Evaluation Of Efficacy And Safety Of Elouximab In Clinical Application

Objective With the increasing detection rate of critical coronary artery disease,it is particularly important to choose an appropriate treatment scheme.To observe the efficacy and safety of ezetimibe or evolocumab combined with statins in the treatment of patients with critical coronary artery disease.Methods 160 patients with single vessel critical lesions diagnosed by coronary angiography in our hospital from November 2020 to September 2021 were randomly divided into two groups.On the basis of statins,the experimental group was treated with evolocumab and the control group was treated with ezetimibe.Both groups were treated with other secondary prevention conventional drugs for coronary heart disease(except lipid-lowering drugs).They were adjusted according to the specific condition of patients for 16 weeks.The primary end point was the changes of blood lipid and the occurrence of cardiovascular events in the two groups,and the secondary end point was the occurrence of adverse reactions.Result 1.The TG of the control group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 1.78 ± 0.69 mmol/L,1.53 ± 0.53 mmol/L,1.45 ± 0.43mmol/L and 1.27 ± 0.39 mmol/L respectively.The TG of the experimental group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 1.77 ± 0.59mmol/L,1.24 ± 0.42 mmol/L,1.18 ± 0.41 mmol/L and 1.12 ± 0.37 mmol/L respectively.The TG of the two groups decreased with the extension of treatment time(F = 96.544,P < 0.001),and the TG of the experimental group was lower than that of the control group(F = 6.427,P = 0.012 < 0.05);2.The TC of the control group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 4.21 ± 0.90 mmol/L,3.56 ± 0.75 mmol/L,3.27 ± 0.66 mmol/L and 3.03 ± 0.65 mmol/L respectively.The TC of the experimental group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 4.15 ± 0.99 mmol/L,2.87 ± 0.82 mmol/L,2.51 ± 0.56 mmol/L and2.36 ± 0.54 mmol/L respectively.The TC of the two groups decreased with the extension of treatment time(F = 280.677,P < 0.001),and the TC of the experimental group was lower than that of the control group(F = 24.399,P < 0.001);3.The LDL-C of the control group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 2.51 ± 0.67 mmol/L,1.96 ± 0.54 mmol/L,1.74 ± 0.47 mmol/L and 1.54 ± 0.46mmol/L respectively.The LDL-C of the experimental group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 2.46 ± 0.79 mmol/L,1.38 ± 0.69 mmol/L,1.02 ± 0.44 mmol/L and 0.87 ± 0.38 mmol/L respectively.The LDL-C of the two groups decreased with the extension of treatment time(F = 300.375,P < 0.001),And the experimental group was lower than the control group(F = 38.562,P < 0.001);4.The HDL-C of the control group before treatment,4 weeks,8 weeks and 16 weeks after treatment were 1.32 ± 0.31 mmol/L,1.36 ± 0.30 mmol/L,1.43 ± 0.26 mmol/L and 1.46 ± 0.31 mmol/L respectively.The HDL-C of the experimental group at 4 weeks,8 weeks and 16 weeks after treatment were 1.36 ± 0.32 mmol/L,1.42 ± 0.28mmol/L,1.47 ± 0.26 mmol/L and 1.48 ± 0.27 mmol/L respectively.The HDL-C of the two groups will increase with the extension of treatment time(F = 17.024,P < 0.001),There was no significant difference between the experimental group and the control group(F = 1.015,P = 0.316 > 0.05);5.After 16 weeks of treatment,the median decrease of LDL-C in the experimental group and the control group were 64.3% and 38.8% respectively,which was higher in the experimental group than in the control group(Z =-6.324,P < 0.001);6.After 16 weeks of treatment,the standard rate of LDL-C decline > 50% in the experimental group and the control group were 70.6%and 21.2% respectively,which was higher in the experimental group than in the control group(P < 0.001);7.After 16 weeks of treatment,the compliance rates of LDL-C < 1.4mmol/l in the experimental group and the control group were 91.2% and 42.8% respectively.The experimental group was higher than the control group(P <0.001);8.there was no significant difference in the incidence of ACS,cardiac death,liver dysfunction,statin related muscle symptoms,injection site reaction,new onset diabetes and neurocognitive events between the two groups(P>0.05).No significant memory,attentional and response abilities were observed in patients with LDL-C below 0.78mmol/L after 16 weeks of treatment.Conclusion For the treatment of patients with critical coronary artery disease,statins combined with the two drugs have significant lipid-lowering effects.The curative effect of the experimental group is more obvious than that of the control group.There is no significant difference in the incidence of cardiovascular events and adverse reactions between the two groups.