Effect of PCSK9 inhibitor on lipoprotein particles in patients with acute coronary syndromes

Abstract Background To assess the effects of proprotein convertase subtilisin/kexin type 9 inhibitor (evolocumab) on lipoprotein particles subfractions with Nuclear Magnetic Resonance spectroscopy in patients acute coronary syndromes. Methods A total 99 consecutive ACS were enrolled and assigned to either experimental group (n = 54) or control 45). The combination therapy PCSK9 (Repatha®, 140 mg, q2w) moderate statin (Rosuvastatin, 10 qn) was administered group, monotherapy group. therapeutic particle assessed NMR after 8 weeks treatment, achievement LDL-C target both groups analyzed. Results In evolocumab concentrations blood lipids (TC, its [LDL-1 6], VLDL-C [VLDL-1 5], IDL-C, HDL-C), particles, their [VLDL-P, IDL-P, LDL-P, [LDL-P1 apoB, LP(a)] demonstrated benefits statistical significance ( P < 0.05). decrease LDL-P mainly due a decreased concentration small-sized LDL (LDL-P 5 + 6), which significantly more prominent than medium-sized (LDL-P3 4) large-sized (LDL-P1 2) 0.001). According lipid recommended by latest China Cholesterol Education Program Expert Consensus 2019, 96.3% 13.3% had achieved 0.01). Conclusions Evolocumab treatment for improves plasma profiles patients, might contribute pathonesis atherosclerosis.