The Effect Of PCSK9 Inhibitor On Low Density Lipoprotein Cholesterol,hs-CRP And NLR Levels In Patients With Acute Coronary Syndrome

Objective: To investigate the effect of PCSK9 inhibitors which are named evolocumab on low density lipoprotein cholesterol,hs-CRP and NLR level in patients with acute coronary syndrome(ACS).Methods: 85 ACS patients with elevated LDL-C levels in cardiovascular clinics and inpatient affiliated to the Secend Hospital of Dalian Medical University from October 2019 to December 2020 was selected.Patients were divided into control groups(20mg qn)and treatment groups(Atovastatin 10 mg qn+PCSK9 inhibitors 140 mg Q2W)according to the the use of medication.Record the basic data of the age,sex,BMI,hypertension history,diabetes history,smoking history,alcohol consumption history,blood routines,renal function test,liver function test and etc.The level of hs-CRP was measured by immune turbidimetry.NLR is the ratio of neutrophill to lymphocyte.After4 weeks’ treatment,recheck above clinical outcomes and analyze the therapeutic effects.All data are analysed by SPSS 22.0 statistical software.When P<0.05,significant differences are considered.Results: 1.The clinical baseline data of the control group and the treatment group showed no statistical difference in BMI,hypertension,diabetes,smoking history,alcohol consumption history,and drug use history(including antiplatelet drugs,ARB/ACEI,beta receptor blockers,CCB,diuretics,nitrate)(P>0.05);There was no significant statistical difference in the levels of WBC,N,HGB,PLT,ALT,AST,Cr,UA and Hb A1 C before lipid reduction treatment in both groups(P>0.05).2.There was no statistical difference in the levels of total cholesterol,triglyceride,HDL-C,LDL-C,apolipo AI and apolipoprotein B(Apo B)in both groups before lipid reduction treatment(P>0.05).After treatment,there was a statistical difference(P<0.05)of the two groups in terms of TC,LDL-C and Apo B levels.Both groups of TC,LDL-C and Apo B levels decreased significantly after treatment.There is no statistical difference between HDL-C and TG levels before treatment(P>0.05).15 cases in the control group reached the LDL-C level,of which it reached both 1.4mmol/L or below and decreased 50% than baseline,with a compliance rate of 33.3%,compared with 30 cases in the observation group,with a compliance rate of 87.5%,which was significantly higher than the control group.3.The hs-CRP level of the two groups decreased after lipid reduction treatment,but with no statistically significance(P>0.05).4.After 4 weeks’ treatment,the change of the NLR level from baseline between two groups has no statistically significance(P>0.05).Conclusion: PCSK9 inhibitors can effectively reduce TC and LDL-C levels in patients with acute coronary syndrome,and it is safe to some extent.However,PCSK9 inhibitors have no significant effect on hs-CRP and NLR levels.