Clinical And Prognostic Effects Of PCSK9 Inhibitors On Acute Coronary Syndrome

Objective To analyze the effects of PCSK9 inhibitors on blood lipid,inflammatory indicators and carotid plaque in patients with acute coronary syndrome(ACS),and to explore the effects of PCSK9 inhibitors on cardiac function and cardiovascular adverse events in patients with ACS.Methods A total of 218 patients with ACS who met the inclusion criteria were enrolled in the Ningxia Medical University from March 2021 to March 2022,including 102 patients in the study group and 116 patients in the control group.The study group used PCSK9 inhibitor evolocumab(140 mg/dose,once every 2 weeks,hypodermic injection)on the basis of routine treatment of ACS;The control group was given routine treatment of ACS.The blood lipid indexes such as triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein a(Lp(a));the inflammatory indexes such as hypersensitivity C-reactive protein(hs-CRP),white blood cell count(WBC),neutrophil to lymphocyte ratio(NLR)and other indicators such as Carotid intima-media thickness(IMT),carotid plaque area,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)were compared between the two groups before and after treatment for 3 months;The occurrence of major adverse cardiovascular events(MACE)and adverse reactions after medication were observed by outpatient and telephone during the follow-up period of 6 months.Results:1.Before treatment,there were no statistically significant differences in TG,TC,LDL-C,HDL-C,Lp(a),hs-CRP,WBC,NLR,IMT,carotid plaque area,LVEDD,LVESD and LVESD indexes between two groups(P﹥0.05).2.After 3 months of treatment,TG,TC and LDL-C in both groups decreased compared with before treatment,and the decrease was more obvious in the study group(P ﹤ 0.05);Lp(a)in the study group decreased after treatment,and the difference between the two groups after treatment was statistically significant(P﹤0.05);The magnitude of blood lipid reduction in the study group was significantly higher than that in the control group(P﹤0.05);the blood lipids compliance rates in the study group was 95.10%,compared with 26.72% in the control group was more higher(P﹤0.05);The hs-CRP,WBC and NLR of patients in both groups decreased significantly compared with those before treatment,and the hs-CRP in the study group was significantly lower(P﹤0.05).3.After 3 months of treatment,the IMT and carotid plaque area of patients in both groups decreased,and the decrease in the study group was more significant(P<0.05);After treatment,LVESD decreased and LVEF increased in both groups compared with before.There was no statistically significant difference between the two groups after treatment(P﹥0.05).4.At a mean follow-up of 6 months,the incidence of MACE events in the study group was lower than that in control group(P﹤0.05).There was no statistically significant difference in adverse reactions after drug administration between the two groups(P﹥0.05).Conclusion PCSK9 inhibitors can effectively reduce the levels of triglyceride,total cholesterol,low density lipoprotein cholesterol,and lipoprotein a levels in patients with ACS,and improve blood lipids compliance rates;PCSK9 inhibitors can reduce the inflammatory reaction of patients;Reduce the carotid intima-media thickness and carotid plaque area,reduce the risk of MACE events in patients with ACS,and have favorable clinical safety。...