Effect Of PCSK9 Inhibitor On Triglyceride Of Various Level

Backgroud In 2019 ESC/EAS Guidelines for the management of dyslipidaemias,for the first time,PCSK9 inhibitors was elevated of class I recommendations in combination with statins for patients who’s in extremely high risk of cardiovascular disease,which opened the prelude of post-statin era.However,the pratical effect of PCSK9 inhibitors on different triglyceride levels,especially in the people with moderate/severe hypertriglyceridemia,is still unclear.Objective To investigate the pratical effects of PCSK9 inhibitors on triglycerides at different triglyceride baseline levels in Chinese.Methods A total of 57 patients treated with PCSK9 inhibitors(Ruibai’an,Evolocumab)from February 2019 to December 2019 were enrolled and retrospectively studied in present study.They came from 5 hospitals which composing by Nanfang Hospital,Guangdong Provincial people’s Hospital,The First Affiliated Hospital,Sun Yat-sen University,Foshan Nanhai District People’s Hospital and Yulin first people’s Hospital.According to the baseline triglyceride level,the patients were divided into two groups:normal triglyceride group(TG<1.70mmol/L)and hypertriglyceridemia group(TG>1.70 mmol/L).hypertrigly ceridemia group was further divided into mild hypertriglyceridemia group(TG between 1.70-2.29mmol/L),moderate hypertriglyceridemia group(TG between 2.30-5.63mmol/L)and severe hypertriglyceridemia group(TG>5.64 mmol/L).The effects of PCSK9 inhibitors on triglycerides at different baseline levels were retrospectively analyzed by comparing normal triglyceride group and hypertriglyceridemia groups.Results(ⅰ)In the study,After PCSK9 inhibitor treatment,the average value of LDL-c decreased absolutly by 2.46 mmol/L,with an average decrease of 55.53%;the average absolute decrease of TG was 1.73mmol/L,the change of triglyceride was 19.21%,all the data were statistically significant.(ⅱ)There were 38.6%of the patients in the normal triglyceride group and 61.4%in the hypertriglyceridemia group.There was no significant difference in the change of triglyceride after PCSK9 inhibitors treatment in normal triglyceride group,but there was significant difference in hypertriglyceridemia group after PCSK9 inhibitor treatment(P<0.001).(ⅲ)It was found that the median change of triglyceride was-14.89%in the normal triglyceride group,-11.96%in the mild hypertriglyceridemia group,-46.37%in the moderate hypertriglyceridemia group,and-68.31%in the severe hypertriglyceridemia group with further grouping,and there was significant difference in the triglyceride changes among the groups(P=0.000).Pairwise comparison showed that there was no significant difference in triglyceride change between normal triglyceride group and mild hypertriglyceridemia group,moderate hypertriglyceridemia group and severe hypertriglyceridemia group,but the triglyceride change in normal triglyceride group was smaller than that in moderate hypertriglyceridemia group and severe hypertriglyceridemia group which was statistical significance(P<0.05).Similarly,the triglyceride change in mild hypertriglyceridemia group was smaller than that in moderate hypertriglyceridemia group and severe hypertriglyceridemia group which was also statistical significance(P<0.05).Conclusion In moderate and severe triglyceride TG groups,PCSK9 inhibitors can significantly reduce TG and its effect may have a "zoning effect".