Efficacy and safety of evolocumab to reduce lipid levels in patients with acute coronary syndrome after PCI
Objective To investigate the efficacy and safety of evolocumab to reduce lipid levels in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods Totally 145 ACS patients who underwent PCI were randomly divided into the observation group(73 cases)and the control group(72 cases).Pa-tients in the control group received conventional drug treatment according to the perioperative medication guidelines for ACS,while patients in the observation group received subcutaneous injection of evolocumab 140 mg per dose,once every two weeks,on the basis of the control group's treatment.Both groups were treated for one month.Changes in lipid-related indicators before and after treatment,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein choles-terol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB),lipoprotein(a)[Lp(a)],apoli-poprotein A1(ApoA1),ApoB/ApoA1 ratio,and the proportion of LDL-C<1.8 mmol/L and LDL-C<1.4 mmol/L,were recorded.Additionally,the proportion of patients whose LDL-C decreased by>50%and was<1.4 mmol/L compared to baseline was recorded.Safety-related indicators,including fasting plasma glucose(FPG),alanine aminotransferase(ALT),creatinine(Cre)before and after treatment,adverse reactions,and major adverse cardiovascular events(MACE)were also recorded.Results The proportions of LDL-C<1.8 mmol/L and<1.4 mmol/L increased in both groups after treatment in comparison with those before treatment,with more significant increase in the observation group(both P<0.05).The proportion of patients in the observation group whose LDL-C decreased by>50%and was<1.4 mmol/L com-pared to baseline was higher than that in the control group(P<0.05).TC,TG,LDL-C,Lp(a),ApoB,and ApoB/ApoA1 decreased,and ApoA1 increased in both groups after treatment in comparison with those before treatment,with more sig-nificant changes in the observation group(all P<0.05).No significant differences were found in FPG,ALT,or Cre be-tween the two groups before and after treatment(all P>0.05).Muscle pain occurred in one patient in both the observation and control groups,and MACE occurred in 0 and 1 patient in the observation and control groups,respectively,with no sig-nificant differences between the two groups(all P>0.05).Conclusion Subcutaneous injection of evolocumab helps re-duce lipid levels in patients with ACS after PCI and is of high safety.
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