Clinical effect of proprotein convertase subtilisin/kexin type 9 inhibitor combined with atorvastatin in treatment of intracranial atherosclerotic stenosis
Objective To investigate the effect of proprotein convertase subtilisin/kexin type 9 inhibitor(PCSK9)combined with atorvastatin on intracranial plaque in patients with intracranial atherosclerotic stenosis(ICAS).Methods A prospective study was performed for the imaging and clinical data of ICAS patients who were admitted to Tianjin Beichen Hos-pital from January 2022 to April 2023 and received atorvastatin with or without PCSK9 inhibitor.The patients in the atorvas-tatin group received treatment with atorvastatin 10-40 mg per day,once a day,and those in the PCSK9 inhibitor group re-ceived 140 mg evolocumab injection,once every two weeks,in addition to the treatment in the atorvastatin group.The two groups were compared in terms of HR-MRI imaging findings and blood lipid levels before treatment and after 12 weeks of treatment,as well as major vascular events and adverse drug reactions during treatment.Results A total of 98 patients were enrolled,with 46 in the atorvastatin group and 52 in the PCSK9 inhibitor group.There were no significant differences in blood lipid levels and HR-MRI parameters between the two groups at baseline.From baseline to after 12 weeks of treatment,the PCSK9 inhibitor group had significant reductions in the levels of total cholesterol(TC),triglyceride,and low-density li-poprotein(LDL)(all P<0.001),while the atorvastatin group only had significant reductions in the levels of TC and LDL(both P<0.001),and the PCSK9 inhibitor group had significantly lower levels of TC and LDL than the atorvastatin group(both P<0.001).From baseline to after 12 weeks of treatment,the PCSK9 inhibitor group had significant reductions in arte-rial stenosis rate and standardized wall index(both P=0.001),while the atorvastatin group had no significant changes in HR-MRI parameters(all P>0.05).After 12 weeks of treatment,the PCSK9 inhibitor group had a significantly higher proportion of patients with good treatment response than the atorvastatin group(75.00%vs 45.65%,χ2=8.885,P=0.003).Conclusion The combination of PCSK9 inhibitor and atorvastatin can not only reduce level of LDL in ICAS patients,but also reduce the degree of stenosis,with relatively high safety.
国家科技期刊平台
NSTL
万方数据
维普
