Study On The Lipid-lowering Effect Of Evolocumab In Patients With Acute Coronary Syndrome

ObjectiveTo evaluate the lipid-lowering efficacy of Evolocumab(manufactured by Amgen Manufacturing Company(AML),trade name Brian)in patients with Acute Coronary Syndrome(ACS).MethodsThis study is a single-center,retrospective cohort study.We retrospectively collected 174 patients with acute coronary syndrome who were treated at the Fuwai Huazhong Cardiovascular Hospital from January 2019 to September 2020 as the research object,and meet the standard dose of statin drugs(atorvastatin 20mg/day or rosuvastatin 10mg/day)≥3 months later,LDL-C≥1.8mmol/L and all patients have complete clinical data.According to whether the application of evolocumab is divided into evolocumab group(124 cases)and statin group(50 cases),Collect and compare patients’ baseline data(including age,gender,smoking history,past history,PCI history,laboratory tests,etc.).After enrollment,the evolocumab group was treated with evolocumab(140 mg subcutaneously,once every 2 weeks)on the basis of stain;the statin group was treated with statins(oral atorvastatin 40 mg/day or rosuvastatin 20 mg/day),collect and analyze the blood test results of the two groups of patients who came to the hospital for reexamination after 3 months.ResultsCompare the baseline data of the two groups of patients between groups,The results show that: There was no significant difference between the two groups of patients in age,gender,history of diabetes,history of hypertension,and history of PCI(P>0.05);There was no significant difference between the two groups of blood lipid levels before treatment: TC,TG,HDL-C,LDL-C,Apo A1,and Apo B(P>0.05).The blood lipid levels of the two groups were rechecked within 3 months with evolocumab and standard dose of statin and compared between the groups.The results showed that there were significant differences in the levels of TC,HDL-C,LDL-C,and Apo B between the two groups of patients after treatment(P<0.05);there was no significant difference in the levels of TG and Apo A1 between the two groups(P>0.05).Calculate the ratio of Apo B/Apo A1 before and after treatment between the two groups and compare them within and between groups: There is a significant difference between the ratio of Apo B/Apo A1 before and after treatment in the evolocumab group(P<0.05);There was a significant difference in the ratio of Apo B/Apo A1 before and after treatment in the statin group(P<0.05);There was a significant difference between the Apo B/Apo A1 ratios of the two groups of patients after treatment(P<0.05).During the study period,no serious adverse drug-related reactions were found.ConclusionEvolocumab has a good lipid-lowering effect on patients with acute coronary syndromes of coronary heart disease.Combined with statins can significantly reduce the level of LDL-C,and it also has a positive regulatory effect on other cholesterols.It provides a new choice of lipid-lowering therapy for patients with acute coronary syndrome who have poor lipid-lowering effects of statins.