Efficacy of single-dose evolocumab injection in early-phase acute myocardial infarction: a retrospective single-center study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI. Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups. Results: The percentage change of LDL-C level at 1–3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1–3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001). Conclusions: Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.
Abstract
Background/Aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI. Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups. Results: The percentage change of LDL-C level at 1–3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1–3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001). Conclusions: Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.
참고문헌 (16)
- Roffi M, "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation : Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology(ESC)", Eur Heart J, 37, pp.267~315 (2016)
- Koskinas KC, "Effect of statins and non-statin LDL-lowering medications on cardiovascular outcomes in secondary prevention : a meta-analysis of randomized trials", Eur Heart J, 39, pp.1172~1180 (2018)
- Collet JP, "Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation", Eur Heart J, 42, pp.1289~1367 (2021)
- Gulati M, "2021 AHA", ACC, CHEST, pp.SAEM, SCCT[DOI]
- Nicholls SJ, "Effect of Evolocumab on coronary plaque phenotype and burden in statin-treated patients following myocardial infarction", JACC Cardiovasc Imaging, 15, pp.1308~1321 (2022)
- Räber L, "Effect of alirocumab added to high-intensity statin therapy on coronary atherosclerosis in patients with acute myocardial infarction : the PACMAN-AMI randomized clinical trial", JAMA, 327, pp.1771~1781 (2022)
- Koskinas KC, "Evolocumab for early reduction of LDL cholesterol levels in patients with acute coronary syndromes(EVOPACS)", J Am Coll Cardiol, 74, pp.2452~2462 (2019)
- Mehta SR, "Effects of routine early treatment with PCSK9 inhibitors in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : a randomised, double-blind, sham-controlled trial", EuroIntervention, 18, pp.e888~e896 (2022)
- Ray KK, "EU-wide cross-sectional observational study of lipid-modifying therapy use in secondary and primary care : the DA VINCI study", Eur J Prev Cardiol, 28, pp.1279~1289 (2021)
- Andreadou I, "PCSK9 in myocardial infarction and cardioprotection : importance of lipid metabolism and inflammation", Front Physiol, 11, pp.602497~ (2020)
- Marfella R, "Evidence of an anti-inflammatory effect of PCSK9 inhibitors within the human atherosclerotic plaque", Atherosclerosis, 378, pp.117180~ (2023)
- Giugliano RP, "Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab : a prespecified secondary analysis of the FOURIER trial", Lancet, 390, pp.1962~1971 (2017)
- Cannon CP, "Ezetimibe added to statin therapy after acute coronary syndromes", N Engl J Med, 372, pp.2387~2397 (2015)
- Vavlukis M, "Adding ezetimibe to statin therapy : latest evidence and clinical implications", Drugs Context, 7, pp.212534~ (2018)
- Kim BK, "Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease(RACING) : a randomised, open-label, non-inferiority trial", Lancet, 400, pp.380~390 (2022)
- Choi SW, "Acute effect of evolocumab on lipoprotein(a)level and inflammation in patients with coronary artery disease", J Cardiovasc Dev Dis, 9, pp.101~ (2022)