Effect on cholesterol remnants and residual lipid risk with PCSK9 inhibitors: the LIPID-REAL Registry

نویسندگان

چکیده

Abstract Background Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments. Nonetheless, effect other lipid parameters, as remnants or, so-called residual risk, are unknown. Methods Multicenter and retrospective registry patients treated with PCSK9 inhibitors from 14 different hospitals Spain. Before on-treatment parameters were recorded. Cholesterol calculated equation: total minus LDLc HDLc values ≥30 considered high. Residual risk was estimated 1) estimation LDL particle size, triglycerides/HDLc ratio (TG/HDL) <2 assumed low dense particles; 2) cholesterol/HDLc (TC/HDL) >3 high; and; 3) triglycerides-to-glucose (TG/Gluc) index, obtained natural logarithm (triglycerides * glucose/2) Results A 652 analyzed, mean age 60.0 (10.5) years 161 (24.69%) women. Baseline 149.2 (49.9) mg/dl, 29.9 (20.3) TG/HDL 3.9 (4.1), TC/HDL 4.9 (1.9) TG/Gluc index 8.9 (0.7). Most (92.3%) on statins; 54.8% ezetimibe, 8.5% fibrates. Evolocumab initiated in 318 (56.6%) patients; 229 (40.7%) alirocumab 75 mg 15 (2.7%) 150 mg. Median time to second blood determination 187.5 (IQR 101–242) days. Mean 67.46 (45.78) mg/dl what represented a 55% reduction. As shown figure, significant reduction (p=0.017), (p=0.020), (p<0.001) (p<0.001). The percentage >30 decreased: 34.62% 30.07 (p<0.01). Significant reductions also observed >2 (71.25% 61.98%; p<0.01) or (94.28% 38.97%; Conclusions This multicenter real-world demonstrates positive lipid-residual beyond reductions. Funding Acknowledgement Type funding sources: None.

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ژورنال

عنوان ژورنال: European Heart Journal

سال: 2022

ISSN: ['2634-3916']

DOI: https://doi.org/10.1093/eurheartj/ehac544.2368