Objective To investigate the effects of evolocumab combined with atorvastatin on vascular endothelial function and the levels of serum soluble CD40 ligand(sCD40L),lipoprotein related phospholipase A2(Lp-PLA2)and Apelin in elderly patients with coronary heart disease(CHD).Methods A total of 204 elderly patients with CHD who received treatment at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to September 2022 were divided into the group A and the group B by random number table method,102 cases in each group.The group A was given routine treatment and Atorvastatin calcium tablets,and the group B was given evolocumab injection on the basis of the group A.Both groups continued treatment for 6 months.The clinical efficacy after 6 months of treatment,including vascular endothelial function,the levels of serum sCD40L,Lp-PLA2,Apelin,blood lipid indicators and cardiac function parameters before and after 6 months of treatment,the safety during the treatment period were compared of two groups.Results The rate of total effective in the group B after 6 months of treatment was 93.14％,which was higher than 78.43％in the group A(P＜0.05).Compared with before treatment,after 6 months of treatment,the levels of serum endothelin-1(ET-1),sCD40L,Lp-PLA2,Apelin,low-density lipoprotein cholesterol(LDL-C)and lipoprotein a[Lp(a)]in both groups decreased,and compared with the group A,the group B was lower.The levels of serum nitric oxide(NO),vascular endothelial growth factor(VEGF),flow mediated vasodilation(FMD),left ventricular ejection fraction(LVEF),and cardiac index(CI)in the two groups increased,and compared with the group A,the group B was higher(P＜0.05).The incidence of adverse reactions in the group B during the treatment period was lower than the group A(P＜0.05).Conclusion Evolocumab could significantly regulate blood lipid indicators in elderly patients with CHD,improve cardiac and vascular endothelial function,regulate the levels of serum sCD40L,Lp-PLA2,Apelin,and thereby improve clinical efficacy,with high safety.
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