Meta-analysis of the Efficacy and Safety of Evolocumab in Patients with ACS
Objective To systematically review the efficacy and safety of evolocumab in patients with acute coronary syndrome(ACS).Methods CNKI,Wanfang,VIP,PubMed,EMBASE,Cochrane Library and other Chinese and English databases were searched for randomized controlled trials of evolocumab in the treatment of ACS patients.The retrieval time was from the establishment of the database to April 15,2023.According to the inclusion and exclusion criteria,the retrieved literature was screened and relevant data were extracted.The risk of bias of the included literature was evaluated according to the Cocharane bias risk assessment form.Review Manager 5.4 software was used to quantitatively analyze the final selected literature data.Results A total of 10 randomized controlled trials involving 1318 patients were included.The results of Meta-analysis showed that compared with the control group,eloizumab significantly reduced the length of hospital stay due to recurrent angina pectoris in ACS patients[OR=0.26,95％CI(0.12,0.58),P=0.001],reduced LDL-C levels[MD=-1.06,95％CI(-1.51,-0.61),P=0.000]and hs-CRP levels[MD=-0.44,95％CI(-0.70,-0.18),P=0.0008];However,there was no significant advantage in reducing the incidence of acute myocardial infarction[OR=0.68,95％CI(0.31,1.49),P=0.34],coronary artery reconstruction rate[OR=0.69,95％CI(0.42,1.14),P=0.15],cardiovascular mortality[OR=0.90,95％CI(0.34,2.38),P=0.83],stroke incidence[OR=0.99,95％CI(0.32,3.10),P=0.99]and adverse reactions[OR=1.16,95％CI(0.68,1.95),P=0.59].Conclusion Evolocumab can effectively reduce the blood lipid index,inflammation index and hospitalization rate of recurrent angina pectoris in ACS patients.However,there was no significant difference in reducing the incidence of acute myocardial infarction,coronary artery reconstruction rate,cardiovascular mortality,stroke incidence and adverse drug reactions.
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