Efficacy And Safety Of Evolocumab In Patients With Coronary Heart Disease Complicated With Dyslipidemia Security

Objectives To analyze the efficacy,adverse reactions and mace incidence of evolocumab in the treatment of patients with CHD and dyslipidemia.Methods From February 2019 to December 2020,patients with coronary heart disease and dyslipidemia admitted to the department of cardiovascular medicine of Tangshan Workers’ Hospital were selected as the research objects.If the absolute value of LDL-C was ≥1.4mmol/L or the decrease of LDL-C was less than 50%,it was considered that the lipid-lowering treatment did not meet the standard.A total of 104 patients were randomly divided into study group(n = 52)and control group(n = 52).The patients in study group were treated with evolocumab(420mg/4w),stop other lipid lowering drugs,while the patients in control group were treated with atorvastatin(20mg/d).After 3 months of treatment,fasting venous blood was collected in the morning to check blood lipids(TC,TG,LDL-C and HDL-C,Apo A1,ApoB,LP(a),sd LDL-C),liver injury indicators(ALT,AST),renal function index(BUN,SCR,UA,CK,CK-MB,LDH)and the fasting plasma glucose were measured.The adverse reactions and mace events were recorded.SPSS 23.0software was used for statistical analysis.Results 1 The levels of LDL-C,ApoB and sd LDL-C in the two groups were significantly decreased.The levels of TG and TC in atorvastatin group decreased significantly.The level of LP(a)was significantly decreased,while the levels of HDL-C and Apo A1 were significantly increased in the evolocumab group.2 two groups with LDL-C absolute value<1.4 mmol/L or LDL-C reduction≥50% as the lipid-lowering goal,the two groups of LDLC compliance rate were 32.7%/15.4%,51.9%/23.1%,the difference was statistically significant(P<0.05).3 Within three months,the incidence of adverse reactions in the study group and the control group were 7.7%(4/52)and 25%(13/52),respectively,with significant difference between the two groups(P<0.05);The common adverse reactions were transient elevation of liver enzymes and muscle symptoms;the safety showed that FPG in atorvastatin group was significantly higher than that before treatment(P<0.05),and there was a risk of new onset diabetes.4 During the treatment,the incidence of mace events was 11.5%(6/52)and 28.8%(15/52)in the two groups,and the difference was statistically significant(P<0.05).Conclusions 1 In the aspect of reducing LDL-C,the effect of evolocumab is more significant.2 The adverse events of evolocumab were significantly less than those of atorvastatin,and the application of evolocumab was safer.3 Evolocumab is better than atorvastatin in reducing mace events,which is worthy of clinical promotion.Figure0;Table11;Reference 129...