Feasibility of Short-Term Aggressive Lipid-Lowering Therapy with the PCSK9 Antibody in Acute Coronary Syndrome

  • Satoshi Yamashita
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Atsushi Sakamoto
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Satoshi Shoji
    Department of Cardiology, Hino Municipal Hospital, Hino 1910062, Japan
  • Yoshitaka Kawaguchi
    Department of Cardiology, Seirei Mikatahara Hospital, Hamamatsu 4338558, Japan
  • Yasushi Wakabayashi
    Department of Cardiology, Seirei Mikatahara Hospital, Hamamatsu 4338558, Japan
  • Masaki Matsunaga
    Department of Cardiology, Iwata City Hospital, Iwata 4388550, Japan
  • Kiyohisa Suguro
    Department of Cardiology, Fujinomiya City Hospital, Fujinomiya 4180076, Japan
  • Yuji Matsumoto
    Department of Cardiology, Kikugawa City Hospital, Kikugawa 4390022, Japan
  • Hiroyuki Takase
    Department of Internal Medicine, Enshu Hospital, Hamamatsu 4300929, Japan
  • Tomoya Onodera
    Department of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka 4208630, Japan
  • Kei Tawarahara
    Department of Cardiology, Hamamatsu Red Cross Hospital, Hamamatsu 4348533, Japan
  • Masahiro Muto
    Department of Cardiology, Hamamatsu Medical Center, Hamamatsu 4328580, Japan
  • Yasutaka Shirasaki
    Shirasaki Clinic, Kuki 3460031, Japan
  • Hideki Katoh
    Department of Cardiology, Kosai General Hospital, Kosai 4310431, Japan
  • Makoto Sano
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Kenichiro Suwa
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Yoshihisa Naruse
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Hayato Ohtani
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Masao Saotome
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Tsuyoshi Urushida
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan
  • Shun Kohsaka
    Department of Cardiology, Keio University School of Medicine, Tokyo 1608582, Japan
  • Eisaku Okada
    Department of Faculty of Social Policy and Administration, Hosei University, Tokyo 1028160, Japan
  • Yuichiro Maekawa
    Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan

書誌事項

公開日
2023-05-09
資源種別
journal article
権利情報
  • https://creativecommons.org/licenses/by/4.0/
DOI
  • 10.3390/jcdd10050204
公開者
MDPI AG

説明

<jats:p>Background: The guideline-recommended low-density lipoprotein cholesterol target level of <70 mg/dL may not be achieved with statin administration in some patients with acute coronary syndrome (ACS). Therefore, the proprotein convertase subtilisin-kexin type 9 (PCSK9) antibody can be added to high-risk patients with ACS. Nevertheless, the optimal duration of PCSK9 antibody administration remains unclear. Methods and Results: Patients were randomized to receive either 3 months of lipid lowering therapy (LLT) with the PCSK9 antibody followed by conventional LLT (with-PCSK9-antibody group) or 12 months of conventional LLT alone (without-PCSK9-antibody group). The primary endpoint was the composite of all-cause death, myocardial infarction, stroke, unstable angina, and ischemia-driven revascularization. A total of 124 patients treated with percutaneous coronary intervention (PCI) were randomly assigned to the two groups (n = 62 in each). The primary composite outcome occurred in 9.7% and 14.5% of the patients in the with- and without-PCSK9-antibody groups, respectively (hazard ratio: 0.70; 95% confidence interval: 0.25 to 1.97; p = 0.498). The two groups showed no significant differences in hospitalization for worsening heart failure and adverse events. Conclusions: In ACS patients who underwent PCI, short-term PCSK9 antibody therapy with conventional LLT was feasible in this pilot clinical trial. Long-term follow-up in a larger scale clinical trial is warranted.</jats:p>

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