Objective To observe the clinical effect of Evolocumab on patients with in-stent restenosis(ISR)and failure to reach low-density lipoprotein cholesterol(LDL-C)compliance rate after PCI for coronary heart disease(CHD).Methods Fifty patients with ISR and failure to reach LDL-C compliance rate who were admitted from June 2021 to June 2022 were selected and randomly divided into Evolocumab group(n =25)and Ezeimibe group(n =25).The two groups were giv-en Atorvastatin,the Evolocumab group was supplemented with Evolocumab,and the Ezetimibe group was supplemented with Ezetimibe.The changes of blood lipid parameters at 3,6 and 12 months after treatment and the occurrence of adverse reac-tions and cardiovascular adverse events at 1 year after treatment were compared between the two groups.Results Four pa-tients were lost to follow-up in the Evolocumab group,and the remaining 21 patients were included;one patient was lost to fol-low-up in the Ezetimibe group,and the remaining 24 patients were included.Intra-group comparison after treatment showed that in Evolocumab group,the levels of total cholesterol(TC),LDL-C and Lipoprotein(a)[LP(a)]at 3,6 and 12 months after treatment were lower than those before treatment(P＜0.05).LDL-C and LP(a)were significantly different at 3 and 6 months after treatment and at 6 and 12 months after treatment,respectively(P＜0.05).The LDL-C compliance rate at 6 and 12 months after treatment was higher than that before treatment(P＜0.05).In Ezetimibe group,TC and LDL-C at 6 and 12 months after treatment were lower than those before treatment,and triglyceride(TG)at 12 months after treatment was lower than that before treatment(P＜0.05).The LDL-C compliance rate at 6 and 12 months after treatment was higher than that before treatment(P＜0.05).The LDL-C of Evolocumab group at 3,6 and 12 months after treatment was lower than that of Ezetimibe group,and LP(a)at 6 and 12 months after treatment was lower than that of Ezetimibe group,while the LDL-C compliance rate at 12 months after treatment[85.71%(18/21)]was higher than that of Ezetimibe group[54.17%(13/21)](P＜0.05).The total incidence of adverse cardiovascular events was 14.29%(3/21)in the Evolocumab group,which was lower than that in the Ezetimibe group[45.83%(11/24)](P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Evolocumab can effectively reduce the levels of LDL-C and Lp(a)in patients with ISR in the short term,and further reduce the incidence of cardiovascular events and ISR through its rapid and significant lipid-lowering effect,with high safety.
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