Efficacy of early different combined strategies for lipid-lowering after percutaneous coronary intervention in patients with acute coronary syndrome

Liu Hao; Emmanuel Simon Kinayi; Zhang Bo

doi:10.3760/j.issn.1673-4777.2024.01.002

Abstract：Objective To compare the efficacy of early different blood lipid-lowering drug combination strategies in patients with acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).Methods Patients with ACS and underwent PCI in the First Affiliated Hospital of Dalian Medical University from January 2018 to June 2022 were selected.They were divided into group A(statin+ezetimibe),group B(statin+evolocumab),and group C(statin+ezetimibe+evolocumab)according to the lipid-lowering strategy,with 73 cases in each group.The changes in low-density lipoprotein cholesterol(LDL-C)and other blood lipid indicators among three groups of patients at baseline and at 1 and 6 months follow-up were compared.Results At 1 and 6 months follow-up,the decrease of LDL-C in group B and C was significantly greater than that in group A,the proportion of patients with LDL-C＜1.4 mmol/L and a more than 50％decrease from baseline was higher than that in group A[after 1 month of treatment:79.5％(58/73),80.8％(59/73)vs 43.8％(32/73)],the total cholesterol and apolipoprotein B levels in group B and group C were lower than those in group A,and the differences were statistically significant(all P＜0.05).However,there was no statistically significant difference between group B and group C(all P＞0.05).At 1 and 6 months follow-up,there were no statistically significant differences in levels of triacylglycerol and apolipoprotein Al among the three groups(all P＞0.05).Conclusions The combination of statin and evolocumab can quickly reduce blood lipids and increase the LDL-C compliance rate in patients with ACS undergoing PCI,moreover the effect of evolocumab combined with statin and ezetimibe in reducing LDL-C is not superior.