Application of proprotein convertase subtilisin/kexin type 9 inhibitor after drug balloon intervention for unstable angina pectoris
Objective To observe the efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitor after drug balloon intervention in patients with unstable angina pectoris(UAP).Methods From January 2021 to January 2022,280 patients with UAP received drug balloon intervention in Fuwai Central China Cardiovascular Hospital,and were randomly and equally divided into observation group and control group.After operation,control group was given rosuvastatin orally(10 mg,once a day),and observation group was subcutaneously injected with PCSK9 inhibitor ilozumab(140 mg,once two weeks)besides the treatment in control group.The blood lipid levels were detected before and after 12-month treatment.Intravascular ultrasound was performed to record the minimal lumen area after treatment.The efficacy was evaluated after 12-month treatment,and the occurrence of major cardiovascular adverse events was observed.Results The minimal lumen area was larger in observation group[(4.89±0.92)mm2]than that in control group[(4.15±0.82)mm2]after treatment(t=7.105,P＜0.001).The levels of total cholesterol(TC),triacylglycerol(TG),low-denisity lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],apolipoprotein(apo)A and apoB showed no significant differences before treatment between observation group[(4.50±1.20)mmol/L,(2.12±0.54)mmol/L,(2.76±0.76)mmol/L,(1.13±0.24)mmol/L,(320.20±76.33)mg/L,(1.32±0.34)g/L,(1.04±0.22)g/L]and control group[(4.43±1.12)mmol/L,(2.14±0.51)mmol/L,(2.72±0.71)mmol/L,(1.12±0.21)mmol/L,(328.18±74.45)mg/L,(1.31±0.28)g/L,(1.03±0.20)g/L](t=0.505,-0.319,0.455,0.371,-0.886,0.269,0.398;all P values＞0.05).After-12 month treatment,the levels of TC,TG,LDL-C,Lp(a)and apoB were lower in observation group[(3.34±1.01)mmol/L,(1.30±0.38)mmol/L,(1.59±0.27)mmol/L,(199.45±75.50)mg/L,(0.65±0.19 g/L)]than those in control group[(3.78±0.98)mmol/L,(1.66±0.34)mmol/L,(1.80±0.26)mmol/L,(231.10±76.62)mg/L,(0.78±0.17)g/L](t=-3.699,-8.354,-6.629,-3.481,-6.033;all P values＞0.05),and the levels of HDL-C and apoA were higher in observation group[(1.27±0.24)mmol/L,(1.53±0.34)g/L]than those in control group[(1.17±0.17)mmol/L,(1.36±0.31)g/L](t=4.023,P＜0.001;t=4.372,P＜0.001).The levels of TC,TG,LDL-C,Lp(a)and apoB were lower after 12-month treatment than those before treatment in two groups(P＜0.05),and the levels of HDL-C and apoA were higher after 12-month treatment than those before treatment(P＜0.05).The total effective rate was higher in observation group(95.7％)than that in control group(85.7％)(x2=2.633,P=0.008),and the incidence of major cardiovascular adverse events was lower in observation group(2.9％)than that in control group(10.7％)(x2=6.832,P=0.009).Conclusion In patients with UAP,the application of PCSK9 inhibitors on the basis of statin can significantly alleviate the clinical symptoms,lower the lipid levels,and reduce the occurrence of major cardiovascular adverse events after drug balloon intervention.
NETL
NSTL
万方数据
