The clinical effect of proprotein convertase subtilisin/kexin type 9 inhibitors combined with atorvastatin in the treatment of patients with angina pectoris after percutaneous coronary intervention

Li Yingxu; Wang Linlin; Pei Xiaohui; Li Minghui; Zhang Na

doi:10.3760/j.issn.1673-4777.2025.12.004

Abstract：Objective To observe the effect of proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors combined with atorvastatin on angina pectoris after percutaneous coronary intervention(PCI).Methods A total of 225 patients with angina pectoris after PCI in the Department of Cardiology,The Second People's Hospital of Hengshui,Hebei Province from April 2022 to April 2024 were selected.According to the random number table method,they were divided into the control group(112 cases)and the observation group(113 cases).The control group was treated with atorvastatin,and the observation group was treated with atorvastatin combined with PCSK9 inhibitors evolocumab.Both groups were treated for 24 weeks.Blood lipids,cardiac function,inflammatory factors,Seattle angina questionnaire(SAQ)score,adverse drug reactions(ADR)and follow-up were compared between the two groups.Results There were 2 cases in the control group and 3 cases in the observation group who dropped out,respectively.After 4,12 and 24 weeks of treatment,the levels of low-density lipoprotein cholesterol(LDL-C),lipoprotein(a),left ventricular end-systolic diameter(LVESD),interleukin-1β(IL-1β)and IL-6 in the two groups were lower than those before treatment.After 12 and 24 weeks of treatment,the levels of LDL-C,lipoprotein(a),LVESD,IL-1β and IL-6 in the two groups were lower than those after 4 weeks of treatment and 24 weeks of treatment.The levels of LDL-C,lipoprotein(a),LVESD,IL-1β and IL-6 in both groups were lower than those in 12 weeks(all P＜0.05).The levels of LDL-C,lipoprotein(a),LVESD,IL-1β and IL-6 in the observation group were lower than those in the control group at 4,12 and 24 weeks after treatment(all P＜0.05).After 4,12 and 24 weeks of treatment,stroke volume(SV),left ventricular ejection fraction(LVEF)and SAQ scores of the two groups were higher than those before treatment.After 12 and 24 weeks of treatment,the SV,LVEF and SAQ scores of the two groups were higher than those after 4 weeks of treatment.After 24 weeks of treatment,the SV,LVEF and SAQ scores of both groups were higher than those after 12 weeks of treatment(all P＜0.05).The SV,LVEF and SAQ scores of the observation group were higher than those of the control group at 4,12 and 24 weeks of treatment(all P＜0.05).There was no significant difference in the total incidence of ADR between the two groups(P＞0.05).After 12 weeks of follow-up,the incidences of secondary stent implantation and readmission in the observation group were lower than those in the control group[10.0％(11/110)vs 21.8％(24/110),9.1％(10/110)vs 19.1％(21/110)](x2=5.742,P=0.017;x2=4.543,P=0.033).After 24 weeks of follow-up,the incidence of secondary stent implantation and readmission in the observation group was lower than that in the control group[14.6％(16/110)vs 27.3％(30/110),12.7％(14/110)vs 24.6％(27/110)](x2=5.387,P=0.020;x2=5.066,P=0.024).Conclusion PCSK9 inhibitors combined with atorvastatin is effective in the treatment of angina pectoris after PCI,which can improve blood lipid and cardiac function,regulate inflammatory factors,increase SAQ score,reduce secondary stent implantation,and also reduce readmission of patients with angina pectoris after PCI,and does not increase ADR.