combined with statins can significantly reverse plaque progression and increase plaque stability in CHD patients.It is expected that future studies will further determine whether the effect of PCSK9i on plaques can improve patient prognosis.
Keywords：PCSK9icoronary heart diseasemeta-analysisrandomized controlled trial
Publication Date：2026-01-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：7( 1-7 )