Application of different preprotein converting subtilisin/kexin type 9 inhibitors in hypercholesterolemia
Objective To explore the application value of different preprotein converting subtili-sin/kexin type 9(PCSK9)inhibitors in familial hypercholesterolemia(FH).Methods Patients with FH in our hospital were selected and divided into alirocumab group and evolocumab group according to the different PCSK9 inhibitors after excluding the confounding factors of baseline data such as gen-der and age by propensity score matching,41 patients in each group were matched.Both groups were treated for 3 months.The therapeutic effect,and blood lipids levels[triglyceride(TG),total cholester-ol(TC),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)index,apolipoprotein A1(Apo A1),apolipoprotein B(Apo B)],coronary flow reserve[absolute coronary flow reserve(CFR),relative coronary flow reserve(rCFR),fractional flow reserve(FFR)],endothelial function indicators[serum nitric oxide(NO),endothelin-1(ET-1),flow me-diated dilatation(FMD)]and adverse reactions before and after treatment were compared between both groups.Results After three months of treatment,the overall standardized rate of LDL-C in the alirocumab group was 97.56％(40/41),and 92.68％in the evolocumab group,but there was no sta-tistically significant difference between the two groups(P＞0.05).After treatment,the levels of TG,TC,LDL-C,Apo B,and ET-1 in both groups decreased,while the levels of HDL-C,Apo A1,CFR,rCFR,FFR,NO,and FMD increased.Additionally,the levels of TG,TC,LDL-C,Apo B,and ET-1 in the alirocumab group were lower than those in the evolocumab group,while the levels of HDL-C,Apo A1,CFR,rCFR,FFR,NO,and FMD were higher,and the differences were statistically sig-nificant(P＜0.05).The incidence of adverse reactions was 12.20％in the alirocumab group and 9.76％in the evolocumab group,with no statistically significant difference(P＞0.05).Conclu-sion Alirocumab or evolocumab combined with rosuvastatin in treating FH can effectively improve the lipid metabolism,coronary flow reserve function and vascular endothelial function in the treat-ment of patients with hypercholesterolemia,but alirocumab has a better effect.
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